Limited response to cardiac arrest by police equipped with automated external defibrillators

Lack of survival benefit in suburban and rural Indiana - The police as responder automated defibrillation evaluation (PARADE)

William Groh, M. M. Newman, P. E. Beal, N. S. Fineberg, D. P. Zipes

Research output: Contribution to journalArticle

84 Citations (Scopus)

Abstract

Objective: To assess the out-of-hospital cardiac arrest (OHCA) survival advantage after providing police with automated external defibrillators (AEDs) in rural and suburban Indiana. Methods: An observational evaluation was conducted in six Indiana counties (population: 464,741) before (retrospective) and after (prospective) training and equipping police with AEDs. The primary outcome evaluated was survival to hospital discharge for all cases of ventricular tachycardia/ventricular fibrillation (VT/VF) OHCA. Other factors evaluated include age, gender, race, arrest location, witnessed arrest, bystander cardiopulmonary resuscitation, response intervals, and survival to discharge for all OHCAs. Results are reported using chi-square, Student's t-test, and logistic regression. Results. Police were equipped with 112 AEDs, increasing total defibrillator capability by 43.2%. During the study period, AED-equipped police responded prior to emergency medical services (EMS) in 26 of 388 cases (6.7%). The time intervals from 911 call-to-scene and 911 call-to-shock were shortened by 1.6 minutes (95% confidence interval [95% CI] = 0.0 to 3.1, p = 0.05) and 4.8 minutes (95% CI = 1.3 to 8.3, p = 0.008), respectively, with police response as compared with EMS response. Survival to hospital discharge for VT/VF OHCA was 15.0% (3/20) in cases in which police responded first and 10.0% (16/160) in cases in which EMS responded first (relative risk [RR] 0.63, 95% CI = 0.17 to 2.39, p = 0.45). Survival to hospital discharge for VT/VF OHCA did not improve from the prestudy period (16/204, 7.8%) to after police AED availability (19/180, 10.6%) (RR 0.72, 95% CI = 0.36 to 1.45, p = 0.38). Conclusions: Out-of-hospital cardiac arrest survival in suburban and rural Indiana did not improve after police were equipped with AEDs, likely related to poor police response.

Original languageEnglish
Pages (from-to)324-330
Number of pages7
JournalAcademic Emergency Medicine
Volume8
Issue number4
StatePublished - 2001

Fingerprint

Defibrillators
Police
Heart Arrest
Out-of-Hospital Cardiac Arrest
Survival
Emergency Medical Services
Ventricular Fibrillation
Ventricular Tachycardia
Confidence Intervals
Cardiopulmonary Resuscitation
Shock
Logistic Models
Students

Keywords

  • Cardiopulmonary resuscitation
  • Defibrillation
  • Out-of hospital cardiac arrest
  • Outcomes
  • Survival

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

@article{1b7fe167b7f540b78393718f083384d8,
title = "Limited response to cardiac arrest by police equipped with automated external defibrillators: Lack of survival benefit in suburban and rural Indiana - The police as responder automated defibrillation evaluation (PARADE)",
abstract = "Objective: To assess the out-of-hospital cardiac arrest (OHCA) survival advantage after providing police with automated external defibrillators (AEDs) in rural and suburban Indiana. Methods: An observational evaluation was conducted in six Indiana counties (population: 464,741) before (retrospective) and after (prospective) training and equipping police with AEDs. The primary outcome evaluated was survival to hospital discharge for all cases of ventricular tachycardia/ventricular fibrillation (VT/VF) OHCA. Other factors evaluated include age, gender, race, arrest location, witnessed arrest, bystander cardiopulmonary resuscitation, response intervals, and survival to discharge for all OHCAs. Results are reported using chi-square, Student's t-test, and logistic regression. Results. Police were equipped with 112 AEDs, increasing total defibrillator capability by 43.2{\%}. During the study period, AED-equipped police responded prior to emergency medical services (EMS) in 26 of 388 cases (6.7{\%}). The time intervals from 911 call-to-scene and 911 call-to-shock were shortened by 1.6 minutes (95{\%} confidence interval [95{\%} CI] = 0.0 to 3.1, p = 0.05) and 4.8 minutes (95{\%} CI = 1.3 to 8.3, p = 0.008), respectively, with police response as compared with EMS response. Survival to hospital discharge for VT/VF OHCA was 15.0{\%} (3/20) in cases in which police responded first and 10.0{\%} (16/160) in cases in which EMS responded first (relative risk [RR] 0.63, 95{\%} CI = 0.17 to 2.39, p = 0.45). Survival to hospital discharge for VT/VF OHCA did not improve from the prestudy period (16/204, 7.8{\%}) to after police AED availability (19/180, 10.6{\%}) (RR 0.72, 95{\%} CI = 0.36 to 1.45, p = 0.38). Conclusions: Out-of-hospital cardiac arrest survival in suburban and rural Indiana did not improve after police were equipped with AEDs, likely related to poor police response.",
keywords = "Cardiopulmonary resuscitation, Defibrillation, Out-of hospital cardiac arrest, Outcomes, Survival",
author = "William Groh and Newman, {M. M.} and Beal, {P. E.} and Fineberg, {N. S.} and Zipes, {D. P.}",
year = "2001",
language = "English",
volume = "8",
pages = "324--330",
journal = "Academic Emergency Medicine",
issn = "1069-6563",
publisher = "Wiley-Blackwell",
number = "4",

}

TY - JOUR

T1 - Limited response to cardiac arrest by police equipped with automated external defibrillators

T2 - Lack of survival benefit in suburban and rural Indiana - The police as responder automated defibrillation evaluation (PARADE)

AU - Groh, William

AU - Newman, M. M.

AU - Beal, P. E.

AU - Fineberg, N. S.

AU - Zipes, D. P.

PY - 2001

Y1 - 2001

N2 - Objective: To assess the out-of-hospital cardiac arrest (OHCA) survival advantage after providing police with automated external defibrillators (AEDs) in rural and suburban Indiana. Methods: An observational evaluation was conducted in six Indiana counties (population: 464,741) before (retrospective) and after (prospective) training and equipping police with AEDs. The primary outcome evaluated was survival to hospital discharge for all cases of ventricular tachycardia/ventricular fibrillation (VT/VF) OHCA. Other factors evaluated include age, gender, race, arrest location, witnessed arrest, bystander cardiopulmonary resuscitation, response intervals, and survival to discharge for all OHCAs. Results are reported using chi-square, Student's t-test, and logistic regression. Results. Police were equipped with 112 AEDs, increasing total defibrillator capability by 43.2%. During the study period, AED-equipped police responded prior to emergency medical services (EMS) in 26 of 388 cases (6.7%). The time intervals from 911 call-to-scene and 911 call-to-shock were shortened by 1.6 minutes (95% confidence interval [95% CI] = 0.0 to 3.1, p = 0.05) and 4.8 minutes (95% CI = 1.3 to 8.3, p = 0.008), respectively, with police response as compared with EMS response. Survival to hospital discharge for VT/VF OHCA was 15.0% (3/20) in cases in which police responded first and 10.0% (16/160) in cases in which EMS responded first (relative risk [RR] 0.63, 95% CI = 0.17 to 2.39, p = 0.45). Survival to hospital discharge for VT/VF OHCA did not improve from the prestudy period (16/204, 7.8%) to after police AED availability (19/180, 10.6%) (RR 0.72, 95% CI = 0.36 to 1.45, p = 0.38). Conclusions: Out-of-hospital cardiac arrest survival in suburban and rural Indiana did not improve after police were equipped with AEDs, likely related to poor police response.

AB - Objective: To assess the out-of-hospital cardiac arrest (OHCA) survival advantage after providing police with automated external defibrillators (AEDs) in rural and suburban Indiana. Methods: An observational evaluation was conducted in six Indiana counties (population: 464,741) before (retrospective) and after (prospective) training and equipping police with AEDs. The primary outcome evaluated was survival to hospital discharge for all cases of ventricular tachycardia/ventricular fibrillation (VT/VF) OHCA. Other factors evaluated include age, gender, race, arrest location, witnessed arrest, bystander cardiopulmonary resuscitation, response intervals, and survival to discharge for all OHCAs. Results are reported using chi-square, Student's t-test, and logistic regression. Results. Police were equipped with 112 AEDs, increasing total defibrillator capability by 43.2%. During the study period, AED-equipped police responded prior to emergency medical services (EMS) in 26 of 388 cases (6.7%). The time intervals from 911 call-to-scene and 911 call-to-shock were shortened by 1.6 minutes (95% confidence interval [95% CI] = 0.0 to 3.1, p = 0.05) and 4.8 minutes (95% CI = 1.3 to 8.3, p = 0.008), respectively, with police response as compared with EMS response. Survival to hospital discharge for VT/VF OHCA was 15.0% (3/20) in cases in which police responded first and 10.0% (16/160) in cases in which EMS responded first (relative risk [RR] 0.63, 95% CI = 0.17 to 2.39, p = 0.45). Survival to hospital discharge for VT/VF OHCA did not improve from the prestudy period (16/204, 7.8%) to after police AED availability (19/180, 10.6%) (RR 0.72, 95% CI = 0.36 to 1.45, p = 0.38). Conclusions: Out-of-hospital cardiac arrest survival in suburban and rural Indiana did not improve after police were equipped with AEDs, likely related to poor police response.

KW - Cardiopulmonary resuscitation

KW - Defibrillation

KW - Out-of hospital cardiac arrest

KW - Outcomes

KW - Survival

UR - http://www.scopus.com/inward/record.url?scp=0035045068&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035045068&partnerID=8YFLogxK

M3 - Article

VL - 8

SP - 324

EP - 330

JO - Academic Emergency Medicine

JF - Academic Emergency Medicine

SN - 1069-6563

IS - 4

ER -