Transfer of essential AED information to treating hospital (TREAT)

Abstract

Background: Defibrillation in out-of-hospital cardiac arrest (OHCA) is increasingly performed by using an Automated External Defibrillator (AED). Therefore presence of a shockable rhythm is recurrently only documented by the AED. However, AED-information is rarely available to the treating physician.

Purpose: To determine (1) how often a shockable rhythm was recorded only in the AED; (2) if so, how often information that a shockable rhythm had been present reached the physician.

Methods: Data on OHCA patients with (presumed) cardiac cause with an AED connected in the years 2012-2014 (Study period 1) and 2016 (Study period 2) in the Amsterdam Resuscitation Study (ARREST) database were collected. We determined how often only the AED had defibrillated. In these patients, we retrospectively analyzed EMS run sheets and hospital discharge letters to determine if a shockable rhythm and/or AED use was correctly noted. In Study period 2, we prospectively contacted the physicians to study whether AED defibrillation was known.

Results: In Study period 1, of 2840 OHCA CPR attempts with (presumed) cardiac cause, 1521 (54%) patients had a shockable rhythm, with 356 patients (13%) receiving AED defibrillation only. Of these patients, 11 hospital discharge letters (4%) contained no information about a shockable rhythm. In Study period 2, 125/1128 patients (11%) received AED defibrillation only; of these, in two cases the shockable rhythm was unknown by the physician.

Conclusion: In 11-13% of OHCAs, a shockable rhythm is only seen on the AED-ECG. Adequate transfer to the physician of vital AED-information is essential but not always accomplished.

Keywords: AED; AED defibrillation only; AED recording; AED use; AED-ECG transfer; AED-information; Defibrillation; Emergency medical services; Hospital treatment; OHCA; Shockable rhythm; Ventricular fibrillation; Ventricular tachycardia.