Myron L. Weisfeldt, M site .D., Siobhan Everson-Stewart, Ph.D., Colleen Sitlani, M.S., Thomas Rea, M.D., Tom P. Aufderheide, M.D., Dianne L. Atkins, M.D., Blair Bigham, M.Sc., Steven C. Brooks, M.D., M.H.Sc., Christopher Foerster, M.Sc., Randal Gray, M.A.Ed., Joseph P. Ornato, M.D., Judy Powell, B.S.N., Peter J. Kudenchuk, M.D., and Laurie J. Morrison, M.D. For the Resuscitation Outcomes Consortium Investigators: Ventricular Tachyarrhythmias after Cardiac Arrest in public areas versus at Home The incidence of ventricular fibrillation or pulseless ventricular tachycardia because the first recorded rhythm in out-of-hospital cardiac arrest has declined dramatically previously several years.1,2 Thirty years back, 70 percent of such arrests were characterized by preliminary ventricular fibrillation or pulseless ventricular tachycardia; today, the incidence is 23 percent.3,4 This decline is of substantial importance for community health, since a lot more than 300,000 Us citizens have an out-of-medical center arrest each year, with around survival rate of 7.9 percent nationally,5 and nearly all survivors are in the subgroup of persons whose initial rhythm is ventricular fibrillation or pulseless ventricular tachycardia.6 On the other hand, layperson usage of AEDs in residential configurations hasn’t proved to be of benefit, possibly owing in part to a lower prevalence of ventricular fibrillation or pulseless ventricular tachycardia as the initial rhythm.7 These observations suggest that the incremental worth of particular resuscitation strategies, such as the ready option of an AED, could be related to the setting in which the arrest occurs.
First responders reach the picture before an ambulance in about 40 percent of most out-of-hospital cardiac arrests. Two thirds of most out-of-hospital cardiac arrests occur at home16; these events are associated with low rates of bystander-initiated CPR and even worse outcomes. Automated external defibrillators are usually put into public places. A report in the Netherlands showed that mobile-phone text messages were effectively used to send out lay responders who experienced registered road addresses within 1000 m from patients with suspected out-of-hospital cardiac arrest to perform CPR and make use of AEDs.18 Future integration of mobile-phone positioning systems with AED registries may facilitate lay responders in locating the nearest AED and thereby increase efficacy in public-access defibrillation programs.