A link between emergency dispatch and public access AEDs: Potential implications for early defibrillation

From Resuscitation:

Background: Public access defibrillation can improve survival but is involved in only a small fraction of out-of-hospital cardiac arrest. One approach to increase involvement is to couple emergency dispatch with mapping technology to identify public access automated external defibrillators (AEDs) that are on-site or nearby.

Methods: We conducted a retrospective observational cohort investigation of out-of-hospital cardiac arrest who received dispatch by a community dispatch center between January 1, 2007 and December 31, 2009. The dispatch system is linked to the public access AED registry. The technology enables dispatcher alert of an on-site AED and the potential to alert for an AED within 0.1mile. We report the observed and potential frequency of AED involvement.

Results: Of the 763 cardiac arrest events, 4.2% (32/763) had an AED applied by non-EMS persons, 1.3% (10/763) by police and 2.9% (22/763) in layperson settings. Among the remaining 731 where an AED was not applied, 8.1% (59/731) had an AED identified through dispatch; 18 with an AED on-site and an additional 41 with an AED within 0.1mile. When restricting to ventricular fibrillation arrests, 8.9% (16/179) had an AED applied by non-EMS persons, 2.8% (5/179) by police and 6.1% (11/179) in layperson settings. Among the remaining 163 where an AED was not applied, 11.7% (19/163) had an AED identified through dispatch; 9 with an AED on-site and an additional 10 with an AED within 0.1mile.

Conclusion: A working link between emergency dispatch and an AED registry may provide an opportunity to improve resuscitation.

Honolulu ED Slammed by Psych ‘Silver Tsunami’

From MedPage Today:

Psychiatric visits by the elderly to Honolulu’s largest emergency department have increased significantly in the past four years, perhaps signaling the onset of a long-predicted crisis in geriatric mental health, a researcher said.

Elderly patients presenting to the ED at The Queen’s Medical Center in Honolulu for psychiatric evaluations were 7.2% of all psychiatric ED visits in 2009 and 6.2% in 2010, up from an average of 5.6% in 2007-2008 (P=0.02 for trend), said Brett Lu, MD, of the University of Hawaii at Manoa.

He also reported that the average psychiatry-related stay in the ED for elderly patients was significantly longer than for younger patients (401 minutes versus 366 minutes for patients 18 to 64 and 270 minutes for those younger than 18, P<0.01).

At the American Psychiatric Association’s annual meeting here, Lu suggested that the findings may reflect a trend that is expected to worsen significantly in the coming decades.

Workplace smoking ban cuts emergency room admissions

From Sify News:

Workplace smoking bans will reduce emergency room admissions due to respiratory illness, according to a new study.

The study, conducted by researchers in Dublin, found that emergency room admissions due to respiratory illness dropped significantly in Ireland after the implementation of a workplace smoking ban, compared to admissions that took place before the ban went into effect.

Fewer Emergency Rooms Available as Need Rises

From the NY Times:

Urban and suburban areas have lost a quarter of their hospital emergency departments over the last 20 years, according to the study, in The Journal of the American Medical Association. In 1990, there were 2,446 hospitalswith emergency departments in nonrural areas. That number dropped to 1,779 in 2009, even as the total number of emergency room visits nationwide increased by roughly 35 percent.

Emergency departments were most likely to have closed if they served large numbers of the poor, were at commercially operated hospitals, were in hospitals with skimpy profit margins or operated in highly competitive markets, the researchers found.

If Your Heart Stops For 96 Minutes, Pray This Machine Is At Your Side

From Gizmodo:

Ninety six minutes. Eleven shocks by defibrillator. Two dozen rescuers pounding his chest in shifts to bring vital oxygen to his limp body. A helicopter, even. That’s what it took to revive 54-year old Howard Snitzer this month. Oh, and a little celebrated thing called a capnography machine that let everyone know that he was still capable of being brought back from the brink of death.