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Marijon E, Narayanan K, Smith K, Barra S, Basso C, Blom MT, Crotti L, D'Avila A, Deo R, Dumas F, Dzudie A, Farrugia A, Greeley K, Hindricks G, Hua W, Ingles J, Iwami T, Junttila J, Koster RW, Le Polain De Waroux JB, Olasveengen TM, Ong MEH, Papadakis M, Sasson C, Shin SD, Tse HF, Tseng Z, Van Der Werf C, Folke F, Albert CM, Winkel BG. The Lancet Commission to reduce the global burden of sudden cardiac death: a call for multidisciplinary action. Lancet 2023; 402:883-936. [PMID: 37647926 DOI: 10.1016/s0140-6736(23)00875-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 04/13/2023] [Accepted: 04/25/2023] [Indexed: 09/01/2023]
Abstract
Despite major advancements in cardiovascular medicine, sudden cardiac death (SCD) continues to be an enormous medical and societal challenge, claiming millions of lives every year. Efforts to prevent SCD are hampered by imperfect risk prediction and inadequate solutions to specifically address arrhythmogenesis. Although resuscitation strategies have witnessed substantial evolution, there is a need to strengthen the organisation of community interventions and emergency medical systems across varied locations and health-care structures. With all the technological and medical advances of the 21st century, the fact that survival from sudden cardiac arrest (SCA) remains lower than 10% in most parts of the world is unacceptable. Recognising this urgent need, the Lancet Commission on SCD was constituted, bringing together 30 international experts in varied disciplines. Consistent progress in tackling SCD will require a completely revamped approach to SCD prevention, with wide-sweeping policy changes that will empower the development of both governmental and community-based programmes to maximise survival from SCA, and to comprehensively attend to survivors and decedents' families after the event. International collaborative efforts that maximally leverage and connect the expertise of various research organisations will need to be prioritised to properly address identified gaps. The Commission places substantial emphasis on the need to develop a multidisciplinary strategy that encompasses all aspects of SCD prevention and treatment. The Commission provides a critical assessment of the current scientific efforts in the field, and puts forth key recommendations to challenge, activate, and intensify efforts by both the scientific and global community with new directions, research, and innovation to reduce the burden of SCD worldwide.
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Affiliation(s)
- Eloi Marijon
- Division of Cardiology, European Georges Pompidou Hospital, AP-HP, Paris, France; Université Paris Cité, Inserm, PARCC, Paris, France; Paris-Sudden Death Expertise Center (Paris-SDEC), Paris, France.
| | - Kumar Narayanan
- Université Paris Cité, Inserm, PARCC, Paris, France; Paris-Sudden Death Expertise Center (Paris-SDEC), Paris, France; Medicover Hospitals, Hyderabad, India
| | - Karen Smith
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Silverchain Group, Melbourne, VIC, Australia
| | - Sérgio Barra
- Department of Cardiology, Hospital da Luz Arrábida, Vila Nova de Gaia, Portugal
| | - Cristina Basso
- Cardiovascular Pathology Unit-Azienda Ospedaliera and Department of Cardiac Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Marieke T Blom
- Department of General Practice, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Lia Crotti
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy; Istituto Auxologico Italiano, IRCCS, Center for Cardiac Arrhythmias of Genetic Origin, Cardiomyopathy Unit and Laboratory of Cardiovascular Genetics, Department of Cardiology, Milan, Italy
| | - Andre D'Avila
- Department of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Cardiology, Hospital SOS Cardio, Santa Catarina, Brazil
| | - Rajat Deo
- Department of Cardiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Florence Dumas
- Université Paris Cité, Inserm, PARCC, Paris, France; Paris-Sudden Death Expertise Center (Paris-SDEC), Paris, France; Emergency Department, Cochin Hospital, Paris, France
| | - Anastase Dzudie
- Cardiology and Cardiac Arrhythmia Unit, Department of Internal Medicine, DoualaGeneral Hospital, Douala, Cameroon; Yaounde Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon
| | - Audrey Farrugia
- Hôpitaux Universitaires de Strasbourg, France, Strasbourg, France
| | - Kaitlyn Greeley
- Division of Cardiology, European Georges Pompidou Hospital, AP-HP, Paris, France; Université Paris Cité, Inserm, PARCC, Paris, France; Paris-Sudden Death Expertise Center (Paris-SDEC), Paris, France
| | | | - Wei Hua
- Cardiac Arrhythmia Center, FuWai Hospital, Beijing, China
| | - Jodie Ingles
- Centre for Population Genomics, Garvan Institute of Medical Research and UNSW Sydney, Sydney, NSW, Australia
| | - Taku Iwami
- Kyoto University Health Service, Kyoto, Japan
| | - Juhani Junttila
- MRC Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Rudolph W Koster
- Heart Center, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | | | - Theresa M Olasveengen
- Department of Anesthesia and Intensive Care Medicine, Oslo University Hospital and Institute of Clinical Medicine, Oslo, Norway
| | - Marcus E H Ong
- Singapore General Hospital, Duke-NUS Medical School, Singapore
| | - Michael Papadakis
- Cardiovascular Clinical Academic Group, St George's University of London, London, UK
| | | | - Sang Do Shin
- Department of Emergency Medicine at the Seoul National University College of Medicine, Seoul, South Korea
| | - Hung-Fat Tse
- University of Hong Kong, School of Clinical Medicine, Queen Mary Hospital, Hong Kong Special Administrative Region, China; Cardiac and Vascular Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Zian Tseng
- Division of Cardiology, UCSF Health, University of California, San Francisco Medical Center, San Francisco, California
| | - Christian Van Der Werf
- University of Amsterdam, Heart Center, Amsterdam, Netherlands; Department of Clinical and Experimental Cardiology, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Fredrik Folke
- Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Christine M Albert
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Bo Gregers Winkel
- Department of Cardiology, University Hospital Copenhagen, Rigshospitalet, Copenhagen, Denmark
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Nieth D, Henry ACJ, Wunderlich R. Wissen und Fortbildungsbereitschaft bezüglich Reanimation. Notf Rett Med 2022. [DOI: 10.1007/s10049-022-01101-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Zusammenfassung
Zielsetzung
Der plötzliche Herztod gehört europaweit zu den führenden Todesursachen, doch trotz intensiver Bemühungen ist die Laienreanimationsquote in Deutschland seit Jahren niedrig. In dieser Studie wurden der diesbezügliche Wissensstand sowie die Fortbildungsbereitschaft der Bevölkerung am Beispiel Berlin erhoben.
Methodik
Die Studienteilnehmer wurden zufällig ausgewählt. Eingeschlossen wurden 120 Personen im Alter von 40 bis 70 Jahren. Das Wissen über Reanimation wurde mittels eines Fragebogens mit 24 Items erhoben. Zusätzlicher Bestandteil des Fragebogens waren drei Videos mit unterschiedlichen Situationen die Laienreanimation betreffend. Diese mussten von den Teilnehmern mithilfe von 6 Antwortmöglichkeiten bearbeitet werden. Ein Item diente darüber hinaus zur Erhebung der Fortbildungsbereitschaft zu diesem Thema. Um etwaige Unterschiede aufzuzeigen, wurden eine Gruppe mit Erste-Hilfe-Kurs im zurückliegenden Jahr und eine Gruppe mit Erste-Hilfe-Kurs vor längerer Zeit getrennt betrachtet.
Ergebnisse
Von den Teilnehmern schlossen 74 % (n = 89) die Erhebung vollständig ab. Davon hatten 11 % (n = 10) innerhalb des letzten Jahres an einem Erste-Hilfe-Kurs teilgenommen. In dieser Gruppe trauten sich 90 % (n = 9) der Teilnehmer zu, einen Herz-Kreislauf-Stillstand erkennen und versorgen zu können, dem gegenüber stehen 20 % (n = 16) in der Vergleichsgruppe mit Erste-Hilfe-Kurs vor längerer Zeit. Einen automatisierten externen Defibrillator anzuwenden, trauten sich 50 % (n = 5) bzw. 11 % (n = 9) der Teilnehmer zu. 92 % (n = 82) aller Teilnehmer bestätigten die Bereitschaft zu einer regelmäßigen Erste-Hilfe-Fortbildung.
Schlussfolgerung
Die Gruppe mit kürzlichem Erste-Hilfe-Kurs schneidet im Wissen zu Reanimation, Erkennen und Behandeln von Notfallsituationen besser ab als die Vergleichsgruppe. Um die herausgestellten Kenntnislücken zu schließen, sollte ein neuer Ansatz gefunden werden. Ein bundesweites, jährlich zu absolvierendes Kursprogramm für alle Erwachsenen in Deutschland könnte diese Lücke schnell und nachhaltig füllen.
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Brooks SC, Clegg GR, Bray J, Deakin CD, Perkins GD, Ringh M, Smith CM, Link MS, Merchant RM, Pezo-Morales J, Parr M, Morrison LJ, Wang TL, Koster RW, Ong MEH. Optimizing Outcomes After Out-of-Hospital Cardiac Arrest With Innovative Approaches to Public-Access Defibrillation: A Scientific Statement From the International Liaison Committee on Resuscitation. Circulation 2022; 145:e776-e801. [PMID: 35164535 DOI: 10.1161/cir.0000000000001013] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Out-of-hospital cardiac arrest is a global public health issue experienced by ≈3.8 million people annually. Only 8% to 12% survive to hospital discharge. Early defibrillation of shockable rhythms is associated with improved survival, but ensuring timely access to defibrillators has been a significant challenge. To date, the development of public-access defibrillation programs, involving the deployment of automated external defibrillators into the public space, has been the main strategy to address this challenge. Public-access defibrillator programs have been associated with improved outcomes for out-of-hospital cardiac arrest; however, the devices are used in <3% of episodes of out-of-hospital cardiac arrest. This scientific statement was commissioned by the International Liaison Committee on Resuscitation with 3 objectives: (1) identify known barriers to public-access defibrillator use and early defibrillation, (2) discuss established and novel strategies to address those barriers, and (3) identify high-priority knowledge gaps for future research to address. The writing group undertook systematic searches of the literature to inform this statement. Innovative strategies were identified that relate to enhanced public outreach, behavior change approaches, optimization of static public-access defibrillator deployment and housing, evolved automated external defibrillator technology and functionality, improved integration of public-access defibrillation with existing emergency dispatch protocols, and exploration of novel automated external defibrillator delivery vectors. We provide evidence- and consensus-based policy suggestions to enhance public-access defibrillation and guidance for future research in this area.
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Brooks SC, Clegg GR, Bray J, Deakin CD, Perkins GD, Ringh M, Smith CM, Link MS, Merchant RM, Pezo-Morales J, Parr M, Morrison LJ, Wang TL, Koster RW, Ong MEH. Optimizing outcomes after out-of-hospital cardiac arrest with innovative approaches to public-access defibrillation: A scientific statement from the International Liaison Committee on Resuscitation. Resuscitation 2022; 172:204-228. [PMID: 35181376 DOI: 10.1016/j.resuscitation.2021.11.032] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Out-of-hospital cardiac arrest is a global public health issue experienced by ≈3.8 million people annually. Only 8% to 12% survive to hospital discharge. Early defibrillation of shockable rhythms is associated with improved survival, but ensuring timely access to defibrillators has been a significant challenge. To date, the development of public-access defibrillation programs, involving the deployment of automated external defibrillators into the public space, has been the main strategy to address this challenge. Public-access defibrillator programs have been associated with improved outcomes for out-of-hospital cardiac arrest; however, the devices are used in <3% of episodes of out-of-hospital cardiac arrest. This scientific statement was commissioned by the International Liaison Committee on Resuscitation with 3 objectives: (1) identify known barriers to public-access defibrillator use and early defibrillation, (2) discuss established and novel strategies to address those barriers, and (3) identify high-priority knowledge gaps for future research to address. The writing group undertook systematic searches of the literature to inform this statement. Innovative strategies were identified that relate to enhanced public outreach, behavior change approaches, optimization of static public-access defibrillator deployment and housing, evolved automated external defibrillator technology and functionality, improved integration of public-access defibrillation with existing emergency dispatch protocols, and exploration of novel automated external defibrillator delivery vectors. We provide evidence- and consensus-based policy suggestions to enhance public-access defibrillation and guidance for future research in this area.
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Misztal-Okońska P, Goniewicz K, Goniewicz M, Ranse J, Hertelendy AJ, Gray L, Carlström E, Løwe Sørensen J, Khorram-Manesh A. Importance of Immediate Electronic-Based Feedback to Enhance Feedback for First-Time CPR Trainees. Int J Environ Res Public Health 2021; 18:ijerph18083885. [PMID: 33917203 PMCID: PMC8067975 DOI: 10.3390/ijerph18083885] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/22/2021] [Accepted: 04/06/2021] [Indexed: 11/23/2022]
Abstract
Sudden cardiac arrest is one of the leading causes of death globally. The recommended clinical management in out-of-hospital cardiac arrest cases is the immediate initiation of high-quality cardiopulmonary resuscitation (CPR). Training mannequins should be combined with technology that provides students with detailed immediate feedback on the quality of CPR performance. This study aimed to verify the impacts of the type of feedback (basic or detailed) the responders receive from the device while learning CPR and how it influences the quality of their performance and the motivation to improve their skills. The study was conducted at the Medical University of Lublin among 694 multi-professional health students during first aid classes on basic life support (BLS). The students first practiced on an adult mannequin with a basic control panel; afterward, the same mannequin was connected to a laptop, ensuring a detailed record of the performed activities through a projector. Next, the participants expressed their subjective opinion on how the feedback provided during the classes, basic vs. detailed, motivated them to improve the quality of their CPR performance. Additionally, during the classes, the instructor conducted an extended observation of students’ work and behavior. In the students’ opinion, the CPR training with detailed feedback devices provided motivation for learning and improving CPR proficiency than that with a basic control panel. Furthermore, the comments given from devices seemed to be more acceptable to the students, who did not see any bias in the device’s evaluation compared to that of the instructor. Detailed device feedback motivates student health practitioners to learn and improve the overall quality of CPR. The use of mannequins that provide detailed feedback during BLS courses can improve survival in out-of-hospital cardiac arrest.
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Affiliation(s)
- Patrycja Misztal-Okońska
- Department of Emergency Medicine, Medical University of Lublin, 20-059 Lublin, Poland;
- Correspondence:
| | - Krzysztof Goniewicz
- Department of Aviation Security, Military University of Aviation, 08-521 Dęblin, Poland;
| | - Mariusz Goniewicz
- Department of Emergency Medicine, Medical University of Lublin, 20-059 Lublin, Poland;
| | - Jamie Ranse
- School of Nursing and Midwifery, Griffith University, Gold Coast, QLD 4215, Australia;
- Department of Emergency Medicine, Gold Coast Health, Gold Coast, QLD 4215, Australia
| | - Attila J. Hertelendy
- Fellowship in Disaster Medicine, Department of Emergency Medicine, Beth Israel Deaconess Medical Centre, Boston, MA 02215, USA;
- Department of Emergency Medicine, Harvard Medical School, Boston, MA 02215, USA
- Department of Information Systems and Business Analytics, College of Business, Florida International University, Miami, FL 33119, USA
| | - Lesley Gray
- Department of Primary Health Care and General Practice, University of Otago, Wellington 6242, New Zealand;
- Joint Centre for Disaster Research, Massey University, Wellington 6021, New Zealand
| | - Eric Carlström
- Gothenburg Emergency Medicine Research Group (GEMREG), Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden;
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
- USN School of Business, University of South-Eastern Norway, 3616 Kongsberg, Norway;
| | - Jarle Løwe Sørensen
- USN School of Business, University of South-Eastern Norway, 3616 Kongsberg, Norway;
| | - Amir Khorram-Manesh
- Institute of Clinical Sciences, Department of Surgery, Sahlgrenska Academy, Gothenburg University, 413 45 Gothenburg, Sweden;
- Department of Development and Research, Armed Forces Center for Defense Medicine, 426 76 Gothenburg, Västra Frölunda, Sweden
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Alhussein RM, Albarrak MM, Alrabiah AA, Aljerian NA, Bin Salleeh HM, Hersi AS, Wani TA, Al Aseri ZA. Knowledge of non-healthcare individuals towards cardiopulmonary resuscitation: a cross-sectional study in Riyadh City, Saudi Arabia. Int J Emerg Med 2021; 14:11. [PMID: 33568064 PMCID: PMC7876786 DOI: 10.1186/s12245-021-00335-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 02/02/2021] [Indexed: 11/10/2022] Open
Abstract
Background Most sudden cardiac arrests occur at home, with low rates of bystander cardiopulmonary resuscitation being performed. We aimed to assess knowledge of cardiopulmonary resuscitation among individuals in Riyadh City, Saudi Arabia, who are not involved in health care. Methods A community-based cross-sectional study was conducted between January and February 2020 in 4 different areas in Riyadh City: North, South, East, and West. The participants were surveyed using a validated self-administered questionnaire. The Statistical Package for Social Sciences version 25.0 was used for inferential statistics and binary logistic regression analysis. Results A total of 856 participants completed the questionnaire, 51.8% were unaware of cardiopulmonary resuscitation. Only 4.4% of the participants had attended a formal cardiopulmonary resuscitation training course, 5.1% were campaign attendees, and 38.7% acquired their experience through the media. Having a higher level of education was positively associated with having knowledge of cardiopulmonary resuscitation. The main concern among attendees of cardiopulmonary resuscitation training courses and campaigns was legal issues, whereas inadequate knowledge was the major barrier for those who had learned about cardiopulmonary resuscitation through the media. Conclusion The level of knowledge of cardiopulmonary resuscitation among non-health care individuals in Riyadh City was found to be insufficient. Therefore, coordinated efforts among different authorities should be considered to implement a structured strategy aiming to increase awareness and knowledge of cardiopulmonary resuscitation among non-health care individuals.
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Affiliation(s)
| | | | - Abdulaziz A Alrabiah
- Department of Emergency Medicine, College of Medicine, King Saud University, P.O. Box 7805, Riyadh, 11472, Kingdom of Saudi Arabia
| | - Nawfal A Aljerian
- Department of Emergency Medicine, King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard, Riyadh, Saudi Arabia.,Medical Referrals Center-Ministry of Health, Riyadh, Saudi Arabia
| | - Hashim M Bin Salleeh
- Department of Emergency Medicine, College of Medicine, King Saud University, P.O. Box 7805, Riyadh, 11472, Kingdom of Saudi Arabia
| | - Ahmad S Hersi
- Department of Cardiac Sciences, College of Medicine, King Saud University, P.O. Box 7805, Riyadh, 11472, Kingdom of Saudi Arabia
| | - Tariq A Wani
- Research Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Zohair A Al Aseri
- College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia. .,Departments of Emergency Medicine and Critical Care, College of Medicine, King Saud University, P.O. Box 7805, Riyadh, 11472, Kingdom of Saudi Arabia.
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Abstract
Introduction: Sufficient CPR skills in the general population are essential to make them active bystanders and contribute to an effective chain of survival in cardiac arrest emergencies. However, having a large proportion of the population regularly retrained is practically infeasible. Objective: The aim of this study was to assess and retrain cardiopulmonary resuscitation (CPR) skills of individuals who received (limited) CPR training several months to years prior. Method: Ninety-nine German adults in a possession of a driver's license were asked to perform CPR on a Laerdal Resusci Anne® QCPR manikin (Laerdal, Stavanger, Norway). After initial assessment, participants watched an instructional video and completed short, isolated compression, and ventilation practice with live feedback. CPR competency was assessed again after retraining and after a retention interval of 45 min. Results: Our results indicate that only 2% of participants managed to reach the performance criteria set by the European Resuscitation Council Guidelines, with most failing to reach even the lowest levels of performance. This corroborates earlier observations that CPR skills have deteriorated almost completely after a long retention interval, calling into question “one-and-done” certification of this basic life-saving. However, we also demonstrated that performance strikingly increased after watching a 6-min instructional video and a short opportunity for isolated practice. This increase in performance was stable over 45 min with 96% of participants meeting performance levels specified in the Guidelines. Closer inspection of the isolated compression practice data suggests that performance was very high at the start of the practice already, indicating that short refresher videos might suffice to change bystanders that would not have initiated CPR due to lack of knowledge into active first responders. Conclusion: We suggest that short refresher trainings could be an effective and affordable means of improving basic lifesaving skills to increase the effective contribution of bystanders during emergencies.
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Affiliation(s)
- Sarah C Maaß
- Department of Experimental Psychology, University of Groningen, Groningen, Netherlands.,Behavioral and Cognitive Neurosciences, University of Groningen, Groningen, Netherlands
| | - Florian Sense
- Department of Experimental Psychology, University of Groningen, Groningen, Netherlands.,Behavioral and Cognitive Neurosciences, University of Groningen, Groningen, Netherlands
| | - Kevin A Gluck
- Air Force Research Laboratory, Wright-Patterson Air Force Base, Dayton, OH, United States
| | - Hedderik van Rijn
- Department of Experimental Psychology, University of Groningen, Groningen, Netherlands
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