• Daniel Jost, Hong Tuan HaVivienVParis Fire Brigade, Emergency Medical Department, France., Julie Trichereau, Benoit Frattini, Clément Derkenne, Sabine Lemoine, Frédéric Lemoine, Romain Jouffroy, Romain Kedzierewicz, Frédérique Briche, Pascal Diegelmann, René Bihannic, Olivier Stibbe, Bertrand Prunet, and Paris Fire Brigade Cardiac Arrest Task Force investigators.
• Paris Fire Brigade, Emergency Medical Department, France; Sudden Death Expertise Center, INSERM U.970, Paris, France. Electronic address: daniel.jost@pompiersparis.fr.
• Resuscitation. 2020 Sep 1; 154: 19-24.

IntroductionIn out-of-hospital cardiac arrest (OHCA), external electric shock (EES) is recommended for treating ventricular fibrillation (VF). Refibrillation commonly occurs within one minute post-shock. We aimed to investigate refibrillation times and identifyclinical and electrical factors associated with them.Materials And MethodsThis retrospective observational study, based on the Paris Fire Brigade database, included non-traumatic OHCA over 18 years of age who received at least one shock with an AED from Basic Life Support (BLS) rescuers and from which we randomly selected a sample to measure the refibrillation-times. Without prior reference to it in the literature, we classified the refibrillation-time into two modalities according to whether it was above or below the median-time. We performed multiple regression analysis to assess associations between refibrillation-time and potential explanatory factors.ResultsAmong 13,181 patients who experienced OHCA from January 2010 to January 2014, we analysed AED data from 215 patients (590 shocks), 82.1% males, median age 61[IQR: 52-75] years. Most of them occurred at home (57%), were witnessed (87%), and were shockable (88.8%). A median of 5[4-7] EES/patients were delivered. The median-time from shock to refibrillation was 25[13-44] s. Multivariate analysis showed that a shorter post-shock hands-off time favoured earlier refibrillation (p = 0.034), as well as older age (p = 0.002) (Fig. 2, Supplementary table).ConclusionIn non-traumatic OHCA, most refibrillations occurred within 45-s post-shock. Age and post-shock hands-off time were the two contributing factors to time to refibrillation.Copyright © 2020 Elsevier B.V. All rights reserved.

17 keywords...

hide…