Cardiopulmonary resuscitation in the combat hospital and forward operating base: use of automated external defibrillators.
OBJECTIVE
Time to defibrillation (t(defib)) directly correlates with survival from cardiac arrest. We investigated whether automated external defibrillators (AED) in a combat setting would improve this crucial variable.


METHODS
We performed a randomized simulation study to compare two systems of cardiac arrest response: public access AED vs. standard manual defibrillation. The study was conducted in two phases at two different settings: (1) in a contiguous United States (CONUS)-based training combat support hospital (CSH) and (2) at a deployed CSH within a combat forward operating base (FOB). The primary outcome was t(defib) and the secondary outcome was difficulty of use.


RESULTS
For the training CSH setting, t(defib) the AED model was significantly faster than the conventional model (1.3 vs. 2.0 minutes, p <0.001, 95% CI of the mean difference = 0.39-1.1). In the combat environment, t(defib) was between 2.2 and 8.4 minutes faster for the AED system. The AED system was found to be significantly easier to use than the standard model.


CONCLUSIONS
In simulated cardiac arrest, the AED model demonstrated significantly improved t(defib) compared to the standard response for both training and combat settings.
Adams
Bruce D
BD
Department of Clinical Investigation, William Beaumont Army Medical Center, 5005 North Piedras Street, El Paso, TX 79920-5001, USA.
Carr
Barb
B
Raez
Abigail
A
Hunter
Curtis J
CJ
D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation* / Q000379:methods / Q000592:standards; D018592:Cross-Over Studies; D047548:Defibrillators; D006323:Heart Arrest / Q000628:therapy*; D006772:Hospitals, Military; D006801:Humans; D008889:Military Personnel; D016544:Patient Simulation; D013997:Time Factors; D014857:Warfare