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External Defibrillators Prehospital Clinical Issues

Jules Scadden, P.S, CQI/Data Coordinator-Sac County Ambulance National Association of EMTs (NAEMT) jkscadden@gmail.com. External Defibrillators Prehospital Clinical Issues. EMS historically provided first defibrillation Studies- improved outcomes with rapid defibrillation (1) (2)

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External Defibrillators Prehospital Clinical Issues

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  1. Jules Scadden, P.S, CQI/Data Coordinator-Sac County Ambulance National Association of EMTs (NAEMT) jkscadden@gmail.com External DefibrillatorsPrehospital Clinical Issues

  2. EMS historically provided first defibrillation Studies- improved outcomes with rapid defibrillation (1) (2) EMS-Call-to-arrive often 4-5 min or longer PAD decreased time-defibrillation (1) By-stander CPR with early defibrillation + coordination with local EMS improved survival rates Back Ground

  3. Lack of interoperability between devices • Electrodes/Defib pads • Adult vs Peds modes requires pad changes • Software Updates/Guideline changes • Cost prohibitive to many EMS services and small businesses • Lack of EMS-PAD program collaboration Challenges

  4. AED used at local high school during a community event. CPR was interrupted twice to change defib pads with arrival of local BLS ambulance and ALS ambulance Volunteer FR AED fails on third shock—battery dead—unit had never been used/checked during monthly meetings indicated batteries were fine Situations

  5. Universal Electrodes and wiring systems Institute universal “Adult” vs “Peds” shock button Remote protocol/algorithms/software updates Cost of AEDs must not be prohibitive Collaboration of AED placement/PAD programs with local EMS Recommendations

  6. Universal pads/electrodes and wiring systems as well as an “adult” vs “Pediatric” shock button can improve patient outcomes by eliminating interrupted CPR Remote system updates will ensure updates are installed in a timely manner, decreasing “out-of-service” time and potential machine failure Significant cost increase with technology increases would place an increased burden on EMS services and potentially make PAD programs prohibitive. Collaboration with local EMS services will enhance a PAD program and improve patient outcomes Summary

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