key: cord-0772956-faeesd6b
authors: Chugh, Sumeet S.; Jui, Jonathan; Salvucci, Angelo
title: Pivotal Role in the Community Response to Cardiac Arrest: The Smart Bystander
date: 2020-07-07
journal: J Am Coll Cardiol
DOI: 10.1016/j.jacc.2020.05.034
sha: ee27cd6a15b95cb86cf67db449b9c5ec480365e5
doc_id: 772956
cord_uid: faeesd6b

[Figure: see text]

OHCA remains a major public health challenge (2), with annual incidence exceeding 350,000 in the United States and 620,000 in Europe (3, 4) . Emergency medical response systems linked to community efforts and advanced care continue to save lives, but survival to discharge from the hospital has plateaued at z10% (3, 5) , leaving significant room for improvement. Bystander CPR and early defibrillation have long been recognized as 2 critical determinants of survival. In a 1985 clinical trial, Cummins et al. (6) demonstrated the benefit of early CPR undertaken by lay persons, firmly reinforcing the concept of bystander CPR. A subsequent meta-analysis reported an approximate doubling of survival with bystander CPR (7) . In parallel, the potential role of early defibrillation by lay rescuers using AEDs deployed in the community was explored. In the Public Access Defibrillation trial (8) More recently, trained bystanders have been connected to OHCAs occurring in their neighborhood by text messages as well as smartphone apps. However, it has been a challenge to make these processes function efficiently (9 The generalizability of these findings will need to be evaluated further. Regions with less favorable socioeconomic status, education level, and cultural cohesiveness may not be able to duplicate these results. Rural areas with low population density as well as AEDs may need unique approaches to improve early defibrillation, such as drone delivery of AEDs, which is currently being piloted or used in several regions. Although only one-half of the suspected @SumeetSChugh.

Smartphone activation of citizen responders to facilitate defibrillation in out-of-hospital cardiac arrest

Public health burden of sudden cardiac death in the United States

Heart disease and stroke statistics-2019 update: a report from the American Heart Association

ONE Registry: a prospective one month analysis of out-ofhospital cardiac arrest outcomes in 27 countries in Europe

Survival after out-of-hospital cardiac arrest in Europe -Results of the EuReCa TWO study

Survival of out-of-hospital cardiac arrest with early initiation of cardiopulmonary resuscitation

Predictors of survival from out-of-hospital cardiac arrest: a systematic review and metaanalysis

Public-access defibrillation and survival after outof-hospital cardiac arrest

The PulsePoint Respond mobile device application to crowdsource basic life support for patients with out-of-hospital cardiac arrest: challenges for optimal implementa