{"id":191,"date":"2008-10-03T09:44:25","date_gmt":"2008-10-03T09:44:25","guid":{"rendered":"http:\/\/cardiophile.org\/?p=191"},"modified":"2008-10-03T09:44:25","modified_gmt":"2008-10-03T09:44:25","slug":"strategies-for-prevention-of-sudden-cardiac-death-at-the-community-level","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/strategies-for-prevention-of-sudden-cardiac-death-at-the-community-level\/","title":{"rendered":"Strategies for prevention of SCD at community level"},"content":{"rendered":"

Strategies for prevention of SCD at community level<\/span><\/h2>\n

Problems with preventive strategy<\/p>\n

    \n
  1. 80% occurs at home, only 15% occur in streets or in public places<\/li>\n
  2. Risk stratification is easy at individual level, but not at a community level<\/span><\/li>\n
  3. Reluctance to start resuscitation due to unwillingness to give mouth to mouth breathing and also the worry about legal problems in case of unwitnessed death<\/span><\/li>\n<\/ol>\n

    Chain of survival was described in 1991: early access to Emergency Medical Service, early CPR, early defibrillation, early ACLS<\/p>\n

    Markers of futility:<\/strong><\/p>\n

      \n
    1. Unwitnessed cardiac arrest \u2013 almost no survival<\/li>\n
    2. Response time more than 8 min – survival < 0.3%<\/span><\/li>\n
    3. If the initial rhythm is asystole or pulseless electrical activity<\/span><\/li>\n<\/ol>\n

      AED should be available in airports, convention centres, sporting arenas, casinos, shopping malls and large office building.<\/p>\n

      Public access to defibrillation trial: NEJM 2004; 20,000 Volunteers, 1600 AEDs, 239 episodes of SCD. Only those with bystander CPR successful. Prevented 16 extra deaths [1].<\/p>\n

      Reference<\/strong><\/span><\/p>\n

        \n
      1. A P Hallstrom, J P Ornato, M Weisfeldt, A Travers, J Christenson, M A McBurnie, R Zalenski, L B Becker, E B Schron, M Proschan, Public Access Defibrillation Trial Investigators. Public-access defibrillation and survival after out-of-hospital cardiac arrest<\/a>. N Engl J Med. 2004 Aug 12;351(7):637-46.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

        Strategies for prevention of SCD at community level<\/p>\n","protected":false},"author":1,"featured_media":38272,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[6],"tags":[],"class_list":["post-191","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ecg-electrophysiology"],"yoast_head":"\nStrategies for prevention of SCD at community level<\/title>\n<meta name=\"description\" content=\"Strategies for prevention of SCD at community level\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/strategies-for-prevention-of-sudden-cardiac-death-at-the-community-level\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta 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