Abstract 19946: Airports: Out-of-hospital Chain of Survival Laboratory?

Abstract

Introduction: Airports are experimentation locations in which automatic external defibrillators (AED) implementation efficacy (and efficiency) has been widely tested. Hypothesis: With a large number of passengers and a fine meshing in terms of AED availability, the aim of this study is to understand the airport cardiac arrests (ACA) in terms of care and to study their survival in such a particular location. Methods: Prospective descriptive and multicentre study based on the French national cardiac arrest registry (RéAC) data gathered between the 01/07/2011 and the 01/11/2014. Results: We analysed 78 ACA among 35667 cardiac arrests. We recorded 83.3% men. The population’s median age was 63 [52-70]. A medical aetiology was recorded in 93.6% cases and 30% had history of cardiovascular diseases. Professional first aid providers’ (generally firemen) median response time was 5 [1-10] min and mobile medical teams’ (MMT) 20 [12-30] min. Three quarter of patients were immediately cared by witnesses of which 53.8% benefited of an AED connexion ; 23.1% of them received a shock. A cardiopulmonary resuscitation (CPR) was attempted by firemen in 84.6% cases. At MMT arrival, 13.3% had a shockable rhythm and 26.7% had already sustained a return of spontaneous circulation. MMT attempted CPR in 87.2% cases and 37.2% sustained a return of spontaneous circulation (ROSC). At hospital admission, 34.6% were alive. At Day 30, 14.1% survived of which 81.9% had a good neurological outcome (CPC1-2). Among them 27.3% had a implantation of automatic defibrillator. Cardiac aetiology was proved in 28% cases and almost half of patients returned directly at home after their hospitalization. Conclusions: ACA victims are often cared very promptly by bystanders, professional first aid providers and medical teams. They also more often benefit of AED connexion and shock than cardiac arrest victims in the general population. Airports are indeed a location in which all the steps of the chain of survival are thoroughly and effectively implemented. As all these steps are patients’ survival key factors, this results in better outcome.