Abstract 32: Chest Compression Fraction Increased When Police Used AED That Analyses Heart Rhythm During CPR

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Introduction: Conventional automated external defibrillators (AED) prompt rescuers to stop cardiopulmonary resuscitation (CPR) for ECG analysis during cardiac arrest (CA), but pauses in CPR are associated with worse outcome. A new AED algorithm, cprINSIGHT™ Analysis Technology, analyses the ECG while rescuers continue chest compressions. Hypothesis: Compared to conventional AEDs, AEDs with the cprINSIGHT algorithm will lead to fewer and shorter interruptions of chest compressions for ECG analysis and, thereby, a higher chest compression fraction (CCF). Methods: Amsterdam Police used conventional AEDs in 2016 (LIFEPAK® 1000 defibrillator) and AEDs with cprINSIGHT in 2018 (LIFEPAK CR2 AED); in the CR2 AED, cprINSIGHT is activated after the first conventional analysis. We analysed AED data from control CA cases in 2016 and intervention CA cases in 2018, comparing pre-shock pause, median CCF and CCF categories. CCF was defined as the proportion of time with chest compressions in the period from the start of CPR after analysis 1 to the start of CPR after analysis 2. The CCF analysis included only cases where CPR was provided with a ratio of 30 compressions to 2 ventilations. Results: Data from 111 control and 87 intervention cases were analysed. The initial recorded rhythm was shockable in 42 control cases (38%) and 36 intervention cases (41%). Rhythm during analysis 2 was shockable in 28/103 (27%) control and 19/80 (24%) intervention cases; 15 cases had no second analysis. In 67/80 (84%) intervention cases, analysis 2 reached a decision without prompting for a CPR pause. Intervention cases had a significantly shorter pre-shock pause than control cases (7 sec vs 22 sec, p < 0.001) and significantly higher median CCF (87% vs 77%, P<0.001). CCF was ≥90% in 38% of intervention cases and 10% of control cases (figure). Conclusion: The use of the cprINSIGHT algorithm in AEDs leads to a shorter pre-shock pause, fewer analysis pauses and an increase in CCF compared to conventional AEDs.