Abstract 313: Assessment of Arrest Procedures, Hospital Care and Functional Survival of Initial VT/VF Arrest Patients Shocked by a Bystander AED vs Patients Shocked by EMS
Bibliographic record
Abstract
Introduction: Although one randomized trial and a prospective cohort study suggest that survival to hospital discharge doubles if a bystander uses an AED to defibrillate vs waiting for an EMS provider to defibrillate, there has been no comprehensive comparison of functional survival outcomes or resuscitation treatment differences for these two resuscitation strategies. METHODS: Population based data from the ROC Registry (Epistry) provided a comparison of public, witnessed initial VT/VF arrests treated with bystander AED shock (n=77) vs EMS shock (n=328) during 2010. Modified Rankin score (MRS) was determined from the hospital record and MRS <3 at discharge was considered to be good functional survival. Results: The two groups were similar in EMS response time, age, and sex. More of the bystander AED vs. EMS shocked patients had bystander CPR (98.7 vs. 62.5%, p<0.001) and fewer received epinephrine (42.9 vs. 72.6%, p<0.001) or amiodarone (9.1 vs. 29.3%, p<0.001). In-hospital care was not different in use of hypothermia (31-32%) but median hospitalization was shorter for bystander AED shocked patients who survived to discharge (10 days vs 13.5 days, ns) Survival to discharge for bystander AED vs. EMS shocked patients was 68% vs. 46% (p=0.001) and survival with MRS < 3 was 53% vs. 33% (p=0.001). The functional survival advantage for bystander AED shocked patients persisted after adjustment for age, sex, bystander CPR and study site: OR of 2.17 (95% CI 1.26, 3.75 p=0.006). CONCLUSIONS: Thus AED shock by bystanders for initial VT/VF arrests is associated with greater survival with good to excellent functional recovery and results in less use of medications to achieve stable hemodynamics after arrest.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".