Simulated survival impact of pulselessness-detection technologies for unwitnessed Out-of-Hospital Cardiac Arrest.

Dr Milena Talikowska1, Dr David Majewski1, Mr Jason Belcher1,2, Dr Stephen Ball1,2, Dr Damien Foo1, Prof. Judith Finn1

1Curtin University, Perth, Australia, 2St John WA, Belmont, Australia

Biography:

Prof Judith Finn is Director of the Prehospital, Resuscitation & Emergency Care Research Unit (PRECRU) in the Curtin School of Nursing, Perth, WA – St John WA being PRECRU’s principal research parter. Judith (critical care registered nurse and epidemiologist) was the inaugural Director of the Australasian Resuscitation Outcomes Consortium (Aus-ROC).

Abstract:

Introduction: Up to two-thirds of all emergency medical service (EMS)-attended out-of-hospital cardiac arrests (OHCA) in Australia and New Zealand are unwitnessed.1 However survival is < 5% in this group.2 With the recent incorporation of pulselessness-detection technologies into consumer wearable devices3 such as smartwatches,4 the potential exists to convert otherwise unwitnessed arrests into device-witnessed cases.

Aim: To quantify the potential increase in survival for unwitnessed OHCA with the use of pulselessness-detection technologies.

Methods: We included non-traumatic, non-EMS-witnessed OHCA in patients ≥ 16 years in Western Australia (WA), 1 July 2020 – 30 June 2025. We included all EMS-attended cases but excluded patients with a do-not-resuscitate order, those for whom treatment was withheld due to malignancy/palliative care and those who achieved sustained return of spontaneous circulation after receiving a bystander shock from an automated external defibrillator. We undertook simulation modelling to estimate the expected number of additional survivors if previously unwitnessed cases were converted to device-witnessed.

Results: Our cohort comprised 11,422 cases. If 100% of previously unwitnessed cases were converted to device-witnessed, with 100% sensor sensitivity, we could expect 765 (95%CI: 699, 831) additional survivors over 5 years in WA. If only 10% of previously unwitnessed cases were converted to device-witnessed, with a sensor sensitivity of 80%, we could still expect 56 (95%CI: 25, 88) additional survivors over 5 years.

Conclusion: Even modest increases in the usage of wearable devices with pulselessness-detection technology could lead to an additional 11 survivors per year in WA.

 

 

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