Optimizing Health Monitoring Systems With Wireless Technology

Cardiovascular diseases are a leading death cause in the world. Cardiac arrest is one of the most usual, and very quickly fatal, especially in out-of-hospital environments. Defibrillation, aside with cardiopulmonary resuscitation, is an effective means to restart blood circulation and heart operation, even though even these forms of treatment can help just in sadly few situations. Defibrillation was invented and first demonstrated already year 1899, but first in the 2000s portable defibrillators with good automatic functions started to penetrate daily environments of people, especially in urban settings. Nowadays the starting point is that every citizen with normal human functionality should be able to use automated defibrillators. The chapter discusses how modern information and communication technology, especially mobiles services, internet, and location services based on them, could help citizens in the first crucial step in implementing their safety competence in emergency situations by using automatic defibrillators if they could only find them.</div

Placement of automated external defibrillators and logistics to facilitate early defibrillation in sudden cardiac arrest

Background and aim. Out-of-hospital cardiac arrest (OHCA) is a leading cause of death in many western countries. Much effort is put in to measures to improve survival. Early cardiopulmonary resuscitation (CPR) and the use of an automated external defibrillator (AED) significantly increase the chance of survival. In 2016, 5,312 cases of OHCA were reported to the Swedish Register for Cardiopulmonary Resuscitation (SRCR), but only 577 (11%) survived to 30-days. The bystander CPR rate in Sweden is high (73%), and AEDs are widely spread in all parts of the country; however, the use of public AEDs is low. If the use of AEDs could be increased, more patients could be saved. The aim of this thesis was to investigate, in four separate studies, how logistics and placement of AEDs can help facilitate early defibrillation. Methods and results: Study 1 A prospective study at five emergency dispatch centres in Sweden where dispatchers were given access to the Swedish AED registry and had instructions to refer callers to nearby AEDs in cases of suspected OHCA. Of 3,009 suspected OHCA calls over seven months, only 200 occurred within 100 metres of an AED, and in only two cases did dispatchers referred callers to a nearby AED. AED accessibility (opening hours of the venue) and the fact that the callers often were alone on the scene, were identified as barriers for referral. Study 2 A retrospective analysis of AED installation sites and locations of OHCA in public locations in Stockholm. We used renowned geographic information system (GIS) analyses and a freely available dataset of land use (Urban Atlas). Incidence of OHCA in public locations in “residential areas” was similar to “non-residential” but AED installation was significantly higher in “non-residential areas”. Study 3 An explorative study to investigate the feasibility of using unmanned aerial vehicles (UAV)/Drones to transport AEDs to decrease time to defibrillation. The study included live test flights of a UAV system as well as retrospective GIS analysis of suitable locations for installation of UAVs equipped with AEDs for maximum coverage of OHCA. Study 4 An overview of the Swedish AED registry (SAEDREG) shows a two-fold increase of registered AEDs since 2013 and that the majority (45%) of the n=15,849 AEDs are placed in offices/workplaces. In a select region of Sweden, a survey was directed to the owners of all n=218 AEDs that focused on AED functionality and reasons for not registering the AED in SAEDREG. An additional n=94 AEDs were found through customer registries from AED vendors. AED functionality was high in both groups. Owners of AEDs not registered in SAEDREG was often unaware of the national AED registry or stated difficulties with the registration process as the main cause for not registering AEDs in SAEDREG. Conclusions: Dispatch centres have the potential to refer callers to nearby AEDs at an early stage in OHCA but may need supporting training and software. There is a mismatch between where public OHCA occur and where AEDs are located. Most AEDs are found in offices and workplaces whereas most OHCA occur in residential areas. Drones have the potential to transport AEDs and compensate for prolonged ambulance response time, especially in rural areas. A high quality national AED register is important for increasing general awareness within the community, thus facilitating early defibrillation in OHCA; however, many AEDs are nonregistered or discarded in the validation process

GIS in Healthcare

The landscape of healthcare is dynamic, gradually becoming more complicated with factors beyond simple supply and demand. Similar to the diversity of social, political and economic contexts, the practical utilization of healthcare resources also varies around the world. However, the spatial components of these contexts, along with aspects of supply and demand, can reveal a common theme among these factors. This book presents advancements in GIS applications that reveal the complexity of and solutions for a dynamic healthcare landscape

The North Carolina Automated External Defibrillator Location Project: Recommendations for Use of Automated External Defibrillators in the Resuscitation of Victims of Out-of-Hospital Sudden Cardiac Death

Purpose: The study was undertaken to determine the current level of Automated External Defibrillator (AED) preparedness in North Carolina and to evaluate potential alternatives for future actions in the area of AED deployment and Public Access Defibrillation (PAD). Methods: A literature review was conducted to evaluate the efficacy and costeffectiveness of treatment options for out-of-hospital sudden cardiac death (SCD). Primary data were obtained via phone and electronic mail surveys of state and county EMS officials, commercial AED vendors, and American Heart Association Training Centers. Results: Review of the literature indicates successful defibrillatory treatment of SCD must be accomplished within 10 minutes of collapse. With few exceptions, most communities cannot achieve such a prompt response with traditional EMS service. Communities with AED-equipped first responders accomplish such a prompt response with greater frequency than those without such responders. PAD allows for prompt defibrillation and a markedly increased probability of survival for SCD victims in public places; only 3% of all SCDs occur in such public places. In North Carolina, in addition to 282 EMS agencies and Fire Departments, 600 locations were found to have at least 1 AED, many of which have the possibility of PAD. None of the 9-1-1 centers in the state had the locations of AEDs entered into Computer Automated Dispatch (CAD), 33% percent of counties did not have an AED or other defibrillator on all first-responding fire or EMS vehicles, and 45% of counties are unable to provide instructions for use of an AED over the phone. Conclusions: All first-responding EMS units and fire engines need to be equipped with AEDs. Those AEDs located in areas for potential PAD need to have their location registered with 9-1-1 dispatch in order to ensure they are used in the event of a near-by SCD. Emergency Medical Dispatchers must be prepared to provide instructions for use of an AED to the untrained bystander. More research is needed before recommendations regarding placement of additional AEDs for PAD can be made.Master of Public Healt

A globally relevant change taxonomy and evidence-based change framework for land monitoring

A globally relevant and standardized taxonomy and framework for consistently describing land cover change based on evidence is presented, which makes use of structured land cover taxonomies and is underpinned by the Driver-Pressure-State�Impact-Response (DPSIR) framework. The Global Change Taxonomy currently lists 246 classes based on the notation ‘impact (pressure)’, with this encompassing the consequence of observed change and associated reason(s), and uses scale-independent terms that factor in time. Evidence for different impacts is gathered through temporal comparison (e.g., days, decades apart) of land cover classes constructed and described from Environmental Descriptors (EDs; state indicators) with pre-defined measurement units (e.g., m, %) or categories (e.g., species type). Evidence for pressures, whether abiotic, biotic or human-influenced, is similarly accumulated, but EDs often differ from those used to determine impacts. Each impact and pressure term is defined separately, allowing flexible combination into ‘impact (pressure)’ categories, and all are listed in an openly accessible glossary to ensure consistent use and common understanding. The taxonomy and framework are globally relevant and can reference EDs quantified on the ground, retrieved/classified remotely (from groundbased, airborne or spaceborne sensors) or predicted through modelling. By providing capacity to more consistently describe change processes—including land degradation, desertification and ecosystem restoration—the overall framework addresses a wide and diverse range of local to international needs including those relevant to policy, socioeconomics and land management. Actions in response to impacts and pressures and monitoring towards targets are also supported to assist future planning, including impact mitigation actions

History of the Development of Automated External Defibrillators

This chapter is structured as a historical overview of the history of the development of defibrillators and the most prominent personalities who contributed to the development of the modern concept of resuscitation. Defibrillators in medical practice can be external or implanted. The devices, known as automated external defibrillators, automate the diagnosis of a patient’s rhythm and the process of stopping arrhythmias, meaning they can be used successfully by nonspecialists. In Europe, 350,000–700,000 people suffer from sudden cardiac arrest every year. On average, it is 55–113 per 100,000 people. Most of these people are usually at home, but about 10–20% of victims are in a public place at the time. Defibrillation within 3–5 minutes of cardiac arrest can increase survival by 50–70%. For every minute that defibrillation is delayed, the chance of survival decreases by 10–12%. A significant contribution to the development of the defibrillation concept was made by Peter Kristians Abildgård, Albert Salisbury Hyman, William Bennett Couwenhoven, Paul Morris Zoll, James Francis Pantridge, and many others. Clinical studies confirm that public access defibrillators (PADs), when available and used correctly during out-of-hospital cardiac arrest, were associated with a 40% median survival rate

Feedback systems for the quality of chest compressions during cardiopulmonary resuscitation

167 p.Se define la parada cardiorrespiratoria como la detención súbita de la actividad mecánica del corazón, confirmada por la ausencia de signos de circulación. En caso de parada cardiorrespiratoria, dos actuaciones son clave para la supervivencia del paciente: la reanimación cardiopulmonar (RCP) precoz, y la desfibrilación precoz. La RCP consiste en proporcionar compresiones torácicas y ventilaciones al paciente para mantener un mínimo flujo de sangre oxigenada a los órganos vitales. La calidad de las compresiones está relacionada con la supervivencia del paciente. Por esta razón las guías de resucitación recomiendan el uso de sistemas de feedback que monitorizan la calidad de la RCP en tiempo real. Estos dispositivos se sitúan generalmente entre el pecho del paciente y las manos del rescatador, y guían al rescatador para ayudarle a alcanzar la profundidad y frecuencia de compresión objetivo. Esta tesis explora nuevas alternativas para monitorizar la calidad de las compresiones durante la RCP. Se han seguido dos estrategias: usar la señal de impedancia transtorácica (ITT), que es adquirida por los desfibriladores actuales a través de los parches de desfibrilación, y usar la aceleración del pecho, que podría ser registrada usando un dispositivo adicional

A globally relevant change taxonomy and evidence-based change framework for land monitoring

A globally relevant and standardized taxonomy and framework for consistently describing land cover change based on evidence is presented, which makes use of structured land cover taxonomies and is underpinned by the Driver-Pressure-State-Impact-Response (DPSIR) framework. The Global Change Taxonomy currently lists 246 classes based on the notation 'impact (pressure)', with this encompassing the consequence of observed change and associated reason(s), and uses scale-independent terms that factor in time. Evidence for different impacts is gathered through temporal comparison (e.g., days, decades apart) of land cover classes constructed and described from Environmental Descriptors (EDs; state indicators) with pre-defined measurement units (e.g., m, %) or categories (e.g., species type). Evidence for pressures, whether abiotic, biotic or human-influenced, is similarly accumulated, but EDs often differ from those used to determine impacts. Each impact and pressure term is defined separately, allowing flexible combination into 'impact (pressure)' categories, and all are listed in an openly accessible glossary to ensure consistent use and common understanding. The taxonomy and framework are globally relevant and can reference EDs quantified on the ground, retrieved/classified remotely (from ground-based, airborne or spaceborne sensors) or predicted through modelling. By providing capacity to more consistently describe change processes-including land degradation, desertification and ecosystem restoration-the overall framework addresses a wide and diverse range of local to international needs including those relevant to policy, socioeconomics and land management. Actions in response to impacts and pressures and monitoring towards targets are also supported to assist future planning, including impact mitigation actions

School Policy and Practice to Tackle a Public Health Problem: Sudden Cardiac Arrest

Sudden cardiac arrest (SCA) is a leading cause of death in the United States. While the medical research has exhaustively documented that immediate response directly impacts survival rates in SCA and that schools could be the best catalyst for creating change by bystanders, there is little to no educational research addressing school policy or practices in regards to cardiac emergencies in schools. The purpose of this dissertation was to identify and describe characteristics of the Colorado schools that offer cardiopulmonary resuscitation (CPR) training and onsite automated external defibrillators (AED). Two research questions were answered, Of respondents, what are the characteristics of schools that provide CPR training? Of respondents, what are the characteristics of schools that have an on-site AED? This dissertation was a quantitative study with survey design as the methodology. Participants for the study were Colorado school leaders. The survey collection method was electronic questionnaire. Data analysis was descriptive statistics. The data analysis described trends associated with school characteristics to CPR training and AED availability at responding schools. These trends indicated a need for further research of CPR training and AED availability in Colorado schools