Resuscitation with an AED: putting the data to use
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Neth Heart J https://doi.org/10.1007/s12471-020-01504-z
Resuscitation with an AED: putting the data to use M. A. R. Bak · M. T. Blom · R. W. Koster · M. C. Ploem
Accepted: 6 October 2020 © The Author(s) 2020
Abstract The increased use of the automated external defibrillator (AED) contributes to the rising survival rate after sudden cardiac arrest in the Netherlands. When used, the AED records the unconscious person’s medical data (heart rhythm and information about cardiopulmonary resuscitation), which may be important for further diagnosis and treatment. In practice, ethical and legal questions arise about what can and should be done with these ‘AED data’. In this article, the authors advocate the development of national guidelines on the handling of AED data. These guidelines should serve two purposes: (1) to safeguard that data are handled carefully in accordance with data protection principles and the rules of medical confidentiality; and (2) to ensure nationwide availability of data for care of patients who survive resuscitation, as well as for quality monitoring of this care and for related scientific research. Given the medical ethical duties of beneficence and fairness, existing (sometimes lifesaving) information about AED use ought to be made available to clinicians and researchers on a structural basis. Creating a national AED data infrastructure, however, requires overcoming practical
M. A. R. Bak () Section of Medical Ethics, Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands [email protected] M. T. Blom · R. W. Koster ARREST Research Group, Department of Cardiology, Heart Center, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands M. C. Ploem Section of Health Law, Department of Social Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
and organisational barriers. In addition, further legal study is warranted. Keywords Resuscitation · Automated external defibrillator · Out-of-hospital cardiac arrest · Quality of healthcare · Medical records · Ethics
Introduction Every year, 15,000–16,000 people in the Netherlands are affected by sudden cardiac arrest outside the hospital, with an average survival rate of 23% [1]. This is high compared with the rate in other countries, due in part to the increased deployment of the automated external defibrillator (AED) since its introduction nearly 20 years ago. Nowadays, an AED is connected in more than half of all resuscitations in the Netherlands. For patients with a cardiac arrest and a ‘shockable’ rhythm (ventricular fibrillation or ventricular tachycardia), rapid defibrillation is crucial. In the period of 2006–2014, the increased use of an AED in this group of patients was associated with an increase in the survival rate from 32.4% to 49.5% [2]. Of the surviving patients, 56% received initial defibrillation with an AED [3]. An AED can be deployed by so-called ‘first responders’ (police and fire brigade) after notification by ambulance care dispatch centre. I
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