Sudden Cardiac Arrest and Early Defibrillation Presenting the
Sudden Cardiac Arrest and Early Defibrillation Presenting the Power. Heart AED®
Automated External Defibrillator 自動體外心臟電擊器 傻瓜電擊器 ? ?
Response Times and Survival Rates Time to Chance First of Shock Survival Traditional Ambulance First Responder (police, fire) On-site Defibrillation Phone Call Response Team On-site 1 min 8 min 4 min To Patient 10 min <10% 6 min 40% 3 min >60% 1 min On-site and to patient 1 min 2 min Speed is the key to greater survival!
Factors that Influence Defibrillation • 阻抗 - Impedance • 電擊闕值 - Defibrillation Threshold • 細胞反應曲線 - Cellular Response Curve
The Power. Heart Waveforms - Finally Optimized Current Delivery! Optimized Current Delivery = Successful Defibrillation!
Optimized Current Delivery Waveform Finally the Answer • STAR 技術, 自動量測病患阻抗 • 自動改變Biphasic波型 • 自動改變電流送達時間 • 只有 Cardiac Science 能自動改變送 達總電流量 Optimized Current Delivery = Successful Defibrillation!
The Power. Heart Monophasic Waveform
The Power. Heart STAR Biphasic Waveform: The Discovery of a New STAR!
Charge Balancing Principle Conventional Biphasic STAR Biphasic
How STAR Biphasic Works - Variable Energy Low Current High Current
The Power. Heart STAR Biphasic Waveform: Putting it all Together!
Factors That Influence Successful Defibrillation: • 電擊闕值 Defibrillation Threshold (DFT) – 需高於DFT值, 電擊才會有效 – 不同病患DFT均不同 – 必需能快速提昇能量以越高過DFT – 越過DFT ASAP!
Factors That Influence Successful Defibrillation: • 電荷歸零 Charge Balancing – 電擊過後, 細胞內都有殘餘電荷 – 設計適當的AED必須能使電荷歸零 – Biphasic的2 nd phase目的在消除多餘電荷 – Biphasic非低能量 150 Joul x 2
Factors that influence Variable Energy: Current Delivered 正確的電流 Patient’s Impedance 病患的阻抗 Defibrillation Threshold 電荷闕值 Cellular Response 細胞反應 Charge Balancing 電荷歸零 結果是: 提供最適當的能量
The Power. Heart STAR Biphasic Waveform Clinical Study Outcomes: STAR Waveforms Out-shine the Competition!
Clinical Study • 115 patients acting as own controls – Each patient received two shocks • Experimental biphasic • Control waveform - monophasic • Two arms – Escalating energy • 200 J, 360 J versus Low and High Energy – High energy arm • 360 J versus High Energy
Comparison of patient enrollment Sur. Viva. Link 115 patients HP/Heartstream 264 patients Physio-Control 247 patients Experimental costs between $1, 500 -$2, 000 per patient
Investigators • Cedar-Sinai Medical Center, Los Angeles, CA – Dr. Charles Swerdlow • Cleveland Clinic Foundation, Cleveland, OH – Dr. Pat Tchou • Medical Center of Virginia, Richmond, VA – Dr. Kenneth Ellenbogen • Ohio State University, Columbus, OH – Dr. Charles Love • Pacemaker Surveillance Clinic, Atlanta, GA • Dr. Thomas Deering
Waveform Comparison • STAR Biphasic success rate statistically higher than either Monophasic Damped Sine or HTST Biphasic • STAR Monophasic success rate statistically higher than either Monophasic Damped Sine or HTST Biphasic
The Analysis Algorithm: Making the Decision ECG ? • 為何Cardiac Science不將EKG在 LCD上顯示 • 避免操作人員犯任何可能的錯誤 • 第一時間搶救病患
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