Publications by authors named "Linn Andelius"

Background: A volunteer responder program to out-of-hospital cardiac arrest (OHCA) was implemented stepwise in Denmark (2017-2020). This study assessed automated external defibrillator (AED) and volunteer responder coverage of historical OHCAs in Denmark.

Methods: Non-emergency medical services witnessed OHCAs (2016-2020) from the Danish Cardiac Arrest Registry with known location and AEDs from the Danish AED network were included.

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Background: Strategies to reach out-of-hospital cardiac arrests (called cardiac arrest) in residential areas and reduce disparities in care and outcomes are warranted. This study investigated incidences of cardiac arrests in public housing areas.

Methods: This register-based cohort study included cardiac arrest patients from Amsterdam (the Netherlands) from 2016 to 2021, Copenhagen (Denmark) from 2016 to 2021, and Vienna (Austria) from 2018 to 2021.

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Background: Patients with out-of-hospital cardiac arrest (OHCA) in rural areas experience longer emergency response times and have lower survival rates compared with patients in urban areas. Volunteer responders might improve care and outcomes for patients with OHCA specifically in rural areas. Therefore, we investigated volunteer responder interventions based on the degree of urbanization.

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Article Synopsis
  • A study examined the characteristics and outcomes of public out-of-hospital cardiac arrests (OHCAs) occurring in residential neighborhoods in Vienna and Copenhagen from 2016 to 2021.
  • Findings revealed that a significant portion of OHCAs happened in residential areas, but interventions such as CPR, defibrillation, and the use of AEDs were less effective compared to non-residential areas.
  • The study concluded that the likelihood of survival following a cardiac arrest in residential neighborhoods is lower, emphasizing the need for improved emergency response and intervention strategies in these locations.
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Background: Systems for dispatch of volunteer responders to collect automated external defibrillators and/or to provide cardiopulmonary resuscitation (CPR) in cases of nearby out-of-hospital cardiac arrest (OHCA) are widely implemented.

Objectives: This study aimed to investigate whether the activation of a volunteer responder system to OHCAs was associated with higher rates of bystander CPR, bystander defibrillation, and 30-day survival vs no system activation.

Methods: This was a retrospective observational analysis within the ESCAPE-NET (European Sudden Cardiac Arrest network: Towards Prevention, Education, New Effective Treatment) collaborative research network.

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Introduction: Smartphone technology is increasingly used to engage lay people as volunteer responders in resuscitation attempts. Attention has recently been drawn to how resuscitation attempts may impact bystanders. Attempting resuscitation in out-of-hospital cardiac arrests (OHCA) may be an overwhelming experience and, in some cases, difficult to cope with.

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Background Survival from out-of-hospital cardiac arrest (OHCA) varies across regions. The aim of this study was to evaluate the association between urbanization (rural, suburban, and urban areas), bystander interventions (cardiopulmonary resuscitation and defibrillation), and 30-day survival from OHCAs in Denmark. Methods and Results We included OHCAs not witnessed by ambulance staff in Denmark from January 1, 2016, to December 31, 2020.

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Objectives: Smartphone dispatch of volunteer responders for out-of-hospital cardiac arrest (OHCA) is implemented worldwide. While basic life support courses prepare participants to provide CPR, the courses rarely address the possibility of meeting a family member or relative in crisis. This study aimed to examine volunteer responders' provision of support to relatives of cardiac arrest patients and how relatives experienced the interaction with volunteer responders.

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Background: Volunteer responder (VR) programs for activation of laypersons in out-of-hospital cardiac arrest (OHCA) have been deployed worldwide, but the optimal number of VRs to dispatch is unknown.

Objectives: The purpose of this study was to investigate the association between the number of VRs arriving before Emergency Medical Services (EMS) and the proportion of bystander cardiopulmonary resuscitation (CPR) and defibrillation.

Methods: We included OHCAs not witnessed by EMS with VR activation from the Capital Region (September 2, 2017, to May 14, 2019) and the Central Region of Denmark (November 5, 2018, to December 31, 2019).

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Article Synopsis
  • The study analyzed the impact of smartphone-activated volunteer responders on bystander defibrillation during out-of-hospital cardiac arrests (OHCA) in both homes and public places in Sweden and Denmark.
  • Out of 1,271 cases, a higher percentage of patients received bystander defibrillation when a volunteer responder arrived before Emergency Medical Services (EMS), with notable increases in private homes.
  • Although bystander defibrillation rates improved with the arrival of volunteer responders, the study found no significant difference in 30-day survival rates between those cases and those where EMS arrived first.
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During the past 20 years the survival after out-of-hospital cardiac arrest (OHCA) has almost quadrupled from 4% in 2001 to 14% in 2020. There has been a huge focus on layman education in cardiopulmonary resuscitation and use of automated external defibrillators (AED), implementation of healthcare staff at 1-1-2 dispatch centers, early recognition of OHCA, establishment of a national AED register with publicly available AEDs, and dispatch of volunteer responders in case of nearby OHCA. This review describes implemented initiatives with the purpose of improving survival from OHCA in Denmark.

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Aim: The primary aim was to investigate the association between alarm acceptance compared to no-acceptance by volunteer responders, bystander intervention, and survival in out-of-hospital cardiac arrest.

Materials And Methods: This retrospective observational study included all suspected out-of-hospital cardiac arrests (OHCAs) with activation of volunteer responders in the Capital Region of Denmark (1 November 2018 to 14 May 2019), the Central Denmark Region (1 November 2018 to 31 December 2020), and the Northern Denmark Region (14 February 2020 to 31 December 2020). All OHCAs unwitnessed by Emergency Medical Services (EMS) were analyzed on the basis on alarm acceptance and arrival before EMS.

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Article Synopsis
  • A study was conducted to assess the levels of CPR and AED training in the Danish population and among volunteer responders, using an electronic survey sent out in November 2018.
  • The results showed a significant difference in training levels, with 81% of the general population and 99% of volunteer responders reporting CPR training, and 54% vs. 89.5% for AED training.
  • The findings suggest that while training is widespread, there’s a need for new strategies to ensure that unemployed and self-employed individuals have equal access to CPR/AED training opportunities.
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Aims: Little is known about automated external defibrillator (AED) functionality in real-life settings. We aimed to assess the functionality of all registered AEDs in a geographically selected area and calculate the proportion of historical out-of-hospital cardiac arrests (OHCAs) covered by non-functioning AEDs.

Methods: In this cross-sectional study we inspected all registered and available AEDs on the island of Bornholm in Denmark.

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Background Little is known about how COVID-19 influenced engagement of citizen responders dispatched to out-of-hospital cardiac arrest (OHCA) by a smartphone application. The objective was to describe and analyze the Danish Citizen Responder Program and bystander interventions (both citizen responders and nondispatched bystanders) during the first COVID-19 lockdown in 2020. Methods and Results All OHCAs from January 1, 2020, to June 30, 2020, with citizen responder activation in 2 regions of Denmark were included.

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Article Synopsis
  • The study analyzed patterns of citizen responder availability during out-of-hospital cardiac arrest (OHCA) incidents in Denmark, focusing on variations by time of day and day of the week.
  • Citizen responders were found to be more active and likely to accept alarms during the evening and on weekends, resulting in a higher percentage arriving before Emergency Medical Services.
  • Despite the increased responder presence during certain times, there was no significant difference in the quality of care provided, such as cardiopulmonary resuscitation or defibrillation, regardless of when responders arrived.
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Background: The optimal locations and cost-effectiveness of placing automated external defibrillators (AEDs) for out-of-hospital cardiac arrest (OHCAs) in urban residential neighbourhoods are unclear.

Methods: We used prospectively collected data from 2016 to 2018 from the British Columbia OHCA Registry to examine the utilization and cost-effectiveness of hypothetical AED deployment in municipalities with a population of over 100 000. We geo-plotted OHCA events using seven hypothetical deployment models where AEDs were placed at the exteriors of public schools and community centers and fetched by bystanders.

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Background: Activating citizen responders may increase survival after out-of-hospital cardiac arrest (OHCA) but could induce significant psychological impact on the citizen responders. We examined psychological impact among citizen responders within the first days following resuscitation attempt.

Methods And Results: A mobile phone application to activate citizen responders to perform cardiopulmonary resuscitation (CPR) was implemented in the Capital Region of Denmark.

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Article Synopsis
  • Citizen responder programs send volunteers to assist with out-of-hospital cardiac arrests (OHCA) before official emergency services arrive, but their collaboration with emergency personnel is not well understood.
  • A study involving 65 emergency physicians in the Capital Region of Denmark evaluated their interactions with citizen responders, finding that most physicians appreciate their assistance, particularly in performing CPR and carrying equipment.
  • While 93% of physicians have interacted with citizen responders and many found the collaboration beneficial, some challenges were noted, such as confusion between responders and relatives and issues with communication and crowding at the scene.
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Background Citizen responder programs are implemented worldwide to dispatch volunteer citizens to participate in out-of-hospital cardiac arrest resuscitation. However, the risk of injuries in relation to activation is largely unknown. We aimed to assess the risk of physical injury for dispatched citizen responders.

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Background Little is known about the psychological risks of dispatched citizen responders who have participated in resuscitation attempts. Methods and Results A cross-sectional survey study was performed with 102 citizen responders who participated in a resuscitation attempt from July 23, 2018, to August 22, 2018, in the Capital Region of Denmark. Psychological distress, defined as symptoms of posttraumatic stress disorder, was assessed 3 weeks after the resuscitation attempt and measured with the Impact of Event Scale-Revised.

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Purpose Of Review: To discuss different approaches to citizen responder activation and possible future solutions for improved citizen engagement in out-of-hospital cardiac arrest (OHCA) resuscitation.

Recent Findings: Activating volunteer citizens to OHCA has the potential to improve OHCA survival by increasing bystander cardiopulmonary resuscitation (CPR) and early defibrillation. Accordingly, citizen responder systems have become widespread in numerous countries despite very limited evidence of their effect on survival or cost-effectiveness.

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Aim: To examine incidence and outcome following out-of-hospital cardiac (OHCA) arrest in a high-risk area characterised by high density of potential bystanders and easy access to nearby automated external defibrillators (AEDs).

Methods: This retrospective observational study investigated pre-hospital and in-hospital treatment, as well as survival amongst persons with OHCA at Copenhagen International Airport between May 25, 2015 and May 25, 2019. OHCA data from pre- and in-hospital medical records were obtained and compared with public bystander witnessed OHCAs in Denmark.

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