Submitted by Jean Medeiros (jeanletras@uepb.edu.br) on 2017-04-06T14:46:22Z No. of bitstreams: 1 PDF - Yang Medeiros Cardoso.pdf: 13425632 bytes, checksum: 72b354ab3844ba38f7747c1b7a2f9948 (MD5) / Approved for entry into archive by Secta BC (secta.csu.bc@uepb.edu.br) on 2017-07-20T11:33:31Z (GMT) No. of bitstreams: 1 PDF - Yang Medeiros Cardoso.pdf: 13425632 bytes, checksum: 72b354ab3844ba38f7747c1b7a2f9948 (MD5) / Made available in DSpace on 2017-07-20T11:33:31Z (GMT). No. of bitstreams: 1 PDF - Yang Medeiros Cardoso.pdf: 13425632 bytes, checksum: 72b354ab3844ba38f7747c1b7a2f9948 (MD5) Previous issue date: 2016-12-19 / Cardiac arrest is one of the most common causes of death in the world. Among the people who can be saved from this condition, most are in Ventricular Fibrillation or Pulseless Ventricular Tachycardia. Electrical defibrillation is the simplest and most important therapy in the treatment of these patients. The Automatic External Defibrillator is the device that can be used by laypersons with a minimum of training to perform defibrillation, reducing the waiting time of the first pulse application, which directly influenciate the success rate of this therapy. This work describes a way of using the Extended Kalman Filter (FKE) to correct ECG signals used by an Automatic External Defibrillator in the decision making of the defibrillatory pulse application in patients, as well as a proposed Defibrillator model describing the aspects of its operation. / A parada cardíaca é uma das causas mais comuns de morte no mundo. Dentre as pessoas que podem ser salvas dessa condição, a maioria encontra-se em Fibrilação Ventricular ou Taquicardia Ventricular sem pulso. A Desfibrilação Elétrica é a terapia mais simples e importante no tratamento desses pacientes. O Desfibrilador Externo Automático é o aparelho que pode ser utilizado por leigos com um mínimo de treinamento para efetuar a Desfibrilação, diminuindo o tempo de espera da aplicação do primeiro pulso, o que influencia diretamente na taxa de sucesso dessa terapia. Neste trabalho descreve-se uma forma de utilização do Filtro de Kalman Estendido (FKE) para corrigir sinais de ECG utilizados por um Desfibrilador Externo Automático na tomada de decisão da aplicação do pulso desfibrilatório em pacientes, bem como uma proposta modelo de Desfibrilador que descreve os aspectos principais do seu funcionamento.

Hjärtstopp sker oftast utanför sjukhus, långt ifrån avancerad sjukvård. För varje minut som går utan behandling minskar chansen att överleva avsevärt. Sju av tio personer som drabbats av hjärtstopp får hjärt-lungräddning innan ambulans är på plats. På grund av att fler ingripanden från åskådare sker innan ambulansen är på plats har tiden från hjärtstopp till start av hjärt-lungräddning minskat från 11 minuter till en minut. Syftet med studien är att belysa hur olika faktorer påverkar överlevnaden hos personer med hjärtstopp vid prehospital hjärt- och lungräddning. En litteraturöversikt valdes som metod. Sökningarna genomfördes i databaserna Cinahl ochPubMed och resulterade i 14 artiklar. Ytterligare fyra artiklar inkluderades manuellt. Artiklarna kvalitetsgranskades och klassificerades enligt Sophiahemmets högskolas bedömningsunderlag. Dataanalysen genomfördes med en integrerad analys. Resultatet påvisade att överlevnad efter hjärtstopp är starkt beroende av tiden. Tiden från kollaps till början av hjärt- lungräddning och tiden från kollaps till defibrillering är avgörande för överlevnadschansen. Kedjan som räddar liv (överlevnadsskedjan) representerar olika steg som skall följas vid ett hjärtstopp för att maximera chansen för optimal behandlingsstrategi vid ett hjärtstopp. Slutsatsen är att nya behandlingsstrategier behövs för att nå ut och behandla personer snabbare. AED gör det möjligt för lekmän att leverera livräddande chocker inom några minuter. Vidare gör utvecklingen av mobiltelefonteknik det möjligt att identifiera och rekrytera lekmän till närliggande hjärtstopp för livräddande åtgärder. / Cardiac arrest usually occurs outside hospitals, far from advanced healthcare. For every minute that goes without treatment, the chance of survival decreases significantly. seven out of 10 people who suffer from cardiac arrest receive cardiopulmonary resuscitation before an ambulance is on site. Due to the fact that more interventions from bystanders take place before the ambulance is in place, the time from cardiac arrest to start of cardiopulmonary resuscitation has been reduced from 11 minutes to one minute. The aim of the study is to shed light on how different factors affect the survival of people with cardiac arrest in prehospital cardiopulmonary resuscitation. A literature review was chosen as the method. The searches were performed in the Cinahl and PubMed databases and resulted in 14 articles. Another four articles were included manually. The quality of the articles were reviewed and classified according to Sophiahemmet University's assessment for quality. The data analysis was performed with an integrated analysis. The results showed that survival after cardiac arrest is strongly dependent on time. The time from collapse to the beginning of cardiopulmonary resuscitation and the time from collapse to defibrillation are crucial for the chance of survival. The chain that saves lives (the survivalchain) represents different steps that must be followed in a cardiac arrest in order to maximizethe chance of optimal treatment strategy in the event of a cardiac arrest. The conclusion is that new treatment strategies are needed to reach out and treat people faster. AED enables laymen to deliver life-saving shocks within minutes. Furthermore, the development of mobile phone technology makes it possible to identify and recruit lay peopleto nearby cardiac arrests for life-saving measures.

Abstract Background Todays guidelines for advanced CPR emphasize chest compressions with good quality and early defibrillation. Prehospital CPR performed by ambulance crew, an automated external defibrillator (AED) is used. The AED analyzes the heart rhythm and the performer is following the advice to chock the heart or not, given by the AED. During on-going CPR there are sequences when no chest compression is performed known as hands-off time. Hands-off time includes the time for the AED to analyze the heart rhythm and the time when advice is given to the crew. Studies show that prolonged hands-off time has a negative impact on survival after a sudden cardiac arrest. Purpose The purpose with this study was to look into if the hands-off time could decrease with use of manual mode on the defibrillator by the ambulance crew. The crew had to analyze, make a decision to chock or not, charge the defibrillator and give the chock if appropriate. Furthermore, the crews’ knowledge in analyzing heart rhythms that can be defibrillate was investigated.  Method A quasi-experimental method was used. 38 participants, all ambulance crew, were included in the study. The participants were randomized into two groups. One group performed CPR with an AED, the second group used the manual mode on the defibrillator. The study data were processed in SPSS. Results The time preceding the first defibrillation was significant shorter in the group using manual mode. There was no difference in total hands-off time between the two groups. All heart rhythms were interpreted right and all defibrillation were done correctly. Conclusions Time from establish cardiac arrest to first defibrillation was significant shorter in manual mode. Furthermore, all heart rhythms were interpreted right and all defibrillation were done correctly. Time from first defibrillation to start of chest compressions was equal in the two groups. There were no significant differences in hands-off time between the two groups.   Keyword: ambulance, cardiac arrest, automatic external defibrillator, manual defibrillator, manual rhythm analyze, hands-off time