In the United States, see recommendations for cardiac safety of sports arenas but also to health and fitness facilities. However, this does not exist in Sweden today. Objective: The purpose of this study is to identify the health- and fitness facilities today are equipped with respect to cardiac safety and specifically relating to preparedness for cardiac arrest. Method: Quantitative data are collected and compiled with the help of a questionnaire. The questionnaire contained 19 questions in total. Random selection of plants and a total of 263 facilities contributed 88 plants in the study. The loss was 67 %. Results: Of the 88 facilities was the 94 % who were trained and certified in cardiac cardiopulmonary resuscitation and 66 % in advanced cardiac cardiopulmonary resuscitation. Just over half of all plants had AED. Half of the establishments, which had more than 10 minutes to the nearest hospitals had no AED and of these, 75 % were privately owned. Conclusion: Preparedness for cardiac arrest on our health and fitness facilities seems to be good, for example, most of the facilities that responded to the questionnaire had AED and practical training of the staff. Most are also trained and certified in cardiac cardiopulmonary resuscitation. But there is room for improvement, for example, only about half of all holdings with > 10 minutes to the hospital had no AED and three facilities lacked both AED and trained staff in CRP. Guidelines are needed on preparedness for acute cardiac events on health and fitness facilities in Sweden, just as there are in the United States today.

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Hjärtstillestånd är ett tillstånd då hjärtat förlorat förmågan att pumpa ut blod i kroppen vilket leder till cerebral och koronar ischemi. Hjärtstillestånd definieras som plötslig och ihållande medvetslöshet med pulslöshet och andningsstillestånd eller agonal andning. Vanliga symtom som kan uppstå en timme före hjärtstilleståndet är yrsel, trötthet, bröstsmärtor och andningssvårigheter. Behandlingen vid hjärtstillestånd i Sverige utgörs av ”basic” och ”advanced cardiac life support”. De viktigaste åtgärderna innefattar hjärt-lung-räddning, defibillering och läkemedelsadministrering. Förstahandsläkemedlet är standarddos adrenalin baserat på den vasokontraherande och därmed blodtryckshöjande effekten. Syftet med arbetet är att utvärdera effekten av standarddos vasopressin alternativt högdos adrenalin jämfört med standarddos adrenalin på vuxna med hjärtstillestånd. Arbetet är en litteraturstudie där sju studier om effekten av standarddos adrenalin jämfört med standarddos vasopressin alternativt högdos adrenalin vid hjärtstillestånd hos vuxna har analyserats. Studierna hämtades från databasen Pubmed. De patienter som behandlades med standarddos vasopressin istället för den första eller andra standarddosen adrenalin hade bättre överlevnad till sjukhusinläggning (31,6% jämfört med 26,0%, p <0,01). De patienter som behandlades med högdos adrenalin istället för standarddos adrenalin hade bättre överlevnad till sjukhusinläggning (26,1% jämfört med 23,1%, p <0,05). Ingen överlevnadsfördel till sjukhusutskrivning fanns för varken standarddos vasopressin eller högdos adrenalin. Dock behövs fler studier med fler patienter för att verifiera resultaten i denna litteraturstudie. Det vore även intressant med studier som fokuserar på de enskilda hjärtstilleståndsrytmerna. Dessutom behövs mer forskning om de potentiellt negativa effekterna på hjärtat och hjärnan som högdos adrenalin kan ha. Orsaken till den dåliga överlevnaden till sjukhusutskrivning oavsett vasopressorisk behandling behöver utredas. / Cardiac arrest is a state when the heart has lost the ability to pump blood to the body which causes cerebral and coronary ischemia. Cardiac arrest is defined as sudden and sustained unconsciousness with pulselessness and suspension of breathing or agonal breathing. Common symptoms that can arise one hour before a cardiac arrest includes dizziness, tiredness, chest pain and breathing difficulties. The treatment for cardiac arrest in Sweden includes basic and advanced cardiac life support. The most important measures are cardiopulmonary resuscitation, defibrillation and drug administration. The drug of choice is standard dose adrenaline based on its vasoconstricting and thus blood pressure raising effect. The aim of this study was to evaluate the effect of standard dose vasopressin alternatively high dose adrenaline compared to standard dose adrenaline in adults with cardiac arrest. This study is a literature review where seven studies on the effect of standard dose adrenaline compared to standard dose vasopressin alternatively high dose adrenaline on cardiac arrest in adults have been analyzed. The studies were found in the database Pubmed. Four studies evaluate the effect on survival by standard dose vasopressin compared to standard dose adrenaline. Three studies evaluate the effect on survival by high dose adrenaline compared to standard dose adrenaline. Patients that were treated with standard dose vasopressin instead of the first or second standard dose adrenaline had better survival to hospital admission (31,6% compared to 26,0%, p <0,01). Patients that were treated with high dose adrenaline instead of standard dose adrenaline had better survival to hospital admission (26,1% compared to 23,1%, p <0,05). There were no effects on survival to hospital discharge for either standard dose vasopressin or high dose adrenaline. More studies are needed though with more patients to verify the results of this literature review. It would also be interesting with studies that focus on the different cardiac arrest rhytms. More research is needed about the potential negative effects on the heart and brain caused by high dose adrenaline. The reason for the bad results regarding survival to hospital discharge regardless of vasopressive treatment needs to be evaluated.