Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-23T10:23:30.793Z Has data issue: false hasContentIssue false
  • English
  • Français

Chain of Survival at Mass Gatherings: A Case Series of Resuscitation Events

Published online by Cambridge University Press:  28 June 2012

Jamie Ranse  and
Kathryn Zeitz
Jamie Ranse*
Affiliation:
Clinical Manager (Research Portfolio), Emergency Department, Calvary Health Care ACT, Australia Chief Nurse, St John Ambulance Australia Research Associate, Flinders University, Research Centre for Disaster Resilience and Health, South Australia
Kathryn Zeitz
Affiliation:
National Staff Officer, St John Ambulance Australia Adjunct Associate Professor School of Nursing, Flinders University, South Australia
*
[email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

At a large public event, or mass gathering, various factors influence patient presentations that brings challenges to patient care. The chain of survival has been investigated in the prehospital setting. However, this has not explicitly included the mass-gathering environment.

Objective:

This study sought to determine the facilitators and barriers to the chain of survival at mass gatherings.

Methods:

This case-series research was exploratory and descriptive, using the analysis of personal experiences of resuscitation. Participants were members of St John Ambulance Australia who had participated actively in a resuscitation event in 2007. Telephone interviews were used as a means of data collection. Participant narrative was recorded electronically, transcribed verbatim, and analyzed thematically using a well established human science approach.

Results:

The thematic analysis revealed five main themes and a number of sub-themes. Four of the main themes were aligned easily with the four chain of survival links. The remaining main theme outlined a new link in the chain of survival of specific importance to mass gatherings, ‘early planning’. Additionally, a number of sub-themes were identified, which exemplified various facilitators and barriers to the chain of survival in this environment.

Conclusions:

This research highlights various barriers and facilitators to the chain of survival in the mass-gathering environment. Additionally, the unique “early planning” link in the chain of survival as described in this research highlights the importance of a preparatory phase for responders at mass gatherings.

Keywords

chain of survivalfirst respondermass gatheringresuscitation
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 25 , Issue 5 , October 2010 , pp. 457 - 463
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Bernard, S: Outcome from prehospital cardiac arrest in Melbourne, Australia. Emerg Med 1998;10:25–29.CrossRefGoogle Scholar
2.Finn, J, Jacobs, I, Holman, C, Oxer, H: Outcomes of out-of-hospital cardiac arrest patients in Perth, Western Australia, 1996-1999. Resuscitation 2001;51(3):247–255.CrossRefGoogle ScholarPubMed
3.Cummins, RO, Ornato, JP, Thies, WH, et al: Improving survival from sudden cardiac arrest: The “chain of survival” concept. A statement for health professionals from the Advanced Cardiac Life Support Subcommittee and the Emergency Cardiac Care Committee, American Heart Association. Circulation 1991;83:1832–1847.Google ScholarPubMed
4.Arbon, P: Mass-gathering medicine: A review of the evidence and future directions for research. Prehosp Disast Med 2007;22(2):131–135.CrossRefGoogle ScholarPubMed
5.Zeitz, K, Tan, H Zeitz, C: Crowd behaviour at mass gatherings—A literature review. Prehosp Disast Med 2009;24(1):32–38.CrossRefGoogle Scholar
6.Valenzuela, T, Roe, D, Nichol, G, et al: Outcomes of rapid defibrillation by security officers after cardiac arrest in casinos. N Engl J Med 2000;343(17):1206–1209.CrossRefGoogle ScholarPubMed
7.Caffrey, S, Willoughby, P, Pepe, P, Becker, L: Public use of automated external defibrillators. N Engl J Med 2002;347(16):1142–1147.CrossRefGoogle ScholarPubMed
8.Page, R, Joglar, J, Kowal, R, et al: Use of automated external defibrillators by a US airline. N Eng J Med 2000;343(17):1210–1216.CrossRefGoogle ScholarPubMed
9.Zeitz, KM, Zeitz, CJ, Grantham, H, Elliot, R: Out-of-hospital cardiac arrest— A review of the demographics of the event in South Australia to inform decisions about the provision of semi-automatic external defibrillators within the community. Prehosp Disaster Med 2010;25(6): in press.CrossRefGoogle Scholar
10.Hallstrom, A, Ornato, J, Weisfeldt, M, et al: Public access defibrillation and survival after out-of-hospital cardiac arrest. N Engl J Med 2004;351:637–646.Google ScholarPubMed
11.Moore, M, Hamilton, A, Cairns, K, et al: The Northern Ireland Public Access Defibrillation (NIPAD) study: Effectiveness in urban and rural populations. Heart 2008;94:1614–1619.CrossRefGoogle ScholarPubMed
12.Ranse, J, Burke, B: Exploring the volunteer first aider's experience post-resuscitation. Journal of Emergency Primary Health Care 2006;4(3):9.Google Scholar
13.Zeitz, CJ, Zeitz, KM, Ward, G, Inglis, A: Training first aiders in the use of automatic defibrillation. Resuscitation 2002;56(1):77–82.CrossRefGoogle Scholar
14.Wassertheil, J, Keane, G, Fisher, N, Ledistschke, JF: Cardiac arrest outcomes at the Melbourne Cricket Gound and Shrine of Remembrance using a tired response strategy—A forerunner to public access defibrillation. Resuscitation 2000;44(2):97–104.CrossRefGoogle Scholar
15.Denzin, N, Lincoln, Y: Handbook of Qualitative Research, 2nd ed. London: Sage Publications, 2000.Google Scholar
16.van Manen, M: Researching Lived Experience: Human Science for an Action Sensitive Pedagogy. New York: The State University of New York; 1990.Google Scholar
17.Arbon, P, Zeitz, K, Ranse, J, Wren, H, Driscoll, K, Elliott, R: The reality of multiple casualty triage: Putting triage theory into practice at the scene of multiple casualty vehicular accidents. Emergency Medicine Journal 2008;25(4):230–234.CrossRefGoogle Scholar
18.Ranse, J, Arbon, P: Graduate nurses' lived experience of in-hospital resuscitation—A hermeneutic phenomenological approach. Australian Critical Care 2008;21(1):38–47.CrossRefGoogle ScholarPubMed