How to improve automated external defibrillator placement for out-of-hospital cardiac arrests: A case study

Abstract

Introduction In out-of-hospital cardiac arrests (OHCAs), the use of an automatic external defibrillator (AED) by a bystander remains low, as AEDs may be misplaced with respect to the locations of OHCAs. As the distribution of historical OHCAs is potentially predictive of future OHCA locations, the purpose of this study is to assess AED positioning with regard to past locations of OHCAs, in order to improve the efficiency of public access defibrillation programs. Methods This is a retrospective observational study from 2014 to 2018. The locations of historical OHCAs and AEDs were loaded into a geodata processing tool. Median distances between AEDs were collected, as well as the number and rates of OHCAs covered (distance of <100 meters from the nearest AED). Areas with high densities of uncovered OHCAs (hotspots) were identified in order to propose the placement of additional AEDs. Areas over-covered by AEDs (overlays) were also identified in order to propose the relocation of overlapping AEDs. Results There were 2,971 OHCA, 79.3% of which occurred at home, and 633 AEDs included in the study. The global coverage rate was 7.5%. OHCAs occurring at home had a coverage rate of 4.5%. Forty hotspots were identified, requiring the same number of additional AEDs. The addition of these would increase the coverage from 7.5% to 17.6%. Regarding AED overlays, 17 AEDs were found to be relocatable without reducing the AED coverage of historical OHCAs. Discussion This study confirms that geodata tools can assess AED locations and increase the efficiency of their placement. Historical hotspots and AED overlays should be considered, with the aim of efficiently relocating or adding AEDs. At-home OHCAs should become a priority target for future public access defibrillation programs as they represent the majority of OHCAs but have the lowest AED coverage rates.

A study of factors associated with the prognosis of cardiac arrest patients in a depopulated area with a high elderly population transported by Shimoda Fire Department

“…In addition, the ratio of cardiac arrests in public areas, such as schools, museums, exercise facilities, stations, and airports, was 2.6% in Tokyo, compared with one (0.3%) patient suffering cardiac arrest in a public area (school) in the present study. This fact may also have contributed to the lack of patients undergoing electrical shock with an AED in the present study 7,8) . Furthermore, the rate of people living alone with solitary deaths has increased in rural areas 9) .…”

Defibrillator access across Australia: the first step in avoiding a chain of fatality

“…Apart from improving PAD density, strategic PAD location should also be deployed. Geodata analysis can ensure that PADs are deployed where they are most likely to be used, and that oversaturation of public and high income areas does not occur 21,22 . Given that 80% of cardiac arrests occur in the home, the greatest challenge is getting PADs into people's homes at any time of day 23 .…”

Observed Equity and Driving Factors of Automated External Defibrillators: A Case Study Using WeChat Applet Data

“…This study further identified and quantified the determinants affecting the spa distribution of AED equity in Guangzhou and Shenzhen using the OPGD model. Bas on the AED-related literature [4,[7][8][9][10]13] and characteristics of the study area, we selec potential determinants from six aspects (Figure 5): local economic level, population d sity, proportion of elderly people, mobility, company density, and residential density. In terms of variable selection, we choose per capita GDP as a variable, representi the level of local economic development.…”

“…When OHCA occurs, the heart stops pumping blood, resulting in insufficient oxygen supply, which can lead to death if first aid measures such as cardiopulmonary resuscitation (CPR) and electrical defibrillation are not performed promptly [5,6]. This is an emergency situation that requires immediate measures for cardiopulmonary resuscitation and the use of an automated external defibrillator (AED) to resume the heart beating on its own as early as possible [7][8][9][10]. The overall incidence of cardiac arrest in China in 2021 was 97.1 per 100,000 [11].…”