Public health surveillance of automated external defibrillators in the USA: protocol for the dynamic automated external defibrillator registry study

Abstract

IntroductionLay use of automated external defibrillators (AEDs) before the arrival of emergency medical services (EMS) providers on scene increases survival after out-of-hospital cardiac arrest (OHCA). AEDs have been placed in public locations may be not ready for use when needed. We describe a protocol for AED surveillance that tracks these devices through time and space to improve public health, and survival as well as facilitate research.Methods and analysisIncluded AEDs are installed in public locations for use by laypersons to treat patients with OHCA before the arrival of EMS providers on scene. Included cases of OHCA are patients evaluated by organised EMS personnel and treated for OHCA. Enrolment of 10 000 AEDs annually will yield precision of 0.4% in the estimate of readiness for use. Enrolment of 2500 patients annually will yield precision of 1.9% in the estimate of survival to hospital discharge. Recruitment began on 21 Mar 2014 and is ongoing. AEDs are found by using multiple methods. Each AED is then tagged with a label which is a unique two-dimensional (2D) matrix code; the 2D matrix code is recorded and the location and status of the AED tracked using a smartphone; these elements are automatically passed via the internet to a secure and confidential database in real time. Whenever the 2D matrix code is rescanned for any non-clinical or clinical use of an AED, the user is queried to answer a finite set of questions about the device status. The primary outcome of any clinical use of an AED is survival to hospital discharge. Results are summarised descriptively.Ethics and disseminationThese activities are conducted under a grant of authority for public health surveillance from the Food and Drug Administration. Results are provided periodically to participating sites and sponsors to improve public health and quality of care.

Simulation of the Effects of Co-Locating Naloxone with Automated External Defibrillators

“…More technologically advanced solutions are available as well, including 911-connected AED cabinets and the FDA-sponsored HeartMap Challenge, which places QR-coded labels on publicly accessible AEDs, enabling real-time tracking of usage. 6,13…”

“…5 Physical AED locations are frequently marked with highly visible signage which make them easy to find in an emergency, and locations of publicly accessible AEDs are increasingly being integrated into electronic databases that enable wide and rapid dissemination. 6 Furthermore, AEDs are broadly distributed across cities in a wide variety of location and building types, owing to the spontaneous nature of out-of-hospital cardiac arrest. 7 Geographically, public overdoses have been shown to occur most frequently in urban locations, leading to potential overlap in AED placement and overdose incidence.…”

Modeling a novel hypothetical use of postal collection boxes as automated external defibrillator access points

“…Mechanisms for locating AEDs included crowdsourcing through the HeartMap Challenge 6 , direct contact with AED distribution programs, and active searching throughout the city by study personnel. AED locations were first recorded as street addresses and then geocoded to latitude/longitude coordinates using the publically available Quantum Geographic Information Systems (QGIS, ver.…”

Assessment of Canadian Public Automated External Defibrillator Registries

“…One study described a protocol for a dynamic AED registry, whereby AEDs are tagged with a 2-dimensional matrix code (QR code). 21 This code is scanned with a smartphone that allows for automatic identification of AED parameters. Information regarding AED status and location is obtained and then transmitted in real time to the dynamic registry.…”