A Poor Association Between Out-of-Hospital Cardiac Arrest Location and Public Automated External Defibrillator Placement

Levy, Matthew J.; Seaman, Kevin G.; Millin, Michael G.; Bissell, Richard A.; Jenkins, J. Lee

doi:10.1017/s1049023x13000411

Cited by 24 publications

(18 citation statements)

References 23 publications

(40 reference statements)

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“…Some studies have shown a poor correlation between the locations of most out-of-hospital cardiac arrests and the locations of most AEDs. 26,27 In addition, many AEDs are located inside buildings or in other sites that cannot be accessed at night or on weekends, which further reduces the availability of public-access defibrillation. 28 Policies for improving the location and accessibility of AEDs may help to alleviate these problems.…”

Section: Discussionmentioning

confidence: 99%

Public-Access Defibrillation and Out-of-Hospital Cardiac Arrest in Japan

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Public-Access Defibrillation and Out-of-Hospital Cardiac Arrest in Japan

et al. 2016

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“…Previous work from the USA described a poor association between location of OHCAs and AED placements and stated that no AEDs were located in the most frequent locations for OHCAs. 40 That study included OHCAs in patients' homes, which we believe may obscure the analysis of associations between OHCA and AED locations. Previous work concludes that public AED use is most effective in public settings 10 41 42 and not in peoples' homes.…”

Section: Discussionmentioning

confidence: 99%

Use of a geographic information system to identify differences in automated external defibrillator installation in urban areas with similar incidence of public out-of-hospital cardiac arrest: a retrospective registry-based study

et al. 2017

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ObjectivesEarly defibrillation in out-of-hospital cardiac arrest (OHCA) is of importance to improve survival. In many countries the number of automated external defibrillators (AEDs) is increasing, but the use is low. Guidelines suggest that AEDs should be installed in densely populated areas and in locations with many visitors. Attempts have been made to identify optimal AED locations based on the incidence of OHCA using geographical information systems (GIS), but often on small datasets and the studies are seldom reproduced. The aim of this paper is to investigate if the distribution of public AEDs follows the incident locations of public OHCAs in urban areas of Stockholm County, Sweden.MethodOHCA data were obtained from the Swedish Register for Cardiopulmonary Resuscitation and AED data were obtained from the Swedish AED Register. Urban areas in Stockholm County were objectively classified according to the pan-European digital mapping tool, Urban Atlas (UA). Furthermore, we reclassified and divided the UA land cover data into three classes (residential, non-residential and other areas). GIS software was used to spatially join and relate public AED and OHCA data and perform computations on relations and distance.ResultsBetween 1 January 2012 and 31 December 2014 a total of 804 OHCAs occurred in public locations in Stockholm County and by December 2013 there were 1828 AEDs available. The incidence of public OHCAs was similar in residential (47.3%) and non-residential areas (43.4%). Fewer AEDs were present in residential areas than in non-residential areas (29.4% vs 68.8%). In residential areas the median distance between OHCAs and AEDs was significantly greater than in non-residential areas (288 m vs 188 m, p<0.001).ConclusionThe majority of public OHCAs occurred in areas classified in UA as ‘residential areas‘ with limited AED accessibility. These areas need to be targeted for AED installation and international guidelines need to take geographical location into account when suggesting locations for AED installation.

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“…19 However, these locations may not be high risk locations for OHCAs—a study of OHCAs in Maryland found that the most frequent locations for AEDs (such as community pools and schools) had the lowest incidence of OHCAs and, conversely, the highest risk OHCA locations (such as nursing facilities and assisted living facilities) had no AEDs. 20 …”

Section: Introductionmentioning

confidence: 99%

Employment and residential characteristics in relation to automated external defibrillator locations

Griffis

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Ruther

et al. 2016

American Heart Journal

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Background Survival from out-of-hospital cardiac arrest (OHCA) is generally poor and varies by geography. Variability in automated external defibrillator (AED) locations may be a contributing factor. To inform optimal placement of AEDs, we investigated AED access in a major US city relative to demographic and employment characteristics. Methods and Results This was a retrospective analysis of a Philadelphia AED registry (2,559 total AEDs). The 2010 US Census and the Local Employment Dynamics (LED) database by ZIP code was used. AED access was calculated as the weighted areal percentage of each ZIP code covered by a 400 meter radius around each AED. Of 47 ZIP codes, only 9%(4) were high AED service areas. In 26%(12) of ZIP codes, less than 35% of the area was covered by AED service areas. Higher AED access ZIP codes were more likely to have a moderately populated residential area (p=0.032), higher median household income (p=0.006), and higher paying jobs (p=008). Conclusions The locations of AEDs vary across specific ZIP codes; select residential and employment characteristics explain some variation. Further work on evaluating OHCA locations, AED use and availability, and OHCA outcomes could inform AED placement policies. Optimizing the placement of AEDs through this work may help to increase survival.

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A Poor Association Between Out-of-Hospital Cardiac Arrest Location and Public Automated External Defibrillator Placement

Abstract: A poor association exists between the location of cardiac arrests and the location of AEDs.

Cited by 24 publications

References 23 publications

Public-Access Defibrillation and Out-of-Hospital Cardiac Arrest in Japan

Public-Access Defibrillation and Out-of-Hospital Cardiac Arrest in Japan

Use of a geographic information system to identify differences in automated external defibrillator installation in urban areas with similar incidence of public out-of-hospital cardiac arrest: a retrospective registry-based study

Employment and residential characteristics in relation to automated external defibrillator locations

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