Is Distance to the Nearest Registered Public Automated Defibrillator Associated with the Probability of Bystander Shock for Victims of Out-of-Hospital Cardiac Arrest?

Briard, Joel Neves; Montigny, Luc de; Ross, Dolorosa Maria; Champlain, François de; Segal, Eli

doi:10.1017/s1049023x18000080

Cited by 10 publications

(4 citation statements)

References 23 publications

(53 reference statements)

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“…Neither the international nor the national variation is fully understood but may be attributed to multiple factors such as organization of the Emergency Medical Service (EMS) system, 16,17 the response time of the EMS, 16 bystander cardiopulmonary resuscitation (CPR), 4,18 and the use of Automatic External Defibrillators 4,16,19,20 . However, Dyson et al 21 found that the Utstein core factors accounted for only 51% of the global variation in survival to hospital discharge.…”

Section: Introductionmentioning

confidence: 99%

International initiation and termination of resuscitation practices: Protocol of a cross‐sectional survey

Havshøj

Juhl

Milling

et al. 2022

Acta Anaesthesiol Scand

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Background: Substantial variation in survival following out-of-hospital cardiac arrest (OHCA) is described both internationally and nationally. The Utstein factors account for half of the variation, but the remaining is not fully understood. Local regulations or guidelines concerning the withholding and termination of resuscitation may influence the reporting of cardiac arrests when comparing outcomes between different Emergency Medical Service systems. Method:We have developed an online cross-sectional mixed-methods explanatory design survey aimed at describing the international and national variations in the initiation, the termination of resuscitation, and the refraining from resuscitation of adult patients (>18 years of age) suffering from non-traumatic OHCA. The respondents will be national experts and the questionnaire will be distributed among members of European Prehospital Research Alliance, the International Liaison Committee of Resuscitation, the European Resuscitation Council, and the Resuscitation Academy.Each invited country will have to identify at least two national experts with special expertise in prehospital resuscitation practices. We exclude countries with less than two respondents.Results: The survey will provide both quantitative and qualitative data. Quantitative data will be presented as frequencies and proportions. Qualitative data will be analyzed using content analysis. Conclusion:This survey could be of importance in understanding the multiple factors leading to the substantial variation in survival found following OHCA. Furthermore, the interpretation of future studies on OHCA from different settings may be improved to further increase survival following OHCA.

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Section: Introductionmentioning

confidence: 99%

International initiation and termination of resuscitation practices: Protocol of a cross‐sectional survey

Havshøj

Juhl

Milling

et al. 2022

Acta Anaesthesiol Scand

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show abstract

“…Fortunately, defibrillation can be performed by bystanders if an automatic external defibrillator (AED) is available. Any OHCA taking place within a 100 m radius of an AED is considered to be "covered", as the device is reachable within 90 seconds by brisk walking, allowing defibrillation to be performed within 3-5 minutes [4][5][6][7], as recommended by the American Heart Association (AHA) [8]. Therefore, public authorities have launched public access defibrillation (PAD) programs, as recommended by the European Resuscitation Council Guidelines [2].…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, the use of an AED by a bystander remains low for a number of reasons. AEDs may be misplaced regarding location of OHCAs [4][5][6][10][11][12], be inaccessible at the time of the OHCA [13][14][15][16] or not registered through the dispatch centre, or bystanders may have difficulty finding them because their locations are poorly indicated [17]. Finally, most OHCAs occur at home, often with no one else around, or with only a sole elderly witness, and these locations are less covered by AEDS [18].…”

Section: Introductionmentioning

confidence: 99%

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

2021

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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.

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“…Providing bystanders with knowledge of AED locations can facilitate their identification and retrieval, 15 reduce time to defibrillation, 22 and, ultimately, may improve OHCA outcomes. Electronic AED maps and applications are being developed and tested to improve timely bystander location and retrieval of AEDs 11,15 .…”

mentioning

confidence: 99%

Out-of-Hospital Cardiac Arrest Bystander Defibrillator Search Time and Experience With and Without Directional Assistance: A Randomized Simulation Trial in a Community Setting

Johnson

Cunningham²,

Zègre‐Hemsey³

et al. 2021

Sim Healthcare

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Introduction: Probability of survival after out-of-hospital cardiac arrest (OHCA) doubles when a bystander initiates cardiopulmonary resuscitation and uses an automated external defibrillator (AED) rapidly. National, state, and community efforts have increased placement of AEDs in public spaces; however, bystander AED use remains less than 2% in the United States. Little is known about the effect of giving bystanders directional assistance to the closest public access AED. Methods: We conducted 35 OHCA simulations using a life-sized manikin with participants aged 18 through 65 years who searched for public access AEDs in 5 zones on a university campus. Zones varied by challenges to pedestrian AED acquisition and number of fixed AEDs. Participants completed 2 searches-first unassisted and then with verbal direction to the closest AED-and we compared AED delivery times. We conducted pretest and posttest surveys. Results: In all 5 zones, the median time from simulated OHCA onset to AED delivery was lower when the bystander received directional assistance. Time savings (minutes:seconds) varied by zone, ranging from a median of 0:53 (P = 0.14) to 3:42 (P = 0.02). Only 3 participants immediately located the closest AED without directional assistance; more than half reported difficulty locating an AED. Conclusions: These findings may inform strategies to ensure that AEDs are consistently marked and placed in visible, accessible locations. Continued emphasis on developing strategies to improve lay bystanders' ability to locate and use AEDs may improve AED retrieval times and OHCA outcomes.

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Is Distance to the Nearest Registered Public Automated Defibrillator Associated with the Probability of Bystander Shock for Victims of Out-of-Hospital Cardiac Arrest?

Cited by 10 publications

References 23 publications

International initiation and termination of resuscitation practices: Protocol of a cross‐sectional survey

International initiation and termination of resuscitation practices: Protocol of a cross‐sectional survey

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

Out-of-Hospital Cardiac Arrest Bystander Defibrillator Search Time and Experience With and Without Directional Assistance: A Randomized Simulation Trial in a Community Setting

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