Real-world insight into public access defibrillator use over five years

Abstract

BackgroundPublic access defibrillators (PADs) represent unique life-saving medical devices as they may be used by untrained lay rescuers. Collecting representative clinical data on these devices can be challenging. Here, we present results from a retrospective observational cohort study, describing real-world PAD utilisation over a 5-year period.MethodsData were collected between October 2012 and October 2017. Responders voluntarily submitted electronic data downloaded from HeartSine PADs, and patient demographics and other details using a case report form in exchange for a replacement battery and electrode pack.ResultsData were collected for 977 patients (692 males, 70.8%; 255 females, 26.1%; 30 unknown, 3.1%). The mean age (SD) was 59 (18) years (range <1 year to 101 years). PAD usage occurred most commonly in homes (n=328, 33.6%), followed by public places (n=307, 31.4%) and medical facilities (n=128, 13.1%). Location was unknown in 40 (4.09%) events. Shocks were delivered to 354 patients. First shock success was 312 of 350 patients where it could be determined (89.1%, 95% CI 85.4% to 92.2%). Patients with reported response times ≤5 min were more likely to survive to hospital admission (89/296 (30.1%) vs 40/250 (16.0%), p<0.001). Response time was unknown for 431 events.ConclusionThis is the first study to report global PAD usage in voluntarily submitted, unselected real-world cases and demonstrates the real-world effectiveness of PADs, as confirmed by first shock success.

Shortening time to defibrillation in shockable cardiac arrest matters: how do we do it?

“…Leveraging this scientific understanding, resuscitation systems have invested in a range of programmes designed to shorten ‘time to shock’ starting with rapid response by emergency medical services (EMS) as a cornerstone. Rapid EMS response can be supplemented by innovative approaches to achieve earlier shock through deployment of fixed-location public access defibrillators (PADs),3 crowdsourcing through smartphone applications directing willing volunteers to retrieve and apply an automatic external defibrillator (AED),4 and training, equipping, and dispatching of professional first responders (firefighters, police) 5. Experimental approaches include the use of drone technology to expedite AED delivery 6…”