Underutilisation of public access defibrillation is related to retrieval distance and time-dependent availability
Deakin, Charles D. Anfield, Steve Hodgetts, Gillian A.
Deakin, Charles D.
Anfield, Steve
Hodgetts, Gillian A.
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Abstract
Introduction Public access defibrillation doubles the
chances of neurologically intact survival following outof-hospital cardiac arrest (OHCA). Although there are
increasing numbers of defibrillators (automated external
defibrillator (AEDs)) available in the community, they
are used infrequently, despite often being available.
We aimed to match OHCAs with known AED locations
in order to understand AED availability, the effects of
reduced AED availability at night and the operational
radius at which they can be effectively retrieved.
Methods All emergency calls to South Central
Ambulance Service from April 2014 to April 2016 were
screened to identify cardiac arrests. Each was mapped to
the nearest AED, according to the time of day. Mapping
software was used to calculate the actual walking
distance for a bystander between each OHCA and
respective AED, when travelling at a brisk walking speed
(4 mph).
Results 4012 cardiac arrests were identified and
mapped to one of 2076 AEDs. All AEDs were available
during daytime hours, but only 713 at night (34.3%).
5.91% of cardiac arrests were within a retrieval
(walking) radius of 100m during the day, falling to
1.59% out-of-hours. Distances to rural AEDs were
greater than in urban areas (P<0.0001). An AED could
potentially have been retrieved prior to actual ambulance
arrival in 25.3% cases.
Conclusion Existing AEDs are underused; 36.4% of
OHCAs are located within 500m of an AED. Although
more AEDs will improve availability, greater use can be
made of existing AEDs, particularly by ensuring they are
all available on a 24/7 basis.
https://heart.bmj.com/content/heartjnl/104/16/1339.full.pdf
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
http://dx.doi.org/10.1136/heartjnl-2018-312998