Locations of Cardiac Arrest: Affirmation for Community Public Access Defibrillation (PAD) Program

AbstractBackground:The purpose of this study was to describe the regional locations of cardiac arrest, and to identify public locations and the annual incidence of arrests within the identified locations, in order to help to determine optimal placement of Automatic External Defibrillators (AEDs) under the regional Public Access Defibrillation (PAD) Program. This is a retrospective study.Methods:The locations of cardiac arrest were abstracted from Ambulance Call Reports (ACRs) collected by the Essex-Kent Base Hospital Centre from regional ambulance services throughout the City of Windsor, and the Counties of Essex and Kent, Ontario, Canada, from 01 January 1994 through 31 December 2000. Arrest locations were grouped into five categories, and then the number of public venues was determined. Public sites were grouped into 28 Public Locations. Also included in the Public Sites were both General Industry and Outdoors categories. Categories identified but excluded from Public Sites were Institutions and Private Residences.Results:During the study, 2,295 arrests occurred, 152 cases were excluded, 2,142 arrests were categorized, (average annual incidence of 306 ±50.4 cardiac arrests), 329 (15.4%) of which were in Public Sites. Nineteen public venues had an average of >1 arrest/year, and nine public venues had an average of ≤1 arrest/year during the study, period. Calculations of the annual incidence of arrests for each public location were completed.Conclusions:These findings have significant prehospital emergency cardiac care implications for communities that wish to strengthen/improve their responses to out-of-hospital cardiac arrests. Public Access Defibrillation Programs should identify the site-specific incidence of arrest within their communities in order to provide legitimacy for funding and planning of programs. Training and availability of AEDs will reduce the time to first shock, thus strengthening the chain-of-survival and will save more lives.

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Outcomes of Out‐of‐Hospital Cardiac Arrest by Public Location in the Public‐Access Defibrillation Era

Journal of the American Heart Association ◽

10.1161/jaha.113.000533 ◽

2014 ◽

Vol 3 (2) ◽

Cited By ~ 56

Author(s):

Yukiko Murakami ◽

Taku Iwami ◽

Tetsuhisa Kitamura ◽

Chika Nishiyama ◽

Tatsuya Nishiuchi ◽

...

Keyword(s):

Cardiac Arrest ◽

Public Access ◽

The Public ◽

Public Access Defibrillation ◽

Hospital Cardiac Arrest

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Location of arrest and survival from out-of-hospital cardiac arrest among children in the public-access defibrillation era in Japan

Resuscitation ◽

10.1016/j.resuscitation.2019.04.045 ◽

2019 ◽

Vol 140 ◽

pp. 150-158 ◽

Cited By ~ 5

Author(s):

Satoshi Matsui ◽

Tetsuhisa Kitamura ◽

Junya Sado ◽

Kosuke Kiyohara ◽

Daisuke Kobayashi ◽

...

Keyword(s):

Cardiac Arrest ◽

Public Access ◽

The Public ◽

Public Access Defibrillation ◽

Hospital Cardiac Arrest

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Public access defibrillation remains out of reach for most victims of out-of-hospital sudden cardiac arrest

Heart ◽

10.1136/heartjnl-2013-305030 ◽

2014 ◽

Vol 100 (8) ◽

pp. 619-623 ◽

Cited By ~ 53

Author(s):

Charles D Deakin ◽

Elizabeth Shewry ◽

Huon H Gray

Keyword(s):

Cardiac Arrest ◽

Weak Link ◽

Public Awareness ◽

Sudden Cardiac Arrest ◽

Public Access ◽

Public Access Defibrillation ◽

South Central ◽

Public Areas ◽

Chain Of Survival ◽

The Uk

IntroductionPublic access defibrillation (PAD) prior to ambulance arrival is a key determinant of survival from out-of-hospital (OOH) cardiac arrest. Implementation of PAD has been underway in the UK for the past 12 years, and its importance in strengthening the chain of survival has been recognised in the government's recent ‘Cardiovascular Disease Outcomes Strategy’. The extent of use of PAD in OOH cardiac arrests in the UK is unknown. We surveyed all OOH cardiac arrests in Hampshire over a 12-month period to ascertain the availability and effective use of PAD.MethodsA retrospective review of all patients with OOH cardiac arrest attended by South Central Ambulance Service (SCAS) in Hampshire during a 1-year period (1 September 2011 to 31 August 2012) was undertaken. Emergency calls were reviewed to establish the known presence of a PAD. Additionally, a review of all known PAD locations in Hampshire was undertaken, together with a survey of public areas where a PAD may be expected to be located.ResultsThe current population of Hampshire is estimated to be 1.76 million. During the study period, 673 known PADs were located in 278 Hampshire locations. Of all calls confirmed as cardiac arrest (n=1035), the caller reported access to an automated external defibrillator (AED) on 44 occasions (4.25%), successfully retrieving and using the AED before arrival of the ambulance on only 18 occasions (1.74%).ConclusionsDespite several campaigns to raise public awareness and make PADs more available, many public areas have no recorded AED available, and in those where an AED was available it was only used in a minority of cases by members of the public before arrival of the ambulance. Overall, a PAD was only deployed successfully in 1.74% OOH cardiac arrests. This weak link in the chain of survival contributes to the poor survival rate from OOH cardiac arrest and needs strengthening.

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Strategic Mapping and Optimised Allocation of Automated External Defibrillators in Urban Areas

International Journal of Scientific Research in Computer Science Engineering and Information Technology ◽

10.32628/cseit206617 ◽

2020 ◽

pp. 138-145

Author(s):

Kanteler Despoina ◽

Katsaros Evangelos ◽

Bakouros Yiannis

Keyword(s):

Cardiac Arrest ◽

Urban Areas ◽

Hot Spot ◽

Public Access ◽

Capital City ◽

Public Health Issue ◽

Time Range ◽

Public Access Defibrillation ◽

Full Coverage ◽

The City

Background: Out-of-hospital cardiac arrest (OHCA) is a leading cause of death and is regarded as a significant public health issue. Immediate treatment with an automated external defibrillator (AED) increases OHCA patient survival potential. For AEDs to be used and fulfil their lifesaving potential, they need to be in close proximity to the victim and accessible at the time of a cardiac arrest. The current paper sheds light upon an optimized location-allocation method achieving full coverage with immediate accessibility in an urban context given a limited number of available AEDs for deployment using GIS. The case study is the Region of Western Macedonia (RWM) in Greece for a pilot AED placement program for the Governance of RWM. The focus of the current study is the capital city of RWM, Kozani. The initial number of the defibrillators (120) that are needed to be distributed is very small and cannot cover the needs for every major city or rural area in the region. Out of the 120 AEDs, the challenge is to find the minimum required number of AEDs to allocate in the city providing full coverage and accessibility. This paper focuses only on one city, however, the same methodology was applied to allocate AEDs in the other selected cities of the region. The rural dimension and methodology are not in the scope of this paper. Methods: Road network data, spatio-temporal analysis of accessibility network, digital elevation model, land uses, population density, seasonal fluctuations and socio-demographic variables were used. GIS algorithms such as spatial analysis, kernel density, hot spot analysis, maximal covering location problem (MCLP) tests, proximity algorithms, buffer zoning, were a few of the tests made in order to find the most efficient positions and maximize coverage keeping in mind that access to an AED until defibrillation time must not exceed the time range of five minutes. Results: optimised sites and allocated AEDs in urban areas we managed to achieve full city coverage with 17 AEDs. In every part of the city, people can have access to a nearby AED with its critical radius of less than or equal to 250m achieving defibrillation in the critical period of 5 minutes. The results are promising for the establishment and expansion of optimised AED deployment in cities. Conclusions: The progress of the project must be monitored and there are still unresolved problems that need to be tackled to provide a robust allocation of future defibrillators. Further research to enhance our understanding on public access defibrillation and optimize the accessibility and functionality of the medical health care services is needed. A network of engaged and informed citizens ready to act is required for a successful public access defibrillation program.

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