Abstract 12132: Diurnal Variation in Citizen Responder and Automated External Defibrillation Coverage of Out-of-Hospital Cardiac Arrest in Denmark According to Area Types

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Nanna B Christensen ◽  
Fredrik Folke ◽  
Julie Kjoelbye ◽  
Louise Kollander Jakobsen ◽  
Anne J Jørgensen ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Time Of Day ◽  
High Density ◽  
Geographical Information ◽  
Residential Areas ◽  
High Coverage ◽  
Automated External Defibrillation ◽  
Working Day ◽  
Leisure Facilities ◽  
Hospital Cardiac Arrest

Introduction: Following the implementation of the Danish AED network and a nationwide citizen responder (CR) program for out-of-hospital cardiac arrest (OHCA), CR and AED coverage for OHCAs according to area types has not been investigated. We aimed to assess AED and CR coverage of historical OHCAs according to area types in daytime (12pm) and nighttime (12am). Methods: We included non-EMS witnessed OHCAs from the Danish Cardiac Arrest Registry (2016-2019) and AEDs registered with the Danish AED network (November 2020) available at 12am (n=22,418) and 12pm (n=14,734). Exact locations of CRs who were registered with the national CR program by December 2020 were identified on a normal working day (Wednesday, December 2, 2020) at 12am and 12pm (representing day- and nighttime location). OHCAs, AEDs, and CRs were identified and geocoded using a geographical information system. Urban Atlas was used to categorize areas into subgroups using satellite images; high density residential areas, low density residential areas, public and industrial sites, nature, sport and leisure facilities, transportation (e.g. airport and railway stations), and fast transit roads. Results: A total of 10,126 OHCAs (63.0% male, median age 73 years). We mapped 14,119 AEDs (12 pm) and 24,372 CR (12 pm) in Urban Atlas. Most OHCAs in all area types were covered by >= 1 AED. A greater variation was observed in CR coverage when compared to AED coverage, according to area type. Little difference in coverage of both AED and CR according to time of day was observed. (Figure 1) Conclusion: The highest CR and AED coverage were observed in high density residential areas, transportation sites, public and industrial areas, and sport and leisure facilities, which is where most OHCAs occurred. These findings indicate a high coverage of citizen responders and AEDs in Denmark.

scholarly journals Optimal Installation Locations for Automated External Defibrillators in Taipei 7-Eleven Stores: Using GIS and a Genetic Algorithm with a New Stirring Operator

2014 ◽  
Vol 2014 ◽  
pp. 1-12 ◽  
Author(s):  
Chung-Yuan Huang ◽  
Tzai-Hung Wen
Keyword(s):  
Genetic Algorithm ◽  
Cardiac Arrest ◽  
Time Of Day ◽  
Residential Areas ◽  
Automated External Defibrillators ◽  
Fire Stations ◽  
Survival Potential ◽  
Hospital Cardiac Arrest ◽  
Allocation Strategies ◽  
External Defibrillator

Immediate treatment with an automated external defibrillator (AED) increases out-of-hospital cardiac arrest (OHCA) patient survival potential. While considerable attention has been given to determining optimal public AED locations, spatial and temporal factors such as time of day and distance from emergency medical services (EMSs) are understudied. Here we describe a geocomputational genetic algorithm with a new stirring operator (GANSO) that considers spatial and temporal cardiac arrest occurrence factors when assessing the feasibility of using Taipei 7-Eleven stores as installation locations for AEDs. Our model is based on two AED conveyance modes, walking/running and driving, involving service distances of 100 and 300 meters, respectively. Our results suggest different AED allocation strategies involving convenience stores in urban settings. In commercial areas, such installations can compensate for temporal gaps in EMS locations when responding to nighttime OHCA incidents. In residential areas, store installations can compensate for long distances from fire stations, where AEDs are currently held in Taipei.

Abstract 13228: Out-of-Hospital Cardiac Arrest Coverage by Volunteer Citizen Responders and Automated External Defibrillators in Denmark

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Nanna B Christensen ◽  
Fredrik Folke ◽  
Louise Kollander Jakobsen ◽  
Anne J Jørgensen ◽  
Julie Kjoelbye ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Time Of Day ◽  
High Density ◽  
Successful Implementation ◽  
Automated External Defibrillators ◽  
Pilot Data ◽  
Hospital Cardiac Arrest ◽  
M 14

Introduction: High density of citizen responders (CR) and automated external defibrillators (AEDs) may increase chances for early bystander defibrillation in out-of-hospital cardiac arrest (OHCA). We aimed to assess coverage using current CR and AED positions applied on historical OHCAs in Denmark. Methods: Non-EMS witnessed OHCAs from the Danish cardiac arrest registry with known location (2016-2019) and AEDs registered with the Danish AED network (November 2020) were included. Locations of all CRs registered with the national CR program were identified (Wed, December 2, 2020) at 12pm (noon) and 12am (midnight). Since pilot data showed 25% of alerted CRs accepted the alarm, we investigated OHCA CR coverage defined ≥4 CR within <1800m (1969 yd), <500m (547 yd) and <200m (219 yd), and OHCA CR + AED coverage as ≥4 CR and 1 AED <1800m, <500m and <200m. We compared OHCA coverage during daytime and nighttime. Results: A total of 18,128 OHCAs (median age 73 years, 63.4% male) were included. A total of 22,418 AEDs (386/100,000 inhabitants) were available at 12pm, 65% were accessible 24/7. A total of 34,033 CR (586 CR/100,000 inhabitants) were available at 12am and 33,938 were available at12pm. During daytime, a median of 29 AEDs and 37 CRs were <1800m of historical OHCAs. Most OHCAs were covered by CRs and AEDs <1800m decreasing with shorter distances with little difference according to time of day (Figure 1). Conclusion: Following the implementation of a nationwide AED network and a citizen responder program, most historical OHCAs (85%) were < 1800m of CRs and AEDs at midnight with a slight decrease during daytime (82%). A decrease in CR and AED coverage were observed for 500m (59%) and 200 m (14%), with little difference according to time of day. During daytime a median of 29 AEDs and 37 CRs were < 1800m of historical OHCAs. Our results indicate successful implementation of a national AED registry and CR program with great potential for improving bystander defibrillation.

scholarly journals Implementation of a National 5‐Year Plan for Prehospital Emergency Care in Singapore and Impact on Out‐of‐Hospital Cardiac Arrest Outcomes From 2011 to 2016

2020 ◽  
Vol 9 (21) ◽  
Author(s):  
Andrew Fu Wah Ho ◽  
Nurun Nisa Amatullah De Souza ◽  
Audrey L. Blewer ◽  
Win Wah ◽  
Nur Shahidah ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Emergency Care ◽  
Survival Rates ◽  
Prehospital Emergency Care ◽  
Shockable Rhythm ◽  
Automated External Defibrillation ◽  
Bystander Cardiopulmonary Resuscitation ◽  
Prehospital Emergency ◽  
Hospital Cardiac Arrest

Background Outcomes of patients from out‐of‐hospital cardiac arrest (OHCA) vary widely globally because of differences in prehospital systems of emergency care. National efforts had gone into improving OHCA outcomes in Singapore in recent years including community and prehospital initiatives. We aimed to document the impact of implementation of a national 5‐year Plan for prehospital emergency care in Singapore on OHCA outcomes from 2011 to 2016. Methods and Results Prospective, population‐based data of OHCA brought to Emergency Departments were obtained from the Pan‐Asian Resuscitation Outcomes Study cohort. The primary outcome was Utstein (bystander witnessed, shockable rhythm) survival‐to‐discharge or 30‐day postarrest. Mid‐year population estimates were used to calculate age‐standardized incidence. Multivariable logistic regression was performed to identify prehospital characteristics associated with survival‐to‐discharge across time. A total of 11 465 cases qualified for analysis. Age‐standardized incidence increased from 26.1 per 100 000 in 2011 to 39.2 per 100 000 in 2016. From 2011 to 2016, Utstein survival rates nearly doubled from 11.6% to 23.1% ( P =0.006). Overall survival rates improved from 3.6% to 6.5% ( P <0.001). Bystander cardiopulmonary resuscitation rates more than doubled from 21.9% to 56.3% and bystander automated external defibrillation rates also increased from 1.8% to 4.6%. Age ≤65 years, nonresidential location, witnessed arrest, shockable rhythm, bystander automated external defibrillation, and year 2016 were independently associated with improved survival. Conclusions Implementation of a national prehospital strategy doubled OHCA survival in Singapore from 2011 to 2016, along with corresponding increases in bystander cardiopulmonary resuscitation and bystander automated external defibrillation. This can be an implementation model for other systems trying to improve OHCA outcomes.

Out-of-Hospital Cardiac Arrest Locations in a Rural Community: Where Should We Place AEDs?

2004 ◽  
Vol 19 (04) ◽  
pp. 352-355 ◽  
Author(s):  
Marc E. Portner ◽  
Marc L. Pollack ◽  
Steven K. Schirk ◽  
Melissa K. Schlenker
Keyword(s):  
Cardiac Arrest ◽  
Rural Community ◽  
Residential Areas ◽  
Study Objective ◽  
Automated External Defibrillators ◽  
The Past ◽  
Extended Care ◽  
High Incidence ◽  
Care Facilities ◽  
Hospital Cardiac Arrest

AbstractEarly defibrillation improves survival for patients suffering cardiac arrest from ventricular fibrillation (VF) or ventricular tachycardia (VT). Automated external defibrillators (AEDs) should be placed in locations in which there is a high incidence of out-of-hospital cardiac arrest (OOHCA). The study objective was to identify high-risk, rural locations that might benefit from AED placement. A retrospective review of OOHCA in a rural community during the past 5.5 years was conducted. The OOHCAs that occurred in non-residential areas were categorized based on location. Nine hundred, forty OOHCAs occurred during the study period of which 265 (28.2%) happened in non-residential areas. Of these, 127 (47.9%) occurred in healthcare-related locations, including 104 (39.2%) in extended care facilities. No location used in this study had more than two OOHCAs. Most (52.1%) non-residential OOHCAs occurred as isolated events in 146 different locations. Almost half of the OOHCAs that occurred in non-residential areas took place in healthcare-related facilities suggesting that patients at these locations may benefit from AED placement. First responders with AEDs are likely to have the greatest impact in a rural community.

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

2018 ◽  
Vol 33 (2) ◽  
pp. 153-159 ◽  
Author(s):  
Joel Neves Briard ◽  
Luc de Montigny ◽  
Dave Ross ◽  
François de Champlain ◽  
Eli Segal
Keyword(s):  
Cardiac Arrest ◽  
Urban Areas ◽  
Prehospital Care ◽  
Time Of Day ◽  
Publication Type ◽  
Cross Sectional ◽  
Automated External Defibrillators ◽  
Life Saving ◽  
Sectional Analysis ◽  
Hospital Cardiac Arrest

AbstractIntroductionRapid access to defibrillation is a key element in the management of out-of-hospital cardiac arrests (OHCAs). Public automated external defibrillators (PAEDs) are becoming increasingly available, but little information exists regarding the relation between the proximity to the arrest and their usage in urban areas.MethodsThis study is a retrospective, observational, cross-sectional analysis of non-traumatic OHCA during a 24-month period in the greater Montreal area (Quebec, Canada). Using logistic regression, bystander shock odds are described with regards to distance from the OHCA scene to the nearest PAED, adjusted for prehospital care arrival delay and time of day, and stratifying for type of location.ResultsOut of a total of 2,443 OHCA victims identified, 77 (3%) received bystander PAED shock, 622 (26%) occurred out-of-home, and 743 (30%) occurred during business hours. When controlling for time (business hours versus other hours) and minimum response delay for prehospital care arrival, a marginal negative association was found between bystander shock and distance to the nearest PAED in logged meters (aOR=0.80; CI, 0.64-0.99) for out-of-home cardiac arrests. No significant association was found between distance and bystander shock for at-home arrests. Out-of-home victims had significantly higher odds of receiving bystander shock up to 175 meters of distance to a PAED inclusively (aOR=2.52; CI, 1.07-5.89).ConclusionFor out-of-home cardiac arrests, proximity to a PAED was associated with bystander shock in the greater Montreal area. Strategies aiming to increase accessibility and use of these life-saving devices could further expand this advantage by assisting bystanders in rapidly locating nearby PAEDs.Neves BriardJ, de MontignyL, RossD, de ChamplainF, SegalE. Is distance to the nearest registered public automated defibrillator associated with the probability of bystander shock for victims of out-of-hospital cardiac arrest?Prehosp Disaster Med. 2018;33(2):153–159.

Abstract 128: Assessing the Temporal Trend in Survival to Hospital Admission Following Out-Of-Hospital Cardiac Arrest: Analysis From a Public Access Defibrillator Registry

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Hannah Torney ◽  
Olibhear McAlister ◽  
Adam Harvey ◽  
Raymond Bond ◽  
Dewar Finlay ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Hospital Admission ◽  
Time Of Day ◽  
Public Access ◽  
Patient Demographics ◽  
Shockable Rhythm ◽  
Post Shock ◽  
Day Of The Week ◽  
Get With The Guidelines ◽  
Hospital Cardiac Arrest

Introduction: The AHA Get With the Guidelines Resuscitation Investigators recently identified that in-hospital cardiac arrest patients admitted during nights and weekends are less likely to survive to discharge. Our analysis aimed to determine if a similar relationship applied to out-of-hospital cardiac arrest (OHCA) patients. Methods: Worldwide data collection began in Oct 2012. Users of HeartSine SAM PAD public access defibrillators submitted electronic event data (comprising time/date of event and electrocardiogram traces) and an event report form (comprising patient demographics, location of arrest and survival to hospital outcome). First shock success was defined as termination of shockable rhythm for 5 seconds post-shock. Data was analysed using R. Results: A total of 3400 OHCA cases were collected. Median (IQR) age was 63 (50, 75) and males accounted for 72.4% of the dataset. A total of 1127 first shocks were delivered, and first shock success was 87.2% (983 shocks). Survival outcomes were reported in 2942 cases, and 783 (26.6%) patients survived to hospital admission. First shock success as a response to day of the week (weekday versus weekend [12am Saturday-11.59pm Sunday]) adjusted for patient age, gender and location of arrest, was assessed and there was no association found. When the same model was fitted with survival to hospital admission as a response to day of the week, it was determined that patients are approximately 20% less likely to survive to hospital admission at the weekend (OR=0.81, 95%CI [0.68, 0.95], p=0.01). There was a negative association between survival and OHCA occurring at home (OR=0.32, 95%CI [0.10, 0.94], p=0.03) and increasing age (per 1-year increase, OR=0.99, 95%CI [0.98, 1.00], p<0.001). Adjusting the model for time of day (morning [6am-11.59am], afternoon [12pm-5.59pm], evening [6pm-11.59pm] and night [12am-5.59am]) did not highlight an association with any particular time of day. Conclusions: OHCA patients are significantly less likely to survive to hospital admission at weekends compared to weekdays. Further analysis on the availability of PADs at professional and recreational locations and availability of trained medical rescuers at the weekend versus weekdays could account for the differences observed.

Time of day does not influence outcome after out-of-hospital cardiac arrest in an urban area

Resuscitation ◽  
2017 ◽  
Vol 118 ◽  
pp. e102 ◽  
Author(s):  
Christoph Schriefl ◽  
Florian Bruce Mayr ◽  
Michael Poppe ◽  
Alexander Nürnberger ◽  
Christian Clodi ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Urban Area ◽  
Time Of Day ◽  
Hospital Cardiac Arrest
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