Introduction:
Though deployment of Automated External Defibrillators (AEDs) is increasing rapidly, AEDs are often deployed in an un-strategic manner. Consequently, little is known about the association between AED density, AED coverage of out-of-hospital cardiac arrest (OHCA), and bystander defibrillation across different countries. This study aimed to investigate the differences in AED densities (AEDS/100,000 inhabitants/1,000 km2), the AED coverage of OHCAs, and bystander defibrillation across Europe.
Hypothesis:
AED density is directly associated with degree of bystander defibrillation across Europe.
Methods:
The study is a European Sudden Cardiac Arrest network towards Prevention, Education, New Effective Treatment (ESCAPE-NET) project. We included data from Ticino (Switzerland), Lombardy (Italy), and The Capital Region (Denmark) from 2019, covering over 3.7 million inhabitants. AED accessibility was defined as the AED being accessible 24/7 or not and AED coverage was defined as the OHCA being covered by an AED within 100, 250 and 500 meters. AED coverages were calculated the same way by all participants using a free software program (QGIS).
Results:
AED densities were: 87.3 for Ticino, 15.2 for Lombardy, and 139.4 for The Capital Region. The percentages of OHCAs covered by any AED and by 24/7 accessible AEDs are shown in Figure 1. The calculated AED density per 1% bystander defibrillation (for the percentage of OHCAs bystander defibrillated within 100, 250 and 500m of an AED) were 34.9, 17.5 and 15.6 for Ticino, 76.0, 50.7 and 38.0 for Lombardy and 19.4, 12.6 and 11.2 for The Capital Region.
Conclusion:
We found great variation in both AED coverage and 24/7 AED accessibility across regions, as well as marked differences in bystander defibrillation according to local AED density. Other factors like geographical differences in the regions, optimal AED placement and citizen responder programs for AED use might explain the observed differences.