Automated external defibrillator accessibility is crucial for bystander defibrillation and survival: A registry-based study

RESUSCITATION

卷:136

Article

Karlsson, Lena^1,2  Hansen, Carolina Malta^2,3  Wissenberg, Mads^1,2  Hansen, Steen Moller⁴  Lippert, Freddy K.²  Rajan, Shahzleen¹  Kragholm, Kristian^4,5  Moller, Sidsel G.¹  Sondergaard, Kathrine Bach¹  Gislason, Gunnar H.^1,6  Torp-Pedersen, Christian^4,7  Folke, Fredrik^1,2 

[1] Univ Copenhagen, Hosp Gentofte, Dept Cardiol, Post 635,Kildegardsvej 28, DK-2900 Hellerup, Denmark

[2] Univ Copenhagen, Emergency Med Serv Copenhagen, Copenhagen, Denmark

[3] Univ Copenhagen, Hosp Hillerod, Dept Cardiol Nephrol & Endocrinol, Copenhagen, Region Northern, Denmark

[4] Aalborg Univ Hosp, Unit Epidemiol & Biostat, Aalborg, Denmark

[5] Aalborg Univ Hosp, Dept Cardiol, Aalborg, Denmark

[6] Univ Southern Denmark, Natl Inst Publ Hlth, Copenhagen, Denmark

[7] Aalborg Univ, Dept Hlth Sci & Technol, Aalborg, Denmark

关键词: cardiac arrest;    resuscitation;    automated external defibrillator;    survival;   

DOI  :  10.1016/j.resuscitation.2019.01.014

来源: Elsevier

【 摘 要 】

Aims: Optimization of automated external defibrillator (AED) placement and accessibility are warranted. We examined the associations between AED accessibility, at the time of an out-of-hospital cardiac arrest (OHCA), bystander defibrillation, and 30-day survival, as well as AED coverage according to AED locations. Methods: In this registry-based study we identified all OHCAs registered by mobile emergency care units in Copenhagen, Denmark (2008-2016). Information regarding registered AEDs (2007-2016) was retrieved from the nationwide Danish AED Network. We calculated AED coverage (AEDs located similar to 200 m route distance from an OHCA) and, according to AED accessibility, the likelihoods of bystander defibrillation and 30-day survival. Results: Of 2500 OHCAs, 22.6% (n = 566) were covered by a registered AED. At the time of OHCA, < 50% of these AEDs were accessible (n = 276). OHCAs covered by an accessible AED were nearly three times more likely to receive bystander defibrillation (accessible: 13.8% vs. inaccessible: 4.8%, p < 0.001) and twice as likely to achieve 30-day survival (accessible: 28.8% vs. inaccessible: 16.4%, p < 0.001). Among bystander-witnessed OHCAs with shockable heart rhythms (accessible vs. inaccessible AEDs), bystander defibrillation rates were 39.8% vs. 20.3% (p = 0.01) and 30-day survival rates were 72.7% vs. 44.1% (p < 0.001). Most OHCAs were covered by AEDs at offices (18.6%), schools (13.3%), and sports facilities (12.9%), each with a coverage loss > 50%, due to limited AED accessibility. Conclusions: The chance of a bystander defibrillation was tripled, and 30-day survival nearly doubled, when the nearest AED was accessible, compared to inaccessible, at the time of OHCA, underscoring the importance of unhindered AED accessibility.

【 授权许可】

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