How to improve automated external defibrillator placement for out-of-hospital cardiac arrests: a case study

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Serval ID
serval:BIB_017FBA4A7A11
Type
A Master's thesis.
Publication sub-type
Master (thesis) (master)
Collection
Publications
Institution
Title
How to improve automated external defibrillator placement for out-of-hospital cardiac arrests: a case study
Author(s)
AEBY D.
Director(s)
DAMI F.
Institution details
Université de Lausanne, Faculté de biologie et médecine
Publication state
Accepted
Issued date
2020
Language
english
Number of pages
25
Abstract
Introduction
In out-of-hospital cardiac arrests (OHCA), the use of an automatic external defibrillator (AED) by a bystander remains generally low, as AEDs may be misplaced with respect to the locations of OHCAs. As the distribution of historical OHCAs is potentially predictive of future OHCA locations, the purpose of this study is to assess AED positioning with regards to past locations of OHCAs, in order to improve the efficiency of public access defibrillation programs.
Methods
This is a retrospective observational study from 2014 to 2018 in the State of Vaud (Switzerland). The locations of historical OHCAs and AEDs were loaded into a geodata processing tool. Median distances between them, as well as rates of OHCAs covered (distance of <100 meters from the nearest AED), were measured. Areas with high densities of uncovered OHCAs (hotspots) were identified to propose new AED placement. Areas over-covered by AEDs (overlays) were also identified to propose the relocation of some AEDs.
Results
For 7.5% of historical OHCAs, an AED was available <100 m (coverage) away. Of all OHCAs, 79.3% occurred at home, with 4.5% of these being covered by an AED. In comparison, 20.7% of OHCAs occurred out-of-home, with 19.1% of these cases being covered by an AED. Forty OHCA hotspots, requiring as many additional AEDs, were identified. If added, the coverage rate would rise from 7.5% to 17.6%. Regarding AED overlays, 17 public AEDs were found to be relocatable, without reducing AED coverage.
Discussion
This study demonstrates that geodata tools can assess AED locations and increase the efficiency of their placement. Historical hotspots and AED overlays should be considered to efficiently move or add AEDs. At-home OHCAs should become a priority target for future public access defibrillation programs as they represent the majority of OHCAs but have the lowest AED coverage rates.
Keywords
Automated External Defibrillator, Cardiac arrest, Lay responder
Create date
07/09/2021 13:17
Last modification date
18/02/2022 7:34
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