Use and coverage of automated external defibrillators according to location in out-of-hospital cardiac arrest



      To evaluate 1) the relative use of automated external defibrillators (AEDs) at different types of AED locations 2) the percentage of AEDs crossing location types during OHCA before use 3) the AED coverage distance at different types of AED locations, and 4) the 30-day-survival in different subgroups.


      From 2014–2018, AEDs used by bystanders during out-of-hospital cardiac arrest (OHCA) in the Region of Southern Denmark were collected. Data regarding registered AEDs was retrieved from the national AED-network. The OHCA site and AED placement was categorized into; 1) Residential; 2) Public; 3) Nursing home, 4) Company/workplace; 5) Institution; 6) Health clinic and 7) Sports facility/recreational. To evaluate 30-day-survival, groups 4–7 were pooled into one Mixed group.


      In total 509 OHCAs were included. There was high relative usage of AEDs from public places, nursing homes, health clinics and sports facilities, and low relative usage from companies/workplaces, residential areas and institutions. Of AEDs used during residential OHCAs 39% were collected from public places. AEDs placed in residential areas and public places had a coverage of 575 m (IQR 130–1300) and 270 m (IQR5-550), respectively. Thirty-day- survival in public, residential and mixed groups were 49%, 14% and 67%, respectively.


      The relative use of AEDs from public places, nursing homes, sports facilities and health clinics was high, and AEDs used during OHCA in residential areas were most frequently collected from public places. AEDs placed in both residential areas and public places may have a wider coverage area than proposed in current literature.


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        • Berdowski J.
        • Berg R.A.
        • Tijssen J.G.
        • Koster R.W.
        Global incidences of out-of-hospital cardiac arrest and survival rates: Systematic review of 67 prospective studies.
        Resuscitation. 2010; 81: 1479-1487
        • Valenzuela T.D.
        • Roe D.J.
        • Nichol G.
        • Clark L.L.
        • Spaite D.W.
        • Hardman R.G.
        Outcomes of rapid defibrillation by security officers after cardiac arrest in casinos.
        N Engl J Med. 2000; 343: 1206-1209
        • Caffrey S.L.
        • Willoughby P.J.
        • Pepe P.E.
        • Becker L.B.
        Public use of automated external defibrillators.
        N Engl J Med. 2002; 347: 1242-1247
        • Kitamura T.
        • Kiyohara K.
        • Sakai T.
        • et al.
        Public-Access Defibrillation and Out-of-Hospital Cardiac Arrest in Japan.
        N Engl J Med. 2016; 375: 1649-1659
        • Weisfeldt M.L.
        • Sitlani C.M.
        • Ornato J.P.
        • et al.
        Survival after application of automatic external defibrillators before arrival of the emergency medical system: evaluation in the resuscitation outcomes consortium population of 21 million.
        J Am Coll Cardiol. 2010; 55: 1713-1720
        • Hansen S.M.
        • Hansen C.M.
        • Folke F.
        • et al.
        Bystander Defibrillation for Out-of-Hospital Cardiac Arrest in Public vs Residential Locations.
        JAMA cardiology. 2017; 2: 507-514
        • Chan T.C.
        • Li H.
        • Lebovic G.
        • et al.
        Identifying locations for public access defibrillators using mathematical optimization.
        Circulation. 2013; 127: 1801-1809
        • Sondergaard K.B.
        • Hansen S.M.
        • Pallisgaard J.L.
        • et al.
        Out-of-hospital cardiac arrest: Probability of bystander defibrillation relative to distance to nearest automated external defibrillator.
        Resuscitation. 2018; 124: 138-144
        • Karlsson L.
        • Hansen C.M.
        • Vourakis C.
        • et al.
        Improving bystander defibrillation in out-of-hospital cardiac arrests at home.
        Eur Heart J Acute Cardiovasc Care. 2020; 2048872619891675
        • Deakin C.D.
        • Anfield S.
        • Hodgetts G.A.
        Underutilisation of public access defibrillation is related to retrieval distance and time-dependent availability.
        Heart. 2018; 104: 1339-1343
        • Hansen C.M.
        • Wissenberg M.
        • Weeke P.
        • et al.
        Automated external defibrillators inaccessible to more than half of nearby cardiac arrests in public locations during evening, nighttime, and weekends.
        Circulation. 2013; 128: 2224-2231
        • Sun C.L.
        • Demirtas D.
        • Brooks S.C.
        • Morrison L.J.
        • Chan T.C.
        Overcoming Spatial and Temporal Barriers to Public Access Defibrillators Via Optimization.
        J Am Coll Cardiol. 2016; 68: 836-845
        • Brooks B.
        • Chan S.
        • Lander P.
        • Adamson R.
        • Hodgetts G.A.
        • Deakin C.D.
        Public knowledge and confidence in the use of public access defibrillation.
        Heart. 2015; 101: 967-971
        • Hallstrom A.P.
        • Ornato J.P.
        • Weisfeldt M.
        • et al.
        Public-access defibrillation and survival after out-of-hospital cardiac arrest.
        N Engl J Med. 2004; 351: 637-646
        • Aufderheide T.
        • Hazinski M.F.
        • Nichol G.
        • et al.
        Community lay rescuer automated external defibrillation programs: key state legislative components and implementation strategies: a summary of a decade of experience for healthcare providers, policymakers, legislators, employers, and community leaders from the American Heart Association Emergency Cardiovascular Care Committee, Council on Clinical Cardiology, and Office of State Advocacy.
        Circulation. 2006; 113: 1260-1270
        • Perkins G.D.
        • Jacobs I.G.
        • Nadkarni V.M.
        • et al.
        Cardiac arrest and cardiopulmonary resuscitation outcome reports: update of the Utstein Resuscitation Registry Templates for Out-of-Hospital Cardiac Arrest: a statement for healthcare professionals from a task force of the International Liaison Committee on Resuscitation (American Heart Association, European Resuscitation Council, Australian and New Zealand Council on Resuscitation, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Southern Africa, Resuscitation Council of Asia); and the American Heart Association Emergency Cardiovascular Care Committee and the Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation.
        Circulation. 2015; 132: 1286-1300
        • Kleinman M.E.
        • Brennan E.E.
        • Goldberger Z.D.
        • et al.
        Part 5: Adult Basic Life Support and Cardiopulmonary Resuscitation Quality: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.
        Circulation. 2015; 132: S414-35
        • Hansen C.M.
        • Lippert F.K.
        • Wissenberg M.
        • et al.
        Temporal trends in coverage of historical cardiac arrests using a volunteer-based network of automated external defibrillators accessible to laypersons and emergency dispatch centers.
        Circulation. 2014; 130: 1859-1867
        • Moller S.G.
        • Wissenberg M.
        • Moller-Hansen S.
        • et al.
        Regional variation in out-of-hospital cardiac arrest: Incidence and survival - A nationwide study of regions in Denmark.
        Resuscitation. 2020; 148: 191-199
        • Pedersen C.B.
        The Danish Civil Registration System.
        Scand J Public Health. 2011; 39: 22-25
        • Folke F.
        • Gislason G.H.
        • Lippert F.K.
        • et al.
        Differences between out-of-hospital cardiac arrest in residential and public locations and implications for public-access defibrillation.
        Circulation. 2010; 122: 623-630
        • Herlitz J.
        • Eek M.
        • Holmberg M.
        • Engdahl J.
        • Holmberg S.
        Characteristics and outcome among patients having out of hospital cardiac arrest at home compared with elsewhere.
        Heart. 2002; 88: 579-582
        • Kiyohara K.
        • Nishiyama C.
        • Matsuyama T.
        • et al.
        Out-of-Hospital Cardiac Arrest at Home in Japan.
        Am J Cardiol. 2019; 123: 1060-1068
        • Murakami Y.
        • Iwami T.
        • Kitamura T.
        • et al.
        Outcomes of out-of-hospital cardiac arrest by public location in the public-access defibrillation era.
        J Am Heart Assoc. 2014; 3e000533
        • Fredman D.
        • Svensson L.
        • Ban Y.
        • et al.
        Expanding the first link in the chain of survival - Experiences from dispatcher referral of callers to AED locations.
        Resuscitation. 2016; 107: 129-134
        • Folke F.
        • Lippert F.K.
        • Nielsen S.L.
        • et al.
        Location of cardiac arrest in a city center: strategic placement of automated external defibrillators in public locations.
        Circulation. 2009; 120: 510-517
        • Dahan B.
        • Jabre P.
        • Karam N.
        • et al.
        Optimization of automated external defibrillator deployment outdoors: An evidence-based approach.
        Resuscitation. 2016; 108: 68-74
        • Fan M.
        • Fan K.L.
        • Leung L.P.
        Walking Route-Based Calculation is Recommended for Optimizing Deployment of Publicly Accessible Defibrillators in Urban Cities.
        J Am Heart Assoc. 2020; 9e014398
        • Karlsson L.
        • Malta Hansen C.
        • Wissenberg M.
        • et al.
        Automated external defibrillator accessibility is crucial for bystander defibrillation and survival: A registry-based study.
        Resuscitation. 2019; 136: 30-37
        • Brooks S.C.
        • Hsu J.H.
        • Tang S.K.
        • Jeyakumar R.
        • Chan T.C.
        Determining risk for out-of-hospital cardiac arrest by location type in a Canadian urban setting to guide future public access defibrillator placement.
        Ann Emerg Med. 2013; 61530-8.e2

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