Abstract
Background
Systematic automated external defibrillator(AED) placement in schools may improve
pediatric out-of-hospital cardiac arrest(OHCA) survival. To estimate their utility,
we identified school-located pediatric and adult OHCAs to estimate the potential utilization
of school-located AEDs. Further, we identified all OHCAs within an AED-retrievable
distance of the school by walking, biking, and driving.
Methods
We used prospectively collected data from the British Columbia(BC) Cardiac Arrest
Registry(2013–2020), and geo-plotted all OHCAs and schools(n = 824) in BC. We identified
adult and pediatric(age < 18 years) OHCAs occurring in schools, as well as nearby
OHCAs for which a school-based externally-placed AED could be retrieved by a bystander
prior to emergency medical system(EMS) arrival.
Results
Of 16,409 OHCAs overall in the study period, 28.6 % occurred during school hours.
There were 301 pediatric OHCAs. 5(1.7 %) occurred in schools, of whom 2(40 %) survived
to hospital discharge. Among both children and adults, 28(0.17 %) occurred in schools(0.0042/school/year),
of whom 21(75 %) received bystander resuscitation, 4(14 %) had a bystander AED applied,
and 14(50 %) survived to hospital discharge. For each AED, an average of 0.29 OHCAs/year(95 %
CI 0.21–0.37), 0.93 OHCAs/year(95 % CI 0.69–1.56) and 1.69 OHCAs/year(95 % CI 1.21–2.89)
would be within the potential retrieval distance of a school-located AED by pedestrian,
cyclist and automobile retrieval, respectively, using the median EMS response times.
Conclusion
While school-located OHCAs were uncommon, outcomes were favourable. 11.1% to 60.9%
of all OHCAs occur within an AED-retrievable distance to a school, depending on retrieval
method. Accessible external school-located AEDs may improve OHCA outcomes of school
children and in the surrounding community.
Keywords
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Article info
Publication history
Published online: October 05, 2022
Accepted:
September 27,
2022
Received in revised form:
September 15,
2022
Received:
June 26,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
