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.
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.
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.
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.
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- Survival after out-of-hospital cardiac arrest in children.J Am Heart Assoc. 2015; 4: 1-8https://doi.org/10.1161/JAHA.115.002122
- Pediatric out-of-hospital cardiac arrest in Korea: A nationwide population-based study.Resuscitation. 2010; 81: 512-517https://doi.org/10.1016/j.resuscitation.2009.11.022
- Out-of-hospital pediatric cardiac arrest: An epidemiologic review and assessment of current knowledge.Ann Emerg Med. 2005; 46: 512-522https://doi.org/10.1016/j.annemergmed.2005.05.028
- Incidence, causes, and outcomes of out-of-hospital cardiac arrest in children: A comprehensive, prospective, population-based study in the netherlands.J Am Coll Cardiol. 2011; 57: 1822-1828https://doi.org/10.1016/j.jacc.2010.11.054
- Cardiac arrest in schools.Circulation. 2007; 116: 1374-1379https://doi.org/10.1161/CIRCULATIONAHA.107.698282
- Public-access defibrillation and out-of-hospital cardiac arrest in Japan.N Engl J Med. 2016; 375: 1649-1659https://doi.org/10.1056/NEJMsa1600011
- Defibrillators coming to all OCDSB schools.CBC. 2018;
- Trends in care processes and survival following prehospital resuscitation improvement initiatives for out-of-hospital cardiac arrest in British Columbia, 2006–2016.Resuscitation. 2018; 125: 118-125
Ministry of Environment and Climate Change. Trends in B.C.’s Population Size & Distribution. 2018. http://www.env.gov.bc.ca/soe/indicators/sustainability/bc-population.html.
Government of BC. BC K-12 School Information. 2020. BC K-12 School.
- Estimating effectiveness of cardiac arrest interventions: A logistic regression survival model.Circulation. 1997; 96: 3308-3313https://doi.org/10.1161/01.CIR.96.10.3308
- A brisk walk—Real-life travelling speed of lay responders in out-of-hospital cardiac arrest.Resuscitation. 2020; 151: 197-204https://doi.org/10.1016/j.resuscitation.2020.01.043
- An analysis of cyclists’ speed at combined pedestrian and cycle paths.Traffic Inj Prev. 2019; 20: 56-61https://doi.org/10.1080/15389588.2019.1658083
- Driving Speeds in Urgent and Non-Urgent Ambulance Missions during Normal and Reduced Winter Speed Limit Periods-A Descriptive Study.Nurs reports (Pavia, Italy). 2022; 12: 50-58https://doi.org/10.3390/nursrep12010006
- Cost-effectiveness of automated external defibrillator deployment in selected public locations.J Gen Intern Med. 2003; 18: 745-754https://doi.org/10.1046/j.1525-1497.2003.21139.x
- Part 4: The Automated External Defibrillator, Key Link in the Chain of Survival.Circulation. 2000; 102 (Supplementary page 22)
- Circumstances and causes of sudden circulatory arrests in the Dutch province of Limburg and the involvement of citizen rescuers.Netherlands Hear J. 2018; 26: 41-48https://doi.org/10.1007/s12471-017-1057-1
- Utilization and cost-effectiveness of school and community center AED deployment models in Canadian cities.Resuscitation. December 2021; 2022: 194-200https://doi.org/10.1016/j.resuscitation.2021.12.035
Published online: October 05, 2022
Accepted: September 27, 2022
Received in revised form: September 15, 2022
Received: June 26, 2022
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