Lena Karlsson1,2,3, Carolina M Hansen2,3, Christina Vourakis4, Christopher Lf Sun5,6, Shahzleen Rajan3, Kathrine B Søndergaard3, Linn Andelius2, Freddy Lippert2, Gunnar H Gislason3,7, Timothy Cy Chan8,9, Christian Torp-Pedersen10,11, Fredrik Folke2,3. 1. Department of Anesthesiology, Copenhagen University Hospital Herlev and Gentofte, Denmark. 2. Copenhagen Emergency Medical Services, University of Copenhagen, Denmark. 3. Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Denmark. 4. Human Developmental and Regenerative Biology, Harvard University, USA. 5. MIT Sloan School of Management, Massachusetts Institute of Technology, Cambridge, USA. 6. Department of Perioperative Services, Massachusetts General Hospital, Boston, USA. 7. National Institute of Public Health, University of Southern Denmark, Denmark. 8. Department of Mechanical and Industrial Engineering, University of Toronto, Canada. 9. Li Ka Shing Knowledge Institute, Canada. 10. Department of Cardiology and Clinical Research, Nordsjaellands Hospital, Hilleroed, Denmark. 11. Department of Cardiology, Aalborg University, Aalborg, Denmark.
Abstract
AIMS: Most out-of-hospital cardiac arrests occur at home with dismal bystander defibrillation rates. We investigated automated external defibrillator coverage of home arrests, and the proportion potentially reachable with an automated external defibrillator before emergency medical service arrival according to different bystander activation strategies. METHODS AND RESULTS: Cardiac arrests in homes (private/nursing/senior homes) in Copenhagen, Denmark (2008-2016) and registered automated external defibrillators (2007-2016), were identified. Automated external defibrillator coverage (distance from arrest to automated external defibrillator) and accessibility at the time of arrest were examined according to route distance to nearest automated external defibrillator and emergency medical service response time. The proportion of arrests reachable with an automated external defibrillator by bystander was calculated using two-way (from patient to automated external defibrillator and back) and one-way (from automated external defibrillator to patient) potential activation strategies. Of 1879 home arrests, automated external defibrillator coverage ≤100 m was low (6.3%) and a two-way bystander could potentially only retrieve an accessible automated external defibrillator before emergency medical service in 31.1% (n=37) of cases. If a bystander only needed to travel one-way to bring an automated external defibrillator (≤100 m, ≤250 m and ≤500 m), 45.4% (n=54/119), 37.1% (n=196/529) and 29.8% (n=350/1174) could potentially be reached before the emergency medical service based on current automated external defibrillator accessibility. CONCLUSIONS: Few home arrests were reachable with an automated external defibrillator before emergency medical service if bystanders needed to travel from patient to automated external defibrillator and back. However, nearly one-third of arrests ≤500 m of an automated external defibrillator could be reached before emergency medical service arrival if the bystander only needed to travel one-way from the automated external defibrillator to the patient.
AIMS: Most out-of-hospital cardiac arrests occur at home with dismal bystander defibrillation rates. We investigated automated external defibrillator coverage of home arrests, and the proportion potentially reachable with an automated external defibrillator before emergency medical service arrival according to different bystander activation strategies. METHODS AND RESULTS: Cardiac arrests in homes (private/nursing/senior homes) in Copenhagen, Denmark (2008-2016) and registered automated external defibrillators (2007-2016), were identified. Automated external defibrillator coverage (distance from arrest to automated external defibrillator) and accessibility at the time of arrest were examined according to route distance to nearest automated external defibrillator and emergency medical service response time. The proportion of arrests reachable with an automated external defibrillator by bystander was calculated using two-way (from patient to automated external defibrillator and back) and one-way (from automated external defibrillator to patient) potential activation strategies. Of 1879 home arrests, automated external defibrillator coverage ≤100 m was low (6.3%) and a two-way bystander could potentially only retrieve an accessible automated external defibrillator before emergency medical service in 31.1% (n=37) of cases. If a bystander only needed to travel one-way to bring an automated external defibrillator (≤100 m, ≤250 m and ≤500 m), 45.4% (n=54/119), 37.1% (n=196/529) and 29.8% (n=350/1174) could potentially be reached before the emergency medical service based on current automated external defibrillator accessibility. CONCLUSIONS: Few home arrests were reachable with an automated external defibrillator before emergency medical service if bystanders needed to travel from patient to automated external defibrillator and back. However, nearly one-third of arrests ≤500 m of an automated external defibrillator could be reached before emergency medical service arrival if the bystander only needed to travel one-way from the automated external defibrillator to the patient.
Authors: Astrid Rolin Kragh; Linn Andelius; Mads Tofte Gregers; Julie Samsøe Kjølbye; Anne Juul Jørgensen; Anders Korsgaard Christensen; Line Zinckernagel; Christian Torp-Pedersen; Fredrik Folke; Carolina Malta Hansen Journal: Resusc Plus Date: 2021-08-13