Abstract 211: Poor AED Availability Despite Improved AED Dissemination: A Challenge for Public Access Defibrillation

Abstract

Background Strategic AED placement and availability are paramount for successful public access defibrillation (PAD). However, analyses of AED coverage in relation to location and incidence of cardiac arrest in community settings are limited. We assessed AED placement and coverage according to workday, weekends and hour of day in relation to out-of-hospital cardiac arrests (OHCAs) in public. Methods All OHCAs in public places from 1994-2011 and all publicly available AEDs in Copenhagen, Denmark, were geographically located. OHCA high-risk areas were defined as those with ≥1 arrest every 2 years, within a 100-meter radius. All OHCAs occurring within a 100-meter radius were counted as well as the number of AEDs in these areas. AEDs available for PAD were registered in a nationwide network with the following information: location, time and weekday availability. Results A total of 2151 OHCAs occurred in public locations. The mean age was 61.7 (SD±17.7) years (74.8% males). High-risk areas accounted for 1.1% (n=112) of the city and 16.5% (n=360) of all arrests. A significant proportion of arrests occurred on weekends and between 6 p.m. and 8 a.m (65.8%). The number of AEDs increased from 36 in 2007 to 555 by the end of 2011. Of these, 5.8% (n=32) covered 44.6% of the high-risk areas and 96.2%, 31.9% and 9.7% were available all weekdays during daytime, evening and nighttime, respectively. On weekends 29.4%, 17.7% and 9.2% of all AEDs were available in daytime, evening and nighttime, respectively. Only 18.8% (n=6) AEDs in high-risk areas had 24-hour and all-week availability. Conclusion Despite a large increase in public AEDs, the coverage of OHCA high-risk areas remains insufficient. Further, only 18.8% of AEDs in OHCA high-risk areas were available at all times although 65.8% of arrests occurred outside working hours. Hence, a much greater proportion of AEDs should offer 24-hour and all-week availability to cover the actual incidence of cardiac arrest.