Implementation of digital signage for nationwide propagation of a public access defibrillation program and nationwide public education

Abstract

Recent study demonstrated an increase in survival with minimal neurologic impairment due to the increased availability of nationwide public access defibrillation (PAD).1Kitamura T. Iwami T. Kawamura T. Nagao K. Tanaka H. Hiraide A. Implementation working group for the All-Japan Utstein Registry of the Fire and Disaster Management agency, Nationwide public-access defibrillation in Japan.N Engl J Med. 2010; 362: 994-1004Google Scholar, 2Nielsen A.M. Folke F. Lippert F.K. Rasmussen L.S. Use and benefits of public access defibrillation in a nation-wide network.Resuscitation. 2013; 84: 430-434Abstract Full Text Full Text PDF Scopus (55) Google Scholar Automated external defibrillators (AEDs) are easy and safe to learn, which encourages the development of less expensive, more user-friendly automated defibrillators for public development in appropriate locations.1Kitamura T. Iwami T. Kawamura T. Nagao K. Tanaka H. Hiraide A. Implementation working group for the All-Japan Utstein Registry of the Fire and Disaster Management agency, Nationwide public-access defibrillation in Japan.N Engl J Med. 2010; 362: 994-1004Google Scholar Despite the necessity for PAD, there are barriers to the dissemination of PAD in the community because of cost issues. Community-based strategies are difficult to implement and CPR trained laypersons would be limited to the people available in each home.3Callans D.J. Out-of-hospital cardiac arrest-the solution is shocking.N Engl J Med. 2004; 351: 632-634Google Scholar PAD programs are expensive for wide-scale development of AEDs.4Schober P. van Dehn F.B. Bierens J.J. Loer S.A. Schwarte L.A. Public access defibrillation: time to access the public.Ann Emerg Med. 2011; 58: 240-247Google Scholar Although legislation varies in different countries, in Korea, PAD has been implemented by Emergency Medical Law from 2008. Additionally, AEDs have been obligatorily installed in apartment houses with more than 500 households by the revision and enforcement of this Emergency Medical Law in 2012. Although the South Korean government appointed 13,999 mandatory AED installation locations in the 2008 Emergency Medical Law, in 2013, the total number of implemented AEDs is approximately 6500. However, despite legislation-mandated installation of AEDs, there are a lot of obligatory locations where they are not yet installed. Dissemination of AEDs is limited by cost and lack of public education. Nationwide public education campaigns are an important next step to exploit the lifesaving potential of PAD.4Schober P. van Dehn F.B. Bierens J.J. Loer S.A. Schwarte L.A. Public access defibrillation: time to access the public.Ann Emerg Med. 2011; 58: 240-247Google Scholar An AED should be placed anywhere a sudden cardiac arrest may occur. Digital signage may be considered as an alternative new solution to cost problems and implementation of nationwide public education about CPR and PAD. Digital signage is a form of electronic display that shows information, advertising and messages in both public and private environments, including stores, restaurants, and buildings. Digital signage has many potential benefits: (1) content may be both frequently and easily updated, (2) it saves printing or construction costs associated with static signage, (3) interactive abilities may be available, and (4) displays are controlled by servers.5Digital signage. Available from: http://en.wikipedia.org/wiki/Digital_signage; 2013 [accessed March, 2013].Google Scholar In Korea, new AEDs embedded in digital signage (MediaLife®, LG Uplus Corp., Seoul, Korea) were installed on the first floor of apartment buildings, beside the elevator. The MediaLife® product was composed of a 23-inch electronic display plus AED. The display provided advertisements and public education on the importance and usage of CPR and AED (Fig. 1). New AEDs with accompanying digital signage matched needs between providers and users. Although lay people usually think of advertising as a form of environmental pollution, in this way they can use an expensive AED for free and get medical information regarding CPR and AED. Digital signage can also generate profits from advertisements. A total of 15,000 have been installed in Seoul and Kyeonggi province since August 2011. Digital signage and accompanying AEDs have been disseminated more rapidly and widely than legislation requirements due to the cost-effectiveness and the fulfillment of both public and providers’ needs. They can be installed in means of transportation like buses, subways, and small scale-community. Furthermore, new PAD may be disseminated to homes with risk. The benefits can expand installation of AEDs and improve public perceptions of CPR and PAD. None.