Public Access Defibrillation: Utilisation and Missed Opportunities

Abstract

Introduction Automated external defibrillators (AEDs) for public use are becoming increasingly prevalent, but little is known about utilisation. The purpose of this study was to compare the locations of out-of-hospital cardiac arrests (OHCAs) to the locations of AEDs to determine whether missed opportunities exist. Methods A retrospective study was performed of all OHCAs in which resuscitation was attempted between 1 January 2005 and 31 December 2010 in Orange County, North Carolina, United States of America, a mixed suburban/rural emergency medical services (EMS) system. Emergency medical services records were used to determine public AED utilisation and OHCA location. The locations were plotted on a map using ArcGIS. Businesses, public buildings and facilities located within a 100 metre radius of each OHCA were surveyed to determine AED availability. Data were analysed using standard descriptive statistics. Results During the study period, 307 OHCAs occurred at 282 locations. Of these, 219 (71%) occurred in private homes, 26 (9%) in nursing or assisted living facilities, and 62 (20%) in public locations. An AED location was within 100 metres of an OHCA location in 22 cases. Five cases were excluded due to the arrest being witnessed by EMS, and late or unknown AED installation time. Of the remaining 17 OHCAs, seven (41%) had a nearby AED that was not used, constituting a missed opportunity for deployment. Conclusion In nearly half of OHCAs that have a nearby public AED, the AED was not utilised. This suggests that public awareness and accessibility of AED locations should be improved.