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Automated external defibrillator accessibility is crucial for bystander defibrillation and survival: A registry-based study.

Karlsson, Lena; Malta Hansen, Carolina; Wissenberg, Mads; Møller Hansen, Steen; Lippert, Freddy K; Rajan, Shahzleen; Kragholm, Kristian; Møller, Sidsel G; Bach Søndergaard, Kathrine; Gislason, Gunnar H; Torp-Pedersen, Christian; Folke, Fredrik.
Resuscitation; 136: 30-37, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30682401


Optimization of automated external defibrillator (AED) placement and accessibility are warranted. We examined the associations between AED accessibility, at the time of an out-of-hospital cardiac arrest (OHCA), bystander defibrillation, and 30-day survival, as well as AED coverage according to AED locations.


In this registry-based study we identified all OHCAs registered by mobile emergency care units in Copenhagen, Denmark (2008-2016). Information regarding registered AEDs (2007-2016) was retrieved from the nationwide Danish AED Network. We calculated AED coverage (AEDs located ≤200 m route distance from an OHCA) and, according to AED accessibility, the likelihoods of bystander defibrillation and 30-day survival.


Of 2500 OHCAs, 22.6% (n = 566) were covered by a registered AED. At the time of OHCA, <50% of these AEDs were accessible (n = 276). OHCAs covered by an accessible AED were nearly three times more likely to receive bystander defibrillation (accessible 13.8% vs. inaccessible 4.8%, p < 0.001) and twice as likely to achieve 30-day survival (accessible 28.8% vs. inaccessible 16.4%, p < 0.001). Among bystander-witnessed OHCAs with shockable heart rhythms (accessible vs. inaccessible AEDs), bystander defibrillation rates were 39.8% vs. 20.3% (p = 0.01) and 30-day survival rates were 72.7% vs. 44.1% (p < 0.001). Most OHCAs were covered by AEDs at offices (18.6%), schools (13.3%), and sports facilities (12.9%), each with a coverage loss >50%, due to limited AED accessibility.


The chance of a bystander defibrillation was tripled, and 30-day survival nearly doubled, when the nearest AED was accessible, compared to inaccessible, at the time of OHCA, underscoring the importance of unhindered AED accessibility.
Selo DaSilva