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Hansen CM, Wissenberg M, Weeke P, Ruwald MH, Lamberts M, Lippert FK, Gislason GH, Nielsen SL, Køber L, Torp-Pedersen C, Folke F. Automated External Defibrillators Inaccessible to More Than Half of Nearby Cardiac Arrests in Public Locations During Evening, Nighttime, and Weekends. Circulation 2013; 128:2224-31. [DOI: 10.1161/circulationaha.113.003066] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Despite wide dissemination, use of automated external defibrillators (AEDs) in community settings is limited. We assessed how AED accessibility affected coverage of cardiac arrests in public locations.
Methods and Results—
We identified cardiac arrests in public locations (1994–2011) in terms of location and time and viewed them in relation to the location and accessibility of all AEDs linked to the emergency dispatch center as of December 31, 2011, in Copenhagen, Denmark. AED coverage of cardiac arrests was defined as cardiac arrests within 100 m (109.4 yd) of an AED and further categorized according to AED accessibility at the time of cardiac arrest. Daytime, evening, and nighttime were defined as 8
am
to 3:59
pm
, 4 to 11:59
pm
, and midnight to 7:59
am
, respectively. Of 1864 cardiac arrests in public locations, 61.8% (n=1152) occurred during the evening, nighttime, or weekends. Of 552 registered AEDs, 9.1% (n=50) were accessible at all hours, and 96.4% (n=532) were accessible during the daytime on all weekdays. Regardless of AED accessibility, 28.8% (537 of 1864) of all cardiac arrests were covered by an AED. Limited AED accessibility decreased coverage of cardiac arrests by 4.1% (9 of 217) during the daytime on weekdays and by 53.4% (171 of 320) during the evening, nighttime, and weekends.
Conclusions—
Limited AED accessibility at the time of cardiac arrest decreased AED coverage by 53.4% during the evening, nighttime, and weekends, which is when 61.8% of all cardiac arrests in public locations occurred. Thus, not only strategic placement but also uninterrupted AED accessibility warrant attention if public-access defibrillation is to improve survival after out-of-hospital cardiac arrest.
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Affiliation(s)
- Carolina Malta Hansen
- From the Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup (C.M.H., M.W., P.W., M.H.R., M.L., G.H.G., F.F.); Emergency Medical Services, Copenhagen, Capital Region of Denmark and Copenhagen University (F.K.L., S.L.N.); National Institute of Public Health, University of Southern Denmark, Copenhagen (G.H.G.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen (L.K.); and Institute of Health, Science and Technology, Aalborg University, Aalborg (C.T.-P
| | - Mads Wissenberg
- From the Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup (C.M.H., M.W., P.W., M.H.R., M.L., G.H.G., F.F.); Emergency Medical Services, Copenhagen, Capital Region of Denmark and Copenhagen University (F.K.L., S.L.N.); National Institute of Public Health, University of Southern Denmark, Copenhagen (G.H.G.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen (L.K.); and Institute of Health, Science and Technology, Aalborg University, Aalborg (C.T.-P
| | - Peter Weeke
- From the Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup (C.M.H., M.W., P.W., M.H.R., M.L., G.H.G., F.F.); Emergency Medical Services, Copenhagen, Capital Region of Denmark and Copenhagen University (F.K.L., S.L.N.); National Institute of Public Health, University of Southern Denmark, Copenhagen (G.H.G.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen (L.K.); and Institute of Health, Science and Technology, Aalborg University, Aalborg (C.T.-P
| | - Martin Huth Ruwald
- From the Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup (C.M.H., M.W., P.W., M.H.R., M.L., G.H.G., F.F.); Emergency Medical Services, Copenhagen, Capital Region of Denmark and Copenhagen University (F.K.L., S.L.N.); National Institute of Public Health, University of Southern Denmark, Copenhagen (G.H.G.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen (L.K.); and Institute of Health, Science and Technology, Aalborg University, Aalborg (C.T.-P
| | - Morten Lamberts
- From the Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup (C.M.H., M.W., P.W., M.H.R., M.L., G.H.G., F.F.); Emergency Medical Services, Copenhagen, Capital Region of Denmark and Copenhagen University (F.K.L., S.L.N.); National Institute of Public Health, University of Southern Denmark, Copenhagen (G.H.G.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen (L.K.); and Institute of Health, Science and Technology, Aalborg University, Aalborg (C.T.-P
| | - Freddy Knudsen Lippert
- From the Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup (C.M.H., M.W., P.W., M.H.R., M.L., G.H.G., F.F.); Emergency Medical Services, Copenhagen, Capital Region of Denmark and Copenhagen University (F.K.L., S.L.N.); National Institute of Public Health, University of Southern Denmark, Copenhagen (G.H.G.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen (L.K.); and Institute of Health, Science and Technology, Aalborg University, Aalborg (C.T.-P
| | - Gunnar Hilmar Gislason
- From the Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup (C.M.H., M.W., P.W., M.H.R., M.L., G.H.G., F.F.); Emergency Medical Services, Copenhagen, Capital Region of Denmark and Copenhagen University (F.K.L., S.L.N.); National Institute of Public Health, University of Southern Denmark, Copenhagen (G.H.G.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen (L.K.); and Institute of Health, Science and Technology, Aalborg University, Aalborg (C.T.-P
| | - Søren Loumann Nielsen
- From the Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup (C.M.H., M.W., P.W., M.H.R., M.L., G.H.G., F.F.); Emergency Medical Services, Copenhagen, Capital Region of Denmark and Copenhagen University (F.K.L., S.L.N.); National Institute of Public Health, University of Southern Denmark, Copenhagen (G.H.G.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen (L.K.); and Institute of Health, Science and Technology, Aalborg University, Aalborg (C.T.-P
| | - Lars Køber
- From the Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup (C.M.H., M.W., P.W., M.H.R., M.L., G.H.G., F.F.); Emergency Medical Services, Copenhagen, Capital Region of Denmark and Copenhagen University (F.K.L., S.L.N.); National Institute of Public Health, University of Southern Denmark, Copenhagen (G.H.G.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen (L.K.); and Institute of Health, Science and Technology, Aalborg University, Aalborg (C.T.-P
| | - Christian Torp-Pedersen
- From the Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup (C.M.H., M.W., P.W., M.H.R., M.L., G.H.G., F.F.); Emergency Medical Services, Copenhagen, Capital Region of Denmark and Copenhagen University (F.K.L., S.L.N.); National Institute of Public Health, University of Southern Denmark, Copenhagen (G.H.G.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen (L.K.); and Institute of Health, Science and Technology, Aalborg University, Aalborg (C.T.-P
| | - Fredrik Folke
- From the Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup (C.M.H., M.W., P.W., M.H.R., M.L., G.H.G., F.F.); Emergency Medical Services, Copenhagen, Capital Region of Denmark and Copenhagen University (F.K.L., S.L.N.); National Institute of Public Health, University of Southern Denmark, Copenhagen (G.H.G.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen (L.K.); and Institute of Health, Science and Technology, Aalborg University, Aalborg (C.T.-P
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