Investigation of availability and accessibility of community automated external defibrillators in a territory in Hong Kong

A spatiotemporal data mining study to identify high-risk neighborhoods for out-of-hospital cardiac arrest (OHCA) incidents

Out-of-hospital cardiac arrest (OHCA) is a worldwide health problem. The aim of the study is to utilize the territorial-wide OHCA data of Hong Kong in 2012-2015 to examine its spatiotemporal pattern and high-risk neighborhoods. Three techniques for spatiotemporal data mining (SaTScan's spatial scan statistic, Local Moran's I, and Getis Ord Gi*) were used to extract high-risk neighborhoods of OHCA occurrence and identify local clusters/hotspots. By capitalizing on the strengths of these methods, the results were then triangulated to reveal "truly" high-risk OHCA clusters. The final clusters for all ages and the elderly 65+ groups exhibited relatively similar patterns. All ages groups were mainly distributed in the urbanized neighborhoods throughout Kowloon. More diverse distribution primarily in less accessible areas was observed among the elderly group. All outcomes were further converted into an index for easy interpretation by the general public. Noticing the spatial mismatches between hospitals and ambulance depots (representing supplies) and high-risk neighborhoods (representing demands), this setback should be addressed along with public education and strategic ambulance deployment plan to shorten response time and improve OHCA survival rate. This study offers policymakers and EMS providers essential spatial evidence to assist with emergency healthcare planning and informed decision-making.

Availability and use of public access defibrillators in Busan Metropolitan City, South Korea

Out-of-hospital cardiac arrest (OHCA) is considered an important health issue worldwide, and early defibrillation is a key element for a favourable prognosis. In South Korea, public access defibrillation (PAD) programmes were initiated in 2007. However, the impact of PAD programmes on OHCA survival rates remains unclear. This study evaluated the deployment and maintenance status of public automatic external defibrillators (AED), including how frequently they were used, in Busan Metropolitan City, South Korea. Managers of possible AED sites were first contacted by telephone and asked to confirm the possession of an AED. AED suppliers were contacted for AED sales records to identify missing AED sites. AEDs located in ambulances and medical institutions were not included. Investigators visited confirmed AED sites and completed a checklist on AED maintenance and use. In total, 206 AEDs were located, indicative of an AED density of 0.268 AED/km² and a prevalence of 6.07 per 100,000 in Busan Metropolitan City. We found that public AEDs had been used for resuscitation only 15 times, an average rate of use of once every 26.3 years. Our results indicate that AEDs in Busan Metropolitan City are underused according to the guidelines, and several are in low-priority locations. We believe that AED deployment based on cardiac arrest statistics is important to optimise layperson AED training and utilisation.

Characterization of available automated external defibrillators in the market based on the product manuals in 2014

BACKGROUND

To popularize the wide-spread use of automated external defibrillator (AED) to save life in sudden cardiac arrest, we compared the strength and weakness of different types of AEDs to enable a sound selection based on regional requirement.

METHODS

This was a retrospective descriptive study. Different types of AEDs were compared according to the information of AEDs from manuals and brochures provided by the manufacturers. Fifteen types of AEDs were divided into 3 groups, basic, intermediate and advanced.

RESULTS

Lifeline™ AUTO AED had the best performance in price, portability and user-friendly among AEDs of basic level. It required less time for shock charging. Samaritan PAD defibrillator was superior in price, portability, durability and characteristic among AEDs of intermediate level. It had the longest warranty and highest protection against water and dust. Lifeline™ PRO AED had the best performance in most of the criteria among AEDs of advanced level and offered CPR video and manual mode for laypersons and clinicians respectively.

CONCLUSION

Lifeline™ AUTO AED, Samaritan PAD defibrillator, Lifeline™ PRO AED are superior in AEDs of basic, intermediate and advanced levels, respectively. A feasible AED may be chosen by users according to the regional requirement and the current information about the best available products.