Dataset Information

Use of a geographic information system to identify differences in automated external defibrillator installation in urban areas with similar incidence of public out-of-hospital cardiac arrest: a retrospective registry-based study.

ABSTRACT:

Objectives

Early defibrillation in out-of-hospital cardiac arrest (OHCA) is of importance to improve survival. In many countries the number of automated external defibrillators (AEDs) is increasing, but the use is low. Guidelines suggest that AEDs should be installed in densely populated areas and in locations with many visitors. Attempts have been made to identify optimal AED locations based on the incidence of OHCA using geographical information systems (GIS), but often on small datasets and the studies are seldom reproduced. The aim of this paper is to investigate if the distribution of public AEDs follows the incident locations of public OHCAs in urban areas of Stockholm County, Sweden.

Method

OHCA data were obtained from the Swedish Register for Cardiopulmonary Resuscitation and AED data were obtained from the Swedish AED Register. Urban areas in Stockholm County were objectively classified according to the pan-European digital mapping tool, Urban Atlas (UA). Furthermore, we reclassified and divided the UA land cover data into three classes (residential, non-residential and other areas). GIS software was used to spatially join and relate public AED and OHCA data and perform computations on relations and distance.

Results

Between 1 January 2012 and 31 December 2014 a total of 804 OHCAs occurred in public locations in Stockholm County and by December 2013 there were 1828 AEDs available. The incidence of public OHCAs was similar in residential (47.3%) and non-residential areas (43.4%). Fewer AEDs were present in residential areas than in non-residential areas (29.4% vs 68.8%). In residential areas the median distance between OHCAs and AEDs was significantly greater than in non-residential areas (288 m vs 188 m, p<0.001).

Conclusion

The majority of public OHCAs occurred in areas classified in UA as 'residential areas' with limited AED accessibility. These areas need to be targeted for AED installation and international guidelines need to take geographical location into account when suggesting locations for AED installation.

SUBMITTER: Fredman D

PROVIDER: S-EPMC5623355 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Publications

Use of a geographic information system to identify differences in automated external defibrillator installation in urban areas with similar incidence of public out-of-hospital cardiac arrest: a retrospective registry-based study.

Fredman David D Haas Jan J Ban Yifang Y Jonsson Martin M Svensson Leif L Djarv Therese T Hollenberg Jacob J Nordberg Per P Ringh Mattias M Claesson Andreas A

BMJ open 20170602 5

<h4>Objectives</h4>Early defibrillation in out-of-hospital cardiac arrest (OHCA) is of importance to improve survival. In many countries the number of automated external defibrillators (AEDs) is increasing, but the use is low. Guidelines suggest that AEDs should be installed in densely populated areas and in locations with many visitors. Attempts have been made to identify optimal AED locations based on the incidence of OHCA using geographical information systems (GIS), but often on small datase ...[more]

PMID: 28576894

Similar Datasets

Project description:ObjectivesGoodSAM is a mobile phone app that integrates with UK ambulance services. During a 999 call, if a call handler diagnoses cardiac arrest, nearby volunteer first responders registered with the app are alerted. They can give cardiopulmonary resuscitation (CPR) and/or use a public access automated external defibrillator (AED). We aimed to identify means of increasing AED use by GoodSAM first responders.MethodsWe conducted semistructured telephone interviews, using the Theoretical Domains Framework to identify and classify barriers to AED use. We analysed findings using the Capability, Opportunity, Motivation, Behaviour (COM-B) model and subsequently used the Behaviour Change Wheel to develop potential interventions to improve AED use.SettingLondon, UK.ParticipantsGoodSAM first responders alerted in the previous 7?days about a cardiac arrest.ResultsWe conducted 30 telephone interviews in two batches in July and October 2018. A public access AED was taken to scene once, one had already been attached on scene another time and three participants took their own AEDs when responding. Most first responders felt capable and motivated to use public access AEDs but were concerned about delaying CPR if they retrieved one and frustrated when arriving after the ambulance service. They perceived lack of opportunities due to unavailable and inaccessible AEDs, particularly out of hours. We subsequently developed 13 potential interventions to increase AED use for future testing.ConclusionsGoodSAM first responders used AEDs occasionally, despite a capability and motivation to do so. Those operating volunteer first responder systems should consider our proposed interventions to improve AED use. Of particular clinical importance are: highlighting AED location and providing route/time estimates to the patient via the nearest AED. This would help single responders make appropriate decisions about AED retrieval. As AED collection may extend time to reach the patient, where there is sufficient density of potential responders, systems could send one responder to initiate CPR and another to collect an AED.

Dataset Information

Use of a geographic information system to identify differences in automated external defibrillator installation in urban areas with similar incidence of public out-of-hospital cardiac arrest: a retrospective registry-based study.

Objectives

Method

Results

Conclusion

Publications

Use of a geographic information system to identify differences in automated external defibrillator installation in urban areas with similar incidence of public out-of-hospital cardiac arrest: a retrospective registry-based study.

Similar Datasets

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