Hostname: page-component-848d4c4894-hfldf Total loading time: 0 Render date: 2024-05-27T20:36:22.827Z Has data issue: false hasContentIssue false

Is Distance to the Nearest Registered Public Automated Defibrillator Associated with the Probability of Bystander Shock for Victims of Out-of-Hospital Cardiac Arrest?

Published online by Cambridge University Press:  13 February 2018

Joel Neves Briard
Affiliation:
Université de Montréal Medical School, Quebec, Canada
Luc de Montigny
Affiliation:
Corporation Urgences-santé, Quebec, Canada Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Quebec, Canada
Dave Ross
Affiliation:
Corporation Urgences-santé, Quebec, Canada Department of Prehospital Medicine, Hôpital du Sacré-Cœur de Montréal, Quebec, Canada
François de Champlain
Affiliation:
Corporation Urgences-santé, Quebec, Canada Department of Emergency Medicine, McGill University Health Centre, Quebec, Canada
Eli Segal*
Affiliation:
Corporation Urgences-santé, Quebec, Canada Department of Prehospital Medicine, Hôpital du Sacré-Cœur de Montréal, Quebec, Canada Department of Emergency Medicine, Jewish General Hospital, Quebec, Canada
*
Correspondence: Eli Segal, MD Research Module, Urgences-santé 6700 Rue Jarry East, 3rd Floor Montreal, Quebec, Canada H1P 0A4 E-mail: eli.segal@mcgill.ca

Abstract

Introduction

Rapid access to defibrillation is a key element in the management of out-of-hospital cardiac arrests (OHCAs). Public automated external defibrillators (PAEDs) are becoming increasingly available, but little information exists regarding the relation between the proximity to the arrest and their usage in urban areas.

Methods

This study is a retrospective, observational, cross-sectional analysis of non-traumatic OHCA during a 24-month period in the greater Montreal area (Quebec, Canada). Using logistic regression, bystander shock odds are described with regards to distance from the OHCA scene to the nearest PAED, adjusted for prehospital care arrival delay and time of day, and stratifying for type of location.

Results

Out of a total of 2,443 OHCA victims identified, 77 (3%) received bystander PAED shock, 622 (26%) occurred out-of-home, and 743 (30%) occurred during business hours. When controlling for time (business hours versus other hours) and minimum response delay for prehospital care arrival, a marginal negative association was found between bystander shock and distance to the nearest PAED in logged meters (aOR=0.80; CI, 0.64-0.99) for out-of-home cardiac arrests. No significant association was found between distance and bystander shock for at-home arrests. Out-of-home victims had significantly higher odds of receiving bystander shock up to 175 meters of distance to a PAED inclusively (aOR=2.52; CI, 1.07-5.89).

Conclusion

For out-of-home cardiac arrests, proximity to a PAED was associated with bystander shock in the greater Montreal area. Strategies aiming to increase accessibility and use of these life-saving devices could further expand this advantage by assisting bystanders in rapidly locating nearby PAEDs.

Neves BriardJ, de MontignyL, RossD, de ChamplainF, SegalE. Is Distance to the Nearest Registered Public Automated Defibrillator Associated with the Probability of Bystander Shock for Victims of Out-of-Hospital Cardiac Arrest?Prehosp Disaster Med. 2018;33(2):153–159.

Type
Original Research
Copyright
© World Association for Disaster and Emergency Medicine 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Conflicts of interest/funding: FdeC is President of the Jacques-de Champlain Foundation (Quebec, Canada), a non-profit organization whose mission is to promote cardiovascular research and to improve resuscitation care in the province of Quebec. JNB was commissioned by the Jacques-de Champlain Foundation from June 2016 to May 2017 to populate the first provincial public automated external defibrillator registry in Quebec. The other authors have no conflicts of interest to report. Urgences-santé (Quebec, Canada) research personnel were remunerated for their work on this study. The other authors did not receive funding.

References

1. Daya, MR, Schmicker, RH, Zive, DM, et al. Out-of-hospital cardiac arrest survival improving over time: results from the Resuscitation Outcomes Consortium (ROC). Resuscitation. 2015;91:108-115.CrossRefGoogle ScholarPubMed
2. Mozaffarian, D, Benjamin, EJ, Go, AS, et al. Heart disease and stroke statistics-2016 update: a report from the American Heart Association. Circulation. 2016;133(4):e38-e360.Google ScholarPubMed
3. Robertson, RM. Sudden death from cardiac arrest - improving the odds. N Engl J Med. 2000;343(17):1259-1260.CrossRefGoogle ScholarPubMed
4. Weisfeldt, ML, Sitlani, CM, Ornato, JP, et al. Survival after application of automatic external defibrillators before arrival of the emergency medical system: evaluation in the resuscitation outcomes consortium population of 21 million. J Am Coll Cardiol. 2010;55(16):1713-1720.CrossRefGoogle ScholarPubMed
5. Berdowski, J, Blom, MT, Bardai, A, Tan, HL, Tijssen, JG, Koster, RW. Impact of onsite or dispatched automated external defibrillator use on survival after out-of-hospital cardiac arrest. Circulation. 2011;124(20):2225-2232.CrossRefGoogle ScholarPubMed
6. Morrison, LJ, Verbeek, PR, Vermeulen, MJ, et al. Derivation and evaluation of a termination of resuscitation clinical prediction rule for advanced life support providers. Resuscitation. 2007;74(2):266-275.CrossRefGoogle ScholarPubMed
7. Sasson, C, Hegg, AJ, Macy, M, Park, A, Kellermann, AL, McNally, B. Prehospital termination of resuscitation in cases of refractory out-of-hospital cardiac arrest. JAMA. 2008;300(12):1432-1438.CrossRefGoogle ScholarPubMed
8. Sasson, C, Rogers, MA, Dahl, J, Kellermann, AL. Predictors of survival from out-of-hospital cardiac arrest: a systematic review and meta-analysis. Circ Cardiovasc Qual Outcomes. 2010;3(1):63-81.CrossRefGoogle ScholarPubMed
9. Drennan, IR, Lin, S, Thorpe, KE, Morrison, LJ. The effect of time to defibrillation and targeted temperature management on functional survival after out-of-hospital cardiac arrest. Resuscitation. 2014;85(11):1623-1628.CrossRefGoogle ScholarPubMed
10. Larsen, MP, Eisenberg, MS, Cummins, RO, Hallstrom, A. Predicting survival from out-of-hospital cardiac arrest: a graphic model. Ann Emerg Med. 1992;22(22):1652-1658.CrossRefGoogle Scholar
11. Sanna, T, La Torre, G, de Waure, C, et al. Cardiopulmonary resuscitation alone vs. cardiopulmonary resuscitation plus automated external defibrillator use by non-healthcare professionals: a meta-analysis on 1583 cases of out-of-hospital cardiac arrest. Resuscitation. 2008;76(2):226-232.CrossRefGoogle ScholarPubMed
12. Weisfeldt, ML, Everson-Stewart, S, Sitlani, CM, et al. Ventricular tachyarrhythmias after cardiac arrest in public versus at home. N Engl J Med. 2011;364(4):313-321.CrossRefGoogle ScholarPubMed
13. Capucci, A, Aschieri, D, Guerra, F, et al. Community-based automated external defibrillator only resuscitation for out-of-hospital cardiac arrest patients. Am Heart J. 2016;172:192-200.CrossRefGoogle ScholarPubMed
14. Brooks, SC, Lam, KK, Morrison, LJ. Out-of-hospital cardiac arrests occurring in southern Ontario health care clinics: bystander cardiopulmonary resuscitation and automated external defibrillator use. Can Fam Physician. 2010;56:e213-e218.Google ScholarPubMed
15. Brooks, SC, Simmons, G, Worthington, H, Bobrow, BJ, Morrison, LJ. The PulsePoint Respond mobile device application to crowdsource basic life support for patients with out-of-hospital cardiac arrest: challenges for optimal implementation. Resuscitation. 2016;98:20-26.CrossRefGoogle ScholarPubMed
16. Ringh, M, Rosenqvist, M, Hollenberg, J, et al. Mobile-phone dispatch of laypersons for CPR in out-of-hospital cardiac arrest. N Engl J Med. 2015;372(24):2316-2325.CrossRefGoogle ScholarPubMed
17. Riyapan, S, Lubin, J. Emergency dispatcher assistance decreases time to defibrillation in a public venue: a randomized controlled trial. Am J Emerg Med. 2016;34(3):590-593.CrossRefGoogle Scholar
18. Bohannon, RW. Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants. Age and Ageing. 1997;26:15-19.CrossRefGoogle ScholarPubMed
19. Hazinski, MF, Idris, AH, Kerber, RE, et al. Lay rescuer automated external defibrillator (“public access defibrillation”) programs: lessons learned from an international multicenter trial: advisory statement from the American Heart Association Emergency Cardiovascular Committee; the Council on Cardiopulmonary, Perioperative, and Critical Care; and the Council on Clinical Cardiology. Circulation. 2005;111(24):3336-3340.CrossRefGoogle Scholar
20. Berg, RA, Hemphill, R, Abella, BS, et al. Adult Basic Life Support: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122(18 Suppl 3):S685-S705.Google ScholarPubMed
21. Neumar, RW, Otto, CW, Link, MS, et al. Adult Advanced Cardiovascular Life Support: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122(18 Suppl 3):S729-S767.CrossRefGoogle ScholarPubMed
22. Sun, CL, Brooks, S, Morrison, LJ, Chan, TC. Ranking businesses and municipal locations by spatiotemporal cardiac arrest risk to guide public defibrillator placement. Circulation. 2017;135(12):1104-1120.CrossRefGoogle ScholarPubMed
23. Sun, CL, Demirtas, D, Brooks, SC, Morrison, LJ, Chan, TC. Overcoming spatial and temporal barriers to public access defibrillators via optimization. J Am Coll Cardiol. 2016;68(8):836-845.CrossRefGoogle ScholarPubMed