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Defibrillators rarely on deck for out-of-hospital cardiac arrest

by Lee Nelson, Contributing Reporter | August 22, 2016
Cardiology Medical Devices
If you experience cardiac arrest and expect someone to shock your heart back to life, the odds are stacked against you.

A new study has shown there is a one-in-five chance that a potentially lifesaving automated external defibrillator (AED) will be nearby. Plus, even if there is an AED close by, there is a 20 to 30 percent chance it will be inaccessible because it is inside a closed building. Out-of-hospital cardiac arrests have a less than 10 percent survival rate and cause 400,000 deaths in North America yearly. But other studies have shown that immediate access to an AED greatly increases a person’s chance of living.

“The courage of a bystander to act and retrieve an AED can have a huge impact on saving someone’s life,” Timothy Chan, Ph.D., told HCB News. He is senior author of the study and director of the Centre for Healthcare Engineering at the University of Toronto, Canada.

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“Thus, we have to do our part to ensure AEDs are placed in accessible and strategic positions.”

The study was published this month in the Journal of the American College of Cardiology.

Evidence-based placement of AEDs is a major focus of Chan's research group, and it has developed optimization models to help determine the best locations to deploy the devices in order to maximize their spatial and temporal accessibility.

Chan said that the feedback on the study has been quite positive from cardiologists and others.

“Our message seems to resonate broadly, and everybody seems to agree that improving accessibility — which could be helped with legislation — can make a big impact,” he explained.

The most important lessons to be learned from the study, Chan said, are: First, for health care people: “Temporal accessibility is a critical factor that needs to be considered when determining AED placements. In fact, temporal accessibility needs to be explicitly addressed in future policies and position statements regarding AED placement. Right now, the focus is on spatial factors only.”

Second, for the general public or those who have heart conditions: “Be aware of where AEDs are in your daily lives, for your sake, for the sake of your family, and for the sake of the community in which you live and work.”

Stressing the importance of 24/7 accessible AEDs is critical, the study showed.

“If we are unable to make all AEDs available 24/7, then we must know exactly when each AED is accessible,” he explained. “Mandatory AED registration or government supported incentives to register an AED in a centralized system will allow emergency responders to have lifesaving information on the whereabouts and availability of AEDs.”

The researchers chose Toronto to do the study. It is the largest city in Canada with roughly the population of Chicago, and had excellent data due to the efforts of Chan’s collaborator, Dr. Laurie Morrison, director of Rescu at St Michael’s Hospital.

“It would certainly be possible to conduct similar studies in the U.S. to see how widespread the phenomenon of temporal access loss is. We hypothesize that while the accessibility issue is universal, intelligently placing AEDs to optimize both temporal and spatial factors simultaneously can overcome this problem,” he added.

Currently, his research group is examining the potential impact that public-private AED partnerships between major businesses/companies and public service organizations can have on improving AED accessibility and awareness. Placing AEDs in familiar locations, accompanied by recognizable brands, can help improve awareness and shave valuable seconds off the AED retrieval time during an emergency.

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