Gratton M, Lindholm D J, Campbell J P
University of Missouri-Kansas City School of Medicine and Department of Emergency Medicine, Truman Medical Center 64108, USA.
Prehosp Emerg Care. 1999 Oct-Dec;3(4):303-5. doi: 10.1080/10903129908958958.
Many prehospital cardiac arrests occur in public places. Even the best EMS systems have a finite response time. Therefore, it has been recommended that automated external defibrillators (AEDs) be placed in public areas for immediate access by trained members of the general public.
To determine the locations of multiple cardiac arrests in order to plan for placement of public-access AEDs.
Retrospective review of all primary cardiac arrests in calendar year 1997. Cardiac arrests in which resuscitation was not attempted (DOA), traumatic cases, pediatric cases, and those due to "other" causes were excluded. Location of the cardiac arrest was obtained from the ambulance run ticket. The EMS system is an urban, Midwestern, all-ALS, public-utility model system with fire department first responders that transports approximately 58,000 patients annually.
There was scene response to 922 cardiac arrests. 377 DOAs and 219 nonprimary cardiac arrests were excluded. There were 326 primary cardiac arrests. Sixteen locations had more than one cardiac arrest: 11 locations had two cardiac arrests, four locations had three cardiac arrests, and one location had four cardiac arrests. The airport, an airline overhaul facility, a casino, and two hotels each had two cardiac arrests; the other locations of multiple cardiac arrests were in nursing homes. The professional sports stadiums had no cardiac arrests.
Since very few locations had more than one cardiac arrest, it may be difficult to identify high-yield public places in which to place an AED. Nursing homes may want to consider AED availability.
许多院外心脏骤停发生在公共场所。即使是最好的急救医疗服务（EMS）系统也有有限的响应时间。因此，有人建议在公共场所放置自动体外除颤器（AED），以便受过训练的普通公众能够立即获取。
确定多次心脏骤停的地点，以便规划公众可使用的AED的放置位置。
回顾性分析1997年全年所有原发性心脏骤停病例。排除未尝试复苏（到达现场已死亡）的心脏骤停、创伤病例、儿科病例以及由“其他”原因导致的病例。心脏骤停的位置从救护车出车单中获取。该EMS系统是一个位于中西部的城市、全高级生命支持（ALS）、公用事业模式系统，由消防部门作为第一响应者，每年运送约58000名患者。
对922例心脏骤停进行了现场响应。排除377例到达现场已死亡病例和219例非原发性心脏骤停病例。有326例原发性心脏骤停。16个地点发生了不止一次心脏骤停：11个地点发生了两次心脏骤停，4个地点发生了三次心脏骤停，1个地点发生了四次心脏骤停。机场、一家航空公司检修设施、一家赌场和两家酒店各发生了两次心脏骤停；多次心脏骤停的其他地点在养老院。专业体育场没有发生心脏骤停。
由于很少有地点发生不止一次心脏骤停，可能难以确定放置AED的高收益公共场所。养老院可能需要考虑配备AED。
