Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON, Canada.
Resuscitation. 2013 Jul;84(7):904-9. doi: 10.1016/j.resuscitation.2012.11.019. Epub 2012 Nov 29.
Public access defibrillation with automated external defibrillators (AEDs) can improve survival from out-of-hospital cardiac arrests (OHCA) occurring in public. Increasing the effective range of AEDs may improve coverage for public location OHCAs.
To quantify the relationship between AED effective range and public location cardiac arrest coverage.
This was a retrospective cohort study using the Resuscitation Outcomes Consortium Epistry database. We included all public-location, atraumatic, EMS-attended OHCAs in Toronto, Canada between December 16, 2005 and July 15, 2010. We ran a mathematical model for AED placement that maximizes coverage of historical public OHCAs given pre-specified values of AED effective range and the number of locations to place AEDs. Locations of all non-residential buildings were obtained from the City of Toronto and used as candidate sites for AED placement. Coverage was evaluated for range values from 10 to 300 m and number of AED locations from 10 to 200, both in increments of 10, for a total of 600 unique scenarios. Coverage from placing AEDs in all public buildings was also measured.
There were 1310 public location OHCAs during the study period, with 25,851 non-residential buildings identified as candidate sites for AED placement. Cardiac arrest coverage increased with AED effective range, with improvements in coverage diminishing at higher ranges. For example, for a deployment of 200 AED locations, increasing effective range from 100 m to 200 m covered an additional 15% of cardiac arrests, whereas increasing range further from 200 m to 300 m covered an additional 10%. Placing an AED in each of the 25,851 public buildings resulted in coverage of 50% and 95% under assumed effective ranges of 50 m and 300 m, respectively.
Increasing AED effective range can improve cardiac arrest coverage. Mathematical models can help evaluate the potential impact of initiatives which increase AED range.
公众可使用自动体外除颤器（AED）进行公共除颤，这可以提高院外心脏骤停（OHCA）患者的生存率。增加 AED 的有效范围可能会提高对公共位置 OHCA 的覆盖范围。
量化 AED 有效范围与公共位置心脏骤停覆盖范围之间的关系。
这是一项回顾性队列研究，使用复苏结果联合会 Epistry 数据库。我们纳入了 2005 年 12 月 16 日至 2010 年 7 月 15 日期间在加拿大多伦多市发生的所有公共位置、无创伤性、EMS 参与的 OHCA。我们运行了一个 AED 放置的数学模型，该模型最大化了给定 AED 有效范围和放置 AED 位置数量的历史公共 OHCA 覆盖范围。从多伦多市获得了所有非住宅建筑物的位置，并将其用作 AED 放置的候选地点。评估了范围值为 10 至 300 m 且 AED 位置数量为 10 至 200（均以 10 为增量）的 600 种独特情况的覆盖范围。还测量了在所有公共建筑物中放置 AED 的覆盖范围。
在研究期间，有 1310 例公共位置 OHCA，有 25851 座非住宅建筑物被确定为 AED 放置的候选地点。随着 AED 有效范围的增加，心脏骤停的覆盖范围也随之增加，而在更高的范围内，覆盖范围的改善逐渐减少。例如，对于 200 个 AED 位置的部署，将有效范围从 100 m 增加到 200 m 将额外覆盖 15%的心脏骤停，而将范围从 200 m 进一步增加到 300 m 将额外覆盖 10%。假设有效范围分别为 50 m 和 300 m，在 25851 座公共建筑物中的每座建筑物中放置一个 AED，覆盖范围分别为 50%和 95%。
增加 AED 的有效范围可以提高心脏骤停的覆盖范围。数学模型可以帮助评估提高 AED 范围的举措的潜在影响。
