Department of Rescue and Disaster Medicine, Poznan University of Medical Sciences, Poznań, Poland; 2nd Department of Cardiology, HCP Medical Centre, Poznan University of Medical Sciences, Poznań, Poland
Department of Rescue and Disaster Medicine, Poznan University of Medical Sciences, Poznań, Poland
Kardiol Pol. 2018;76(1):181-185. doi: 10.5603/KP.a2017.0199. Epub 2017 Nov 23.
Sudden cardiac arrest (SCA) is a frequent cause of death in the developed world. Early defibrillation, preferably within the first minutes of the incident, significantly increases survival rates. Accessible automated external defibrillators (AED) in public areas have been promoted for many years, and several locations are equipped with these devices.
The aim of the study was to assess the real-life availability of AEDs and assess possible sources of delay.
The study took place in the academic towns of Poznan, Lodz, and Warsaw, Poland. The researchers who were not aware of the exact location of the AED in the selected public locations had to deliver AED therapy in simulated SCA scenarios. For the purpose of the trial, we assumed that the SCA takes place at the main entrance to the public areas equipped with an AED.
From approximately 200 locations that have AEDs, 78 sites were analysed. In most places, the AED was located on the ground floor and the median distance from the site of SCA to the nearest AED point was 15 m (interquartile range [IQR] 7-24; range: 2-163 m). The total time required to deliver the device was 96 s (IQR 52-144 s). The average time for discussion with the person responsible for the AED (security officer, staff, etc.) was 16 s (IQR 0-49). The AED was located in open access cabinets for unrestricted collection in 29 locations; in 10 cases an AED was delivered by the personnel, and in 29 cases AED utilisation required continuous personnel assistance. The mode of accessing the AED device was related to the longer discussion time (p < 0.001); however, this did not cause any significant delay in therapy (p = 0.132). The AED was clearly visible in 34 (43.6%) sites. The visibility of AED did not influence the total time of simulated AED implementation.
We conclude that the access to AED is relatively fast in public places. In the majority of assessed locations, it meets the recommended time to early defibrillation of under 3 min from the onset of the cardiac arrest; however, there are several causes for possible delays. The AED signs indicating the location of the device should be larger. AEDs should also be displayed in unrestricted areas for easy access rather than being kept under staff care or in cabinets.
在发达国家，心搏骤停（SCA）是导致死亡的常见原因。尽早除颤，最好在事件发生后的最初几分钟内进行，可显著提高存活率。多年来，公共场所一直推广使用方便获取的自动体外除颤器（AED），并且有几个地点已经配备了这些设备。
本研究旨在评估现实生活中 AED 的可用性，并评估可能导致延迟的原因。
该研究在波兰波兹南、罗兹和华沙的学术城镇进行。研究人员在模拟 SCA 场景中，在未获知所选公共场所中 AED 确切位置的情况下，必须进行 AED 治疗。为了进行试验，我们假设 SCA 发生在配备 AED 的公共场所的主要入口处。
在大约 200 个配备 AED 的地点中，分析了 78 个地点。在大多数地方，AED 位于一楼，从 SCA 发生地点到最近 AED 点的中位数距离为 15 米（四分位距 [IQR] 7-24；范围：2-163 米）。运送设备总共需要 96 秒（IQR 52-144 秒）。与负责 AED（安全人员、工作人员等）的人员进行讨论的平均时间为 16 秒（IQR 0-49）。AED 位于开放存取柜中，可自由取用，在 29 个地点；在 10 个案例中，AED 由人员运送，在 29 个案例中，使用 AED 需要持续的人员协助。访问 AED 设备的模式与较长的讨论时间有关（p<0.001）；但是，这并没有导致治疗明显延迟（p=0.132）。在 34 个（43.6%）地点，AED 清晰可见。AED 的可见性并不影响模拟 AED 实施的总时间。
我们的结论是，在公共场所获取 AED 相对较快。在评估的大多数地点，从心脏骤停开始到进行早期除颤的推荐时间都在 3 分钟以内；但是，存在一些可能导致延迟的原因。指示设备位置的 AED 标志应更大。AED 也应该显示在易于访问的不受限制的区域，而不是由工作人员保管或放置在柜子中。
