Salerno Jessica E, Weiss Leonard S, Salcido David D
Prehosp Emerg Care. 2018 Sep-Oct;22(5):565-570. doi: 10.1080/10903127.2018.1439128. Epub 2018 Mar 1.
Opioid-related overdoses have been steadily increasing over the past decade in the United States. Naloxone is used by first responders to revive overdose victims, but results may be improved by increasing access to and usage of naloxone by bystanders. Automated External Defibrillators (AEDs) are pervasive, recognizable, and publicly accessible. Co-locating naloxone kits with AEDs could increase public naloxone access and usage. However, the impact of co-locating naloxone kits with AEDs is not known.
We sought to evaluate the impact of co-locating naloxone kits with AEDs in a simulation study centered on Allegheny County, Pennsylvania.
Naloxone administration frequency (N = 3,650) at the zip-code level from March 2016 to March 2017 was provided by the Allegheny County Health Department. AED point locations (N = 1,653) were obtained from the University of Pittsburgh's Resuscitation Logistics and Informatics Venture. Zip-code level geospatial analyses were conducted using QGIS and STATA to determine the correlation between AED count and naloxone administrations. AED naloxone kit (N-AED) coverage, based on a maximum "walking-distance" radius of 200 m, was estimated at a zip-code level using the QGIS buffer tool and a custom MATLAB script. Potential impact of N-AEDs was estimated assuming uniform spatial distribution of naloxone administrations.
The median (IQR) AED coverage based on a 200 m access radius per zip code was 4% (0-7). The median (IQR) number of naloxone administrations per zip code was 27(7-55). A total of 82 zip codes had data for both AED locations and naloxone administrations. The correlation between number of AEDs and naloxone administrations per zip code was 0.20. Overall, 16% of naloxone administrations were estimated to be covered by an N-AED.
Using these limited methods, co-locating naloxone with AEDs is not likely to have a standalone impact on preventing overdose fatalities.
在过去十年中，美国与阿片类药物相关的过量用药情况一直在稳步增加。急救人员使用纳洛酮来抢救过量用药受害者，但通过增加旁观者获取和使用纳洛酮的机会，结果可能会得到改善。自动体外除颤器（AED）随处可见、易于识别且公众可使用。将纳洛酮试剂盒与AED放置在一起可以增加公众获取和使用纳洛酮的机会。然而，将纳洛酮试剂盒与AED放置在一起的影响尚不清楚。
我们试图在以宾夕法尼亚州阿勒格尼县为中心的模拟研究中评估将纳洛酮试剂盒与AED放置在一起的影响。
阿勒格尼县卫生部门提供了2016年3月至2017年3月邮政编码级别的纳洛酮给药频率（N = 3650）。AED的点位（N = 1653）来自匹兹堡大学的复苏物流与信息风险项目。使用QGIS和STATA进行邮政编码级别的地理空间分析，以确定AED数量与纳洛酮给药之间的相关性。基于最大“步行距离”半径200米，使用QGIS缓冲区工具和自定义MATLAB脚本在邮政编码级别估计AED纳洛酮试剂盒（N - AED）的覆盖率。假设纳洛酮给药的空间分布均匀，估计N - AED的潜在影响。
每个邮政编码基于200米接入半径的AED覆盖率中位数（IQR）为4%（0 - 7）。每个邮政编码的纳洛酮给药中位数（IQR）为27（7 - 55）。共有82个邮政编码同时拥有AED位置和纳洛酮给药的数据。每个邮政编码的AED数量与纳洛酮给药之间的相关性为0.20。总体而言，估计16%的纳洛酮给药可被N - AED覆盖。
使用这些有限的方法，将纳洛酮与AED放置在一起不太可能对预防过量用药死亡产生独立影响。
