Effective deployment of AEDs targeting sudden cardiac arrest in the home: simulation study using a geographic information system

DOI 25 References
  • Endoh Hiroshi
    Niigata University Medical Dental Hospital Advanced Disaster Medical & Critical Care Center
  • Hida Seiji
    Niigata University Medical Dental Hospital Advanced Disaster Medical & Critical Care Center
  • Oohashi Satomi
    Niigata University Medical Dental Hospital Advanced Disaster Medical & Critical Care Center
  • Kinosita Hidenori
    Niigata University Medical Dental Hospital Advanced Disaster Medical & Critical Care Center
  • Hayashi Yusuke
    Niigata University Medical Dental Hospital Advanced Disaster Medical & Critical Care Center
  • Saitoh Naoki
    Niigata University Medical Dental Hospital Advanced Disaster Medical & Critical Care Center
  • Honda Tadayuki
    Niigata University Medical Dental Hospital Advanced Disaster Medical & Critical Care Center

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  • 自宅における突然の心停止を対象とした自動体外式除細動器の効果的配置の検討‐地理情報システムを用いたシミュレーション‐

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Background: The majority of sudden cardiac arrests (SCA) occur in the home, an area not targeted by current public access defibrillation (PAD) programs.<BR>Objective: The purpose of this study was to investigate effective deployment placement of AEDs against SCA in the home using a geographic information system (GIS).<BR>Methods: A total of 848 in-home SCA were extracted from the Utstein data of Niigata city in 2008. Initially, distances between in-home SCAs and existing AEDs deployed as a part of a PAD program (568 places) were studied. Using GIS, 200m or 100m buffer zones were created around the locations of existing AEDs, and the number of in-home SCAs contained within the buffer zones was counted. Convenience stores and police facilities are frequently located in residential areas and are open 24 hours, which makes them particularly good locations for AED placement against in-home SCA. Therefore, deployment of AEDs in convenience stores and police facilities was studied using the same method.<BR>Results: A total of 23.5% and 5.7% of in-home SCAs occurred within a distance of 200m and 100m, respectively, from an existing PAD program-deployed AED. However, nearly 65% of these placements were in schools, sport facilities, government office, and private company that are not generally accessible all 24 hours. If AEDs were deployed in convenience stores (232 places) and police facilities (93 places), 16.5% and 4.7% of in-home SCAs would have occurred within a distance of 200m and 100m, respectively. The number of in-home SCAs within a distance of 100m was enough to meet the recommendations for performing PAD program, and the number of SCAs per single AED placement was significantly higher than existing AEDs (0.12 versus 0.07, p<0.05). Although more than one witness may be required to perform both in-home CPR and retrieval of an AED, convenience stores and police facilities may be more effective locations because they provide 24 hour AED access.<BR>Conclusion: In the provincial city, convenience stores and police facilities seem to be effective deployment places of AEDs against SCA in home.

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