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Mobile Versus Fixed Deployment of Automated External Defibrillators in Rural EMS

Published online by Cambridge University Press:  27 February 2015

R. Darrell Nelson ,
William Bozeman ,
Greg Collins ,
Brian Booe ,
Todd Baker  and
Roy Alson
R. Darrell Nelson*
Affiliation:
Stokes County Emergency Medical Services, Danbury, North Carolina USA EMS and Disaster Fellowship Program, Department of Emergency Medicine, Wake Forest University Health Sciences, Winston-Salem, North Carolina USA
William Bozeman
Affiliation:
EMS and Disaster Fellowship Program, Department of Emergency Medicine, Wake Forest University Health Sciences, Winston-Salem, North Carolina USA
Greg Collins
Affiliation:
Stokes County Emergency Medical Services, Danbury, North Carolina USA
Brian Booe
Affiliation:
Stokes County Emergency Medical Services, Danbury, North Carolina USA
Todd Baker
Affiliation:
Southeastern Emergency Equipment, Youngsville, North Carolina USA
Roy Alson
Affiliation:
EMS and Disaster Fellowship Program, Department of Emergency Medicine, Wake Forest University Health Sciences, Winston-Salem, North Carolina USA
*
Correspondence: R. Darrell Nelson, MD, FACEP Stokes County Emergency Medical Services Director of EMS and Disaster Fellowship Program Department of Emergency Medicine Wake Forest University Health Sciences Medical Center Boulevard Winston-Salem, NC 27157 E-mail: [email protected]
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Abstract

Introduction

There is no consensus on where automated external defibrillators (AEDs) should be placed in rural communities to maximize impact on survival from cardiac arrest. In the community of Stokes County, North Carolina (USA) the Emergency Medical Services (EMS) system promotes cardiopulmonary resuscitation (CPR) public education and AED use with public access defibrillators (PADs) placed mainly in public schools, churches, and government buildings.

Hypothesis/Problem

This study tested the utilization of AEDs assigned to first responders (FRs) in their private-owned-vehicle (POV) compared to AEDs in fixed locations.

Methods

The authors performed a prospective, observational study measuring utilization of AEDs carried by FRs in their POV compared to utilization of AEDs in fixed locations. Automated external defibrillator utilization is activation with pads placed on the patient and analysis of heart rhythm to determine if shock/no-shock is indicated. The Institutional Review Board of Wake Forest University Baptist Health System approved the study and written informed consent was waived. The study began on December 01, 2012 at midnight and ended on December 01, 2013 at midnight.

Results

During the 12-month study period, 81 community AEDs were in place, 66 in fixed locations and 15 assigned to FRs in their POVs. No utilizations of the 66 fixed location AEDs were reported (0.0 utilizations/AED/year) while 19 utilizations occurred in the FR POV AED study group (1.27 utilizations/AED/year; P<.0001). Odds ratio of using a FR POV located AED was 172 times more likely than using a community fixed-location AED in this rural community.

Discussion

Placing AEDs in a rural community poses many challenges for optimal utilization in terms of cardiac arrest occurrences. Few studies exist to direct rural community efforts in placing AEDs where they can be most effective, and it has been postulated that placing them directly with FRs may be advantageous.

Conclusions

In this rural community, the authors found that placing AED devices with FRs in their POVs resulted in a statistically significant increase in utilizations over AED fixed locations.

NelsonRD , BozemanW , CollinsG , BooeB , BakerT , AlsonR . Mobile Versus Fixed Deployment of Automated External Defibrillators in Rural EMS. Prehosp Disaster Med. 2015;30(2):1-3.

Keywords

cardiopulmonary resuscitationdefibrillationheart arrestresuscitationsudden death
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 30 , Issue 2 , April 2015 , pp. 152 - 154
Copyright
© World Association for Disaster and Emergency Medicine 2015 

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References

1. American Heart Association. 2010 American Heart Association Guidelines for CPR and ECG; Supplement to Circulation. 2010;18(122) Supplement 3:S708-10.Google Scholar
2. Atkins, D. Realistic expectations for public access defibrillation programs. Curr Opin Crit Care. 2010;16(3):191-195.Google Scholar
3. Portner, ME, Pollack, ML, Schirk, SK, Schlenker, MK. Out-of-hospital cardiac arrest locations in a rural community: where should we place AEDs? Prehosp Disaster Med. 2004;19(4):552-555.Google Scholar
4. De Maio, V, Stiell, IG, Vaillancourt, C, et al. Locations of pediatric cardiac arrest: implications for public access defibrillation. Prehosp Emerg Care. 2004;1(8):80.Google Scholar
5. De Maio, V, Stiell, IG, Vaillancourt, C, et al. Predicting the utility of public access defibrillation; why most public school defibrillation programs will not save lives. Emergency Medical Australasia. 2004;16(A):3512.Google Scholar
6. De Maio, V, Stiell, IG, Vaillancourt, C, et al. The epidemiology of cardiac arrest in schools; limited potential for public access defibrillation in a low-risk setting. Acad Emerg Med. 2004;11(5):607.Google Scholar
7. Folke, F, Lippert, FK, Nielsen, SL, et al. Location of cardiac arrest in a city center; strategic placement of AED in public locations. Circ. 2009;120(6):510-517.Google Scholar
8. Haskell, SE, Post, M, Cram, P, Atkins, DL. Community public access sites: compliance with AHA recommendations. Resuscitation. 2009;80(8):854-858.Google Scholar
9. Winkle, RA. The effectiveness and cost effectiveness of public access defibrillation. Clin Cardiol. 2010;33(7):396-399.Google Scholar