Rates of AED use low, even when located near an out-of-hospital cardiac arrest
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Key takeaways:
- For patients with out-of-hospital cardiac arrest, the rate of automated external defibrillator use was low.
- Rates were 16.7% if an AED was within a 1-minute walk but 4% if it was more than a 6-minute walk away.
ATLANTA — In Kansas City, Missouri, which maintains a registry of public automated external defibrillators, use of public AEDs for out-of-hospital cardiac arrests was low, even when an AED was located near the patient, researchers reported.
“Some cities have begun to maintain a registry of public AEDs, but the questions still remain, are these public AEDs where they need to be, and by that I mean, are they within a reasonable distance to the out-of-hospital cardiac arrest we’re observing, and are bystanders actually using these things in a timely manner during the cardiac arrest,” Mirza S. Khan, MD, a physician and medical informatician at the University of Missouri-Kansas City, said during a press conference.
Khan and colleagues analyzed 1,799 out-of-hospital cardiac arrests occurring in Kansas City from 2019 to 2022 that were included in the CARES registry and data from the city’s public access AED registry of 1,422 AEDs. They calculated the walking time between each out-of-hospital cardiac arrest site and the nearest public AED and the frequency of out-of-hospital cardiac arrest, bystander CPR and bystander AED use, stratified by whether the incident occurred at home or in public.
The majority of out-of-hospital cardiac arrests occurred at home (1,521 vs. 278), Khan said at the press conference.
Bystander CPR occurred approximately 40% of the time (41.7% at home, 42.5% in public), he said.
However, he said, there were no cases of bystander AED use in at-home cardiac arrests, despite approximately one-quarter of them being within a 4-minute walk of a public AED, and use of bystander AED in arrests that occurred in public was low, despite nearly half of them being within a 4-minute walk of a public AED.
The overall rate of bystander AED use in arrests that occurred in public was 6.8%, which rose to 16.7% if a public AED was within a 1-minute walk and 9.8% if a public AED was within a 4-minute walk, and declined to 4% if a public AED was more than a 6-minute walk away, Khan said, noting the rates of bystander CPR and AED use among public arrests in the study were consistent with national averages.
The results “highlight that there is more work that needs to be done,” Khan said at the press conference. “I think of public AED registries as an important infrastructure investment, akin to having built the ‘road.’ But for the road to be used well, or at all, you still need street signs, house numbers and maps to allow people to navigate and make use of these important lifesaving tools. Wouldn’t it be great if you had a ‘find my AED’ app? This also stresses the need for improved education, awareness initiatives and signage ... as well as also helps identify hotspots for improved AED deployment and accessibility. We are fortunate to work with local partners who are really interested in making this a reality, and improving outcomes for those who are experiencing out-of-hospital cardiac arrests.”
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Khan MS, et al. Abstract 1254-210. Presented at: American College of Cardiology Scientific Session; April 6-8, 2024; Atlanta.
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