Novel relocation methods for automatic external defibrillator improve out-of-hospital cardiac arrest coverage under limited resources

Autor: Roman Burkart, Martin Weiser, Angelo Auricchio, Nicholas Tierney, H. Jost Reinhold, Claudio Benvenuti, Antonietta Mira
Přispěvatelé: University of Zurich, Auricchio, Angelo
Rok vydání: 2017
Předmět:
Automated external defibrillation
Male
Resuscitation
Defibrillation
610 Medicine & health
Population based
030204 cardiovascular system & hematology
Emergency Nursing
11171 Cardiocentro Ticino
2705 Cardiology and Cardiovascular Medicine
Out of hospital cardiac arrest
Health Services Accessibility
03 medical and health sciences
0302 clinical medicine
medicine
Humans
Registries
Aged
Retrospective Studies
Cardiopulmonary resuscitation
business.industry
Location model
030208 emergency & critical care medicine
Middle Aged
Cardiac arrest
medicine.disease
2907 Emergency Nursing
Emergency Medicine
Automatic external defibrillator
Female
Medical emergency
Rural area
2711 Emergency Medicine
Cardiology and Cardiovascular Medicine
business
Relocation
Defibrillators
Out-of-Hospital Cardiac Arrest
Switzerland
Limited resources
Zdroj: Resuscitation. 125
ISSN: 1873-1570
Popis: Background Mathematical optimisation models have recently been applied to identify ideal Automatic External Defibrillator (AED) locations that maximise coverage of Out of Hospital Cardiac Arrest (OHCA). However, these fixed location models cannot relocate existing AEDs in a flexible way, and have nearly exclusively been applied to urban regions. We developed a flexible location model for AEDs, compared its performance to existing fixed location and population models, and explored how these perform across urban and rural regions. Methods Optimisation techniques were applied to AED deployment and OHCA coverage was assessed. A total of 2802 geolocated OHCAs occurred in Canton Ticino, Switzerland, from January 1st 2005 to December 31st 2015. Results There were 719 AEDs in Canton Ticino. 635 (23%) OHCA events occurred within 100 m of an AED, with 306 (31%) in urban, and 329 (18%) in rural areas. Median distance from OHCA events to the nearest AED was 224 m (168 m urban vs. 269 m rural). Flexible location models performed better than fixed location and population models, with the cost to deploy 20 new AEDs instead relocating 171 existing AEDs to new locations, improving OHCA coverage to 38%, compared to 26% using fixed models, and 24% with the population based model. Conclusions Optimisation models for AEDs placement are superior to population models and should be strongly considered by communities when selecting areas for AED deployment. Compared to other models, flexible location models increase overall OHCA coverage, and decreases the distance to nearby AEDs, even in rural areas, while saving significant financial resources.
Databáze: OpenAIRE
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