Location of cardiac arrest in a city center: strategic placement of automated external defibrillators in public locations
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Location of cardiac arrest in a city center: strategic placement of automated external defibrillators in public locations. / Folke, Fredrik; Lippert, Freddy Knudsen; Nielsen, Søren Loumann; Gislason, Gunnar Hilmar; Hansen, Morten Lock; Schramm, Tina Ken; Sørensen, Rikke; Fosbøl, Emil Loldrup; Andersen, Søren Skøtt; Rasmussen, Søren; Køber, Lars; Torp-Pedersen, Christian; Folke, Fredrik; Lippert, Freddy; Nielsen, Søren Loumann; Gislason, Gunnar Hilmar; Hansen, Morten Lock; Schramm, Tina Ken; Sørensen, Rikke; Fosbøl, Emil Loldrup; Andersen, Søren Skøtt; Rasmussen, Søren; Køber, Lars; Torp-Pedersen, Christian.
In: Circulation, Vol. 120, No. 6, 11.08.2009, p. 510-7.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Location of cardiac arrest in a city center: strategic placement of automated external defibrillators in public locations
AU - Folke, Fredrik
AU - Lippert, Freddy Knudsen
AU - Nielsen, Søren Loumann
AU - Gislason, Gunnar Hilmar
AU - Hansen, Morten Lock
AU - Schramm, Tina Ken
AU - Sørensen, Rikke
AU - Fosbøl, Emil Loldrup
AU - Andersen, Søren Skøtt
AU - Rasmussen, Søren
AU - Køber, Lars
AU - Torp-Pedersen, Christian
AU - Folke, Fredrik
AU - Lippert, Freddy
AU - Nielsen, Søren Loumann
AU - Gislason, Gunnar Hilmar
AU - Hansen, Morten Lock
AU - Schramm, Tina Ken
AU - Sørensen, Rikke
AU - Fosbøl, Emil Loldrup
AU - Andersen, Søren Skøtt
AU - Rasmussen, Søren
AU - Køber, Lars
AU - Torp-Pedersen, Christian
N1 - Keywords: Adult; Aged; Aged, 80 and over; Cardiopulmonary Resuscitation; Cost-Benefit Analysis; Defibrillators; Denmark; Electric Countershock; Emergency Medical Services; Female; Health Planning Guidelines; Health Services Accessibility; Heart Arrest; Humans; Incidence; Male; Middle Aged; Public Facilities; Urban Population
PY - 2009/8/11
Y1 - 2009/8/11
N2 - BACKGROUND: Public-access defibrillation with automated external defibrillators (AEDs) is being implemented in many countries worldwide with considerable financial implications. The potential benefit and economic consequences of focused or unfocused AED deployment are unknown. METHODS AND RESULTS: All cardiac arrests in public in Copenhagen, Denmark, from 1994 through 2005 were geographically located, as were 104 public AEDs placed by local initiatives. In accordance with European Resuscitation Council and American Heart Association (AHA) guidelines, areas with a high incidence of cardiac arrests were defined as those with 1 cardiac arrest every 2 or 5 years, respectively. There were 1274 cardiac arrests in public locations. According to the European Resuscitation Council or AHA guidelines, AEDs needed to be deployed in 1.2% and 10.6% of the city area, providing coverage for 19.5% (n=249) and 66.8% (n=851) of all cardiac arrests, respectively. The excessive cost of such AED deployments was estimated to be $33 100 or $41 000 per additional quality-adjusted life year, whereas unguided AED placement covering the entire city had an estimated cost of $108 700 per quality-adjusted life year. Areas with major train stations (1.8 arrests every 5 years per area), large public squares, and pedestrianized areas (0.6 arrests every 5 years per area) were main predictors of frequent cardiac arrests. CONCLUSIONS: To achieve wide AED coverage, AEDs need to be more widely distributed than recommended by the European Resuscitation Council guidelines but consistent with the American Heart Association guidelines. Strategic placement of AEDs is pivotal for public-access defibrillation, whereas with unguided initiatives, AEDs are likely to be placed inappropriately.
AB - BACKGROUND: Public-access defibrillation with automated external defibrillators (AEDs) is being implemented in many countries worldwide with considerable financial implications. The potential benefit and economic consequences of focused or unfocused AED deployment are unknown. METHODS AND RESULTS: All cardiac arrests in public in Copenhagen, Denmark, from 1994 through 2005 were geographically located, as were 104 public AEDs placed by local initiatives. In accordance with European Resuscitation Council and American Heart Association (AHA) guidelines, areas with a high incidence of cardiac arrests were defined as those with 1 cardiac arrest every 2 or 5 years, respectively. There were 1274 cardiac arrests in public locations. According to the European Resuscitation Council or AHA guidelines, AEDs needed to be deployed in 1.2% and 10.6% of the city area, providing coverage for 19.5% (n=249) and 66.8% (n=851) of all cardiac arrests, respectively. The excessive cost of such AED deployments was estimated to be $33 100 or $41 000 per additional quality-adjusted life year, whereas unguided AED placement covering the entire city had an estimated cost of $108 700 per quality-adjusted life year. Areas with major train stations (1.8 arrests every 5 years per area), large public squares, and pedestrianized areas (0.6 arrests every 5 years per area) were main predictors of frequent cardiac arrests. CONCLUSIONS: To achieve wide AED coverage, AEDs need to be more widely distributed than recommended by the European Resuscitation Council guidelines but consistent with the American Heart Association guidelines. Strategic placement of AEDs is pivotal for public-access defibrillation, whereas with unguided initiatives, AEDs are likely to be placed inappropriately.
U2 - 10.1161/CIRCULATIONAHA.108.843755
DO - 10.1161/CIRCULATIONAHA.108.843755
M3 - Journal article
C2 - 19635969
VL - 120
SP - 510
EP - 517
JO - Circulation
JF - Circulation
SN - 0009-7322
IS - 6
ER -
ID: 17394907