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Regional variation in accessibility of automated external defibrillators in British Columbia

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Abstract

Objectives

Bystander-applied Automated External Defibrillators (AED) improve outcomes for out-of-hospital cardiac arrest. AED placement is often driven by private enterprise or non-for-profit agencies, which may result in inequitable access. We sought to compare AED availability between four regions in British Columbia (BC).

Methods

We identified AEDs (confirmed to be operational) and emergency medical system (EMS)-treated out-of-hospital cardiac arrests (OHCA) from provincial registries. We compared AED availability between BC’s four most populous regions. The primary outcome was the total regional weekly accessible AED-hours per 100,000 population. We also examined: AEDs per 100,000 population and per km2, the ratio of AEDs to OHCA, and the distance from each OHCA to the closest AED.

Results

From provincial registries, we included 879 AEDs from BC’s four most populous regions, where 9333 EMS-treated OHCA occurred over a 5-year period. The most common AED location types were stores, public community centres, and office buildings. Ten percent of AEDs were accessible for all hours. Weekly accessible AED-hours/100,000 population in the four regions were: 3845, 1734, 1594, and 1299. AEDs/100,000 population ranged from 22 to 48, and AEDs/km2 ranged from 0.0048 to 0.20. The number of OHCAs per AED per year ranged from 1.1 to 2.8. The median OHCA-to-closest AED distance ranged from 503 (IQR 244, 947) to 925 (IQR 455, 1501) metres. The regional mean accessibility of individual AEDs ranged between 59 and 79 h per week.

Conclusion

BC’s four most populous regions demonstrate substantial variability in AED accessibility. Further benefit could be derived from AEDs if placed in locations accessible all hours. Our data may encourage community planning efforts to use data-based strategies to systematically place AEDs in optimal locations with strategies to maximize accessibility.

Abstrait

Objectifs

Les défibrillateurs externes automatisés (DEA) appliqués par les témoins améliorent les résultats en cas d’arrêt cardiaque hors hôpital. Le placement des DEA est souvent dirigé par une entreprise privée ou des organismes sans but lucratif, ce qui peut entraîner un accès inéquitable. Nous avons cherché à comparer la disponibilité des DEA entre quatre régions de la Colombie-Britannique.

Méthodes

Nous avons identifié les DEA (dont la mise en service a été confirmée) et les SMU (système médical d’urgence) traités par arrêt cardiaque hors hôpital (AHC) dans les registres provinciaux. Nous avons comparé la disponibilité des DEA entre les quatre régions les plus peuplées de la Colombie-Britannique. Le résultat principal était le nombre total d’heures de DEA accessibles hebdomadaires par région pour 100000 habitants. Nous avons également examiné : les DEA par 100000 habitants et par km2, le rapport entre les DEA et l’AHCA, et la distance entre chaque AHCA et le DEA le plus proche.

Résultats

À partir des registres provinciaux, nous avons inclus 879 DEA des quatre régions les plus peuplées de la Colombie-Britannique, où 9333 OHCA traités par les SMU se sont produits sur une période de 5 ans. Les types de DEA les plus courants étaient les magasins, les centres communautaires publics et les immeubles de bureaux. Dix pour cent des DEA étaient accessibles toutes les heures. La population hebdomadaire accessible en heures AED/100000 habitants dans les quatre régions était de 3845, 1734, 1594 et 1299. Le nombre de DEA/100 000 habitants variait de 22 à 48, et le nombre de DEA/km2 variait de 0,018 à 0,018. Le nombre de CASO par DEA par année variait de 1,1 à 2,8. La distance médiane entre le DEA OHCA et le DEA le plus proche variait de 503 mètres (IQR 244, 947) à 925 mètres (IQR 455, 1501). L’accessibilité moyenne régionale des DEA individuels variait entre 59 et 79 heures par semaine.

Conclusion

Les quatre régions les plus populeuses de la Colombie-Britannique présentent une variabilité importante de l’accessibilité aux DEA. D’autres avantages pourraient découler des DEA s’ils sont placés dans des endroits accessibles toutes les heures. Nos données peuvent encourager les efforts de planification communautaire à utiliser des stratégies fondées sur les données pour placer systématiquement les DEA dans des endroits optimaux avec des stratégies pour maximiser l’accessibilité.

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Acknowledgements

The BC Cardiac Arrest Registry is funded by the Heart and Stroke Foundation of Canada, and benefits from in-kind support from Province Health Care, BC Emergency Health Services, and Provincial Health Services Authority

Funding

None.

Author information

Author notes

  1. Zhang Hao Li and Matthieu Heidet: Co-First authors, based on equal contributions.

Authors and Affiliations

  1. Division of Radiation Oncology, University of British Columbia, Vancouver, BC, Canada

    Zhang Hao Li

  2. Assistance Publique-Hôpitaux de Paris (AP-HP), SAMU 94 and Emergency Department, Hôpitaux Universitaires Henri Mondor, Créteil, France

    Matthieu Heidet

  3. Université Paris-Est Créteil (UPEC), CIR (EA-3956), Créteil, France

    Matthieu Heidet

  4. BC Resuscitation Research Collaborative, Vancouver, BC, Canada

    Matthieu Heidet, Frank Scheuermeyer, Jon Deakin, Andrew MacPherson, Jim Christenson & Brian Grunau

  5. Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada

    Joban Bal

  6. Department of Psychiatry, University of Toronto, Toronto, ON, Canada

    Sophia Ly

  7. Department of Radiology, University of British Columbia, Vancouver, BC, Canada

    Tyler Yan

  8. Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada

    Frank Scheuermeyer, Andrew MacPherson, Jim Christenson & Brian Grunau

  9. St. Paul’s Hospital, Vancouver, BC, Canada

    Frank Scheuermeyer, Santabhanu Chakrabarti, Jim Christenson & Brian Grunau

  10. Heart and Stroke Foundation, Ottawa, ON, Canada

    Mary Stambulic

  11. British Columbia Emergency Health Services, Vancouver, BC, Canada

    Jon Deakin, Andrew MacPherson & Brian Grunau

  12. Division of Cardiology, University of British Columbia, Vancouver, BC, Canada

    Santabhanu Chakrabarti

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  1. Zhang Hao Li
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Correspondence to Brian Grunau.

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Li, Z.H., Heidet, M., Bal, J. et al. Regional variation in accessibility of automated external defibrillators in British Columbia. Can J Emerg Med 26, 23–30 (2024). https://doi.org/10.1007/s43678-023-00610-2

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