Strategies on locations of public access defibrillator: A systematic review

• Published in: The American journal of emergency medicine 2021-09, Vol.47, p.52-57
• Main Authors: Liu, Cheng-Heng, Sung, Chih-Wei, Fan, Cheng-Yi, Lin, Hao-Yang, Chen, Chi-Hsin, Chiang, Wen-Chu, Ma, Matthew Huei-Ming, Huang, Edward Pei-Chuan
• Format: Article
• Language: English
• Subjects: Ambulance services; Automated external defibrillators; Automation; Cardiac arrest; Cardiopulmonary resuscitation; CPR; Defibrillation; Defibrillators; Deployment; Emergency medical care; Heart attacks; Heterogeneity; Literature reviews; Location; Mathematical models; Optimization techniques; Out-of-hospital cardiac arrest; Post offices; Public access; Public access defibrillator; Qualitative analysis; Schools; Sports facilities; Survival; Systematic review
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2021.02.033

Out-of-hospital cardiac arrest (OHCA) is a critical condition with poor outcomes. Although the survival rate increases in those who undergo defibrillation, the utility of on-time defibrillation among bystanders remained low. An evaluation of the deployment strategy for public access defibrillators (PADs) is necessary to increase their use and accessibility. This study was to conduct a systematic review for deployment strategies of PADs. Two authors independently searched for articles published before October 2019 from PubMed, Embase, Web of Science, and Cochrane Library. An independent librarian provided the search strategy and assisted the literature research. We included articles that were focused on the main topic, but excluded those which were missing results or that used an unclear definition. The qualitative outcomes were the utility and OHCA coverage of PADs. We performed a qualitative analysis across the studies, but a quantitative analysis was not available due to the studies' heterogeneity in design and variety of outcomes. We eventually included 15 studies. Three strategies were presented: guidelines-based, grid-based, and landmark-based. The guidelines-based deployment was common fit for OHCA events. The grid-based method increased the use of bystander defibrillation 3-fold, and 30-day survival doubled. The top 3 landmarks in the landmark-based strategy were offices (18.6%), schools (13.3%), and sports facilities (12.9%). Utility of PADs might increase if we optimize PAD location by mathematical modeling and evaluation feedback. Three deployment strategies were presented. Although the optimal method could not be fully identified, a more efficient PAD deployment could benefit the population in terms of OHCA coverage and survival among patients with OHCA.