Locational effect on automated external defibrillator use and association of age with on-site return of spontaneous circulation

Tsung Hsi Wang, Hui An Lin, Wei Fong Kao, Chun Chieh Chao

Research output: Contribution to journalArticle

Abstract

Background: Emergency medical services (EMSs) are used by approximately 383,000 patients with out-of-hospital sudden cardiac arrest (SCA) in the United States. Hence, it is crucial to implement automated external defibrillator (AED) programs to prepare responders for an SCA emergency. Taiwanese pass legislature to enforce AED installation in 8 mandatory areas since 2013. Our study investigated the efficacy of the policy regarding AED installation. Materials and methods: We collected data of patients who had sudden cardiac arrest (SCA) in pre-hospital settings, and received resuscitative efforts, including cardiopulmonary resuscitation or defibrillation with AEDs. The data were from July 11, 2013 to July 31, 2015. In total, 209 adult patients were documented by on-site caregivers of different facilities, and a report was mailed to the central health and welfare unit. Results: Schools, large-scale gathering places, and special institutions used AEDs the most, accounting for 33 (15.3%) cases. From non-mandatory AED areas, long-term care facilities had the maximum cases of AED use (32 cases; 14.9%). With commuting stations as a reference, long-distance transport had the lowest odds ratio (OR) of 0.481 (95% confidence interval [CI], 0.24–0.962). The OR for schools, large-scale gathering places, and special institutions was 4.474 (95% CI: 2.497–8.015). Regarding failure of return of spontaneous circulation (ROSC), the OR for the ≥80-year age group was higher than that for the 20–39-year age group. Conclusions: The policy regarding the legislation to install AEDs in mandatory areas improved AED accessibility. Elderly patients aged ≥80 years have a higher rate of ROSC failure.

Original languageEnglish
JournalAmerican Journal of Emergency Medicine
DOIs
Publication statusAccepted/In press - Jan 1 2018

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Defibrillators
Sudden Cardiac Death
Odds Ratio
Age Groups
Confidence Intervals
Out-of-Hospital Cardiac Arrest
Cardiopulmonary Resuscitation
Emergency Medical Services
Long-Term Care
Legislation
Caregivers
Emergencies
Health

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

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title = "Locational effect on automated external defibrillator use and association of age with on-site return of spontaneous circulation",
abstract = "Background: Emergency medical services (EMSs) are used by approximately 383,000 patients with out-of-hospital sudden cardiac arrest (SCA) in the United States. Hence, it is crucial to implement automated external defibrillator (AED) programs to prepare responders for an SCA emergency. Taiwanese pass legislature to enforce AED installation in 8 mandatory areas since 2013. Our study investigated the efficacy of the policy regarding AED installation. Materials and methods: We collected data of patients who had sudden cardiac arrest (SCA) in pre-hospital settings, and received resuscitative efforts, including cardiopulmonary resuscitation or defibrillation with AEDs. The data were from July 11, 2013 to July 31, 2015. In total, 209 adult patients were documented by on-site caregivers of different facilities, and a report was mailed to the central health and welfare unit. Results: Schools, large-scale gathering places, and special institutions used AEDs the most, accounting for 33 (15.3{\%}) cases. From non-mandatory AED areas, long-term care facilities had the maximum cases of AED use (32 cases; 14.9{\%}). With commuting stations as a reference, long-distance transport had the lowest odds ratio (OR) of 0.481 (95{\%} confidence interval [CI], 0.24–0.962). The OR for schools, large-scale gathering places, and special institutions was 4.474 (95{\%} CI: 2.497–8.015). Regarding failure of return of spontaneous circulation (ROSC), the OR for the ≥80-year age group was higher than that for the 20–39-year age group. Conclusions: The policy regarding the legislation to install AEDs in mandatory areas improved AED accessibility. Elderly patients aged ≥80 years have a higher rate of ROSC failure.",
author = "Wang, {Tsung Hsi} and Lin, {Hui An} and Kao, {Wei Fong} and Chao, {Chun Chieh}",
year = "2018",
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language = "English",
journal = "American Journal of Emergency Medicine",
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T1 - Locational effect on automated external defibrillator use and association of age with on-site return of spontaneous circulation

AU - Wang, Tsung Hsi

AU - Lin, Hui An

AU - Kao, Wei Fong

AU - Chao, Chun Chieh

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Emergency medical services (EMSs) are used by approximately 383,000 patients with out-of-hospital sudden cardiac arrest (SCA) in the United States. Hence, it is crucial to implement automated external defibrillator (AED) programs to prepare responders for an SCA emergency. Taiwanese pass legislature to enforce AED installation in 8 mandatory areas since 2013. Our study investigated the efficacy of the policy regarding AED installation. Materials and methods: We collected data of patients who had sudden cardiac arrest (SCA) in pre-hospital settings, and received resuscitative efforts, including cardiopulmonary resuscitation or defibrillation with AEDs. The data were from July 11, 2013 to July 31, 2015. In total, 209 adult patients were documented by on-site caregivers of different facilities, and a report was mailed to the central health and welfare unit. Results: Schools, large-scale gathering places, and special institutions used AEDs the most, accounting for 33 (15.3%) cases. From non-mandatory AED areas, long-term care facilities had the maximum cases of AED use (32 cases; 14.9%). With commuting stations as a reference, long-distance transport had the lowest odds ratio (OR) of 0.481 (95% confidence interval [CI], 0.24–0.962). The OR for schools, large-scale gathering places, and special institutions was 4.474 (95% CI: 2.497–8.015). Regarding failure of return of spontaneous circulation (ROSC), the OR for the ≥80-year age group was higher than that for the 20–39-year age group. Conclusions: The policy regarding the legislation to install AEDs in mandatory areas improved AED accessibility. Elderly patients aged ≥80 years have a higher rate of ROSC failure.

AB - Background: Emergency medical services (EMSs) are used by approximately 383,000 patients with out-of-hospital sudden cardiac arrest (SCA) in the United States. Hence, it is crucial to implement automated external defibrillator (AED) programs to prepare responders for an SCA emergency. Taiwanese pass legislature to enforce AED installation in 8 mandatory areas since 2013. Our study investigated the efficacy of the policy regarding AED installation. Materials and methods: We collected data of patients who had sudden cardiac arrest (SCA) in pre-hospital settings, and received resuscitative efforts, including cardiopulmonary resuscitation or defibrillation with AEDs. The data were from July 11, 2013 to July 31, 2015. In total, 209 adult patients were documented by on-site caregivers of different facilities, and a report was mailed to the central health and welfare unit. Results: Schools, large-scale gathering places, and special institutions used AEDs the most, accounting for 33 (15.3%) cases. From non-mandatory AED areas, long-term care facilities had the maximum cases of AED use (32 cases; 14.9%). With commuting stations as a reference, long-distance transport had the lowest odds ratio (OR) of 0.481 (95% confidence interval [CI], 0.24–0.962). The OR for schools, large-scale gathering places, and special institutions was 4.474 (95% CI: 2.497–8.015). Regarding failure of return of spontaneous circulation (ROSC), the OR for the ≥80-year age group was higher than that for the 20–39-year age group. Conclusions: The policy regarding the legislation to install AEDs in mandatory areas improved AED accessibility. Elderly patients aged ≥80 years have a higher rate of ROSC failure.

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