Automated External Defibrillators and Survival After Nonresidential Out of Hospital Cardiac Arrest in a Small North American City

Most studies demonstrate that the use of automated external defibrillators (AEDs) during out of hospital cardiac arrest is associated with survival, but the majority of these studies were performed in large cities. With this in mind, the aims of our study were to examine AED placement and variables associated with survival after nonresidential out of hospital cardiac arrest (NROHCA) in a small North American city. Cases of NROHCA and locations with AEDs, in Regina, between January 2010 and December 2014 were reviewed. Common locations for NROHCA were identified, the frequency of AED availability was determined, and the relations between survival and AED presence, bystander initiated cardiopulmonary resuscitation (CPR), or shockable rhythms were determined. Only 20% of cases of NROHCA had an AED present on the premise. The presence of an AED (p = 0.94) was not associated with survival to the emergency department, whereas bystander initiated CPR (p<0.01) and shockable rhythm (p<0.01) were associated with survival to the emergency department. The presence of an AED (p = 0.86) and bystander initiated CPR (p = 0.06) were not associated with survival to discharge from the hospital, whereas the presence of a shockable rhythm was (p<0.01). Multivariable logistic regression analysis demonstrated that the presence of a shockable rhythm was independently associated with survival to the emergency department (OR 11.78, p<0.01) and discharge from the hospital (OR 6.08, p<0.01). The optimal locations for AED placement in cities of similar size and density may need to be reexamined, as the findings may have implications for public policies surrounding AED placement. (C) 2017 Elsevier Inc. All rights reserved.