Real-world insight into public access defibrillator use over five years

• Published in: Open heart Vol. 7; no. 1; p. e001251
• Main Authors: Torney, Hannah, McAlister, Olibhéar, Harvey, Adam, Kernaghan, Amy, Funston, Rebecca, McCartney, Ben, Davis, Laura, Bond, Raymond, McEneaney, David, Adgey, Jennifer
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group 01.06.2020
• Series: Original research
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Arrhythmias and Sudden Death; Child; Child, Preschool; Defibrillators; Electric Countershock - instrumentation; Female; Health Services Accessibility; Humans; Infant; Male; Middle Aged; Out-of-Hospital Cardiac Arrest - mortality; Out-of-Hospital Cardiac Arrest - physiopathology; Out-of-Hospital Cardiac Arrest - therapy; Recovery of Function; Retrospective Studies; Time Factors; Time-to-Treatment; Treatment Outcome; Young Adult; ventricular fibrillation; resuscitation; ventricular tachycardia; defibrillation
• ISSN: 2053-3624; 2053-3624
• DOI: 10.1136/openhrt-2020-001251

Public access defibrillators (PADs) represent unique life-saving medical devices as they may be used by untrained lay rescuers. Collecting representative clinical data on these devices can be challenging. Here, we present results from a retrospective observational cohort study, describing real-world PAD utilisation over a 5-year period. Data were collected between October 2012 and October 2017. Responders voluntarily submitted electronic data downloaded from HeartSine PADs, and patient demographics and other details using a case report form in exchange for a replacement battery and electrode pack. Data were collected for 977 patients (692 males, 70.8%; 255 females, 26.1%; 30 unknown, 3.1%). The mean age (SD) was 59 (18) years (range <1 year to 101 years). PAD usage occurred most commonly in homes (n=328, 33.6%), followed by public places (n=307, 31.4%) and medical facilities (n=128, 13.1%). Location was unknown in 40 (4.09%) events. Shocks were delivered to 354 patients. First shock success was 312 of 350 patients where it could be determined (89.1%, 95% CI 85.4% to 92.2%). Patients with reported response times ≤5 min were more likely to survive to hospital admission (89/296 (30.1%) vs 40/250 (16.0%), p<0.001). Response time was unknown for 431 events. This is the first study to report global PAD usage in voluntarily submitted, unselected real-world cases and demonstrates the real-world effectiveness of PADs, as confirmed by first shock success.