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http://dx.doi.org/10.14408/KJEMS.2022.26.2.097

Factors influencing success and safety of AED retrieval in out of hospital cardiac arrests in Singapore  

NG, Jonathan Shen You (Ministry of Health Holdings)
HO, Reuben Jia Shun (Ministry of Health Holdings)
YU, Jae Yong (Department of Digital Health, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University)
NG, Yih Yng (Ministry of Health Holdings)
Publication Information
The Korean Journal of Emergency Medical Services / v.26, no.2, 2022 , pp. 97-111 More about this Journal
Abstract
Purpose: Automated External Defibrillator (AED) usage in out-of-hospital cardiac arrests (OHCAs) improves the survival of patients. In Singapore, public AEDs are protected by locked boxes with a 'break glass' mechanism to deter theft. Community responders have sustained injuries while breaking glass to retrieve AEDs. This unprecedented study aimed to elucidate the factors influencing successful retrieval of an AED and to document the prevalence of injuries. Methods: A survey was created and distributed. Participants were required to have responded to an OHCA in the past 12 months. Comparison tests were performed with the Fischer-Freeman-Halton Exact test or Pearson chi square test at 5% significance levels, and with multiple logistic regression with a logit link function. Results: Eighty-eight participants were eligible. The success of retrieving an AED was found not to be impacted by occupation, age, gender or time. Participants who responded to an OHCA because of activation by the myResponder App were more likely to retrieve an AED successfully. (AOR 11.111, 95% CI: 2.141-58.824) Conclusion: Use of the myResponder mobile application is associated with the greater success of retrieving an AED. Successful retrieval of an AED is not impacted by time, gender, age, or the occupation of the responder. Community responders in Singapore remain motivated to respond to Cardiac Arrests despite risk of injury.
Keywords
Automated external defibrillators(AED); Out-of-hospital Cardiac arrest(OHCA); Mobile applications; Cardiopulmonary resuscitation;
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  • Reference
1 Page RL. The AED in Resuscitation: It's not just about the shock. Trans Am Clin Climatol Assoc 2011;347-55.
2 White AE, Poh JS, Pek PP, Shahidah N, Ng YY, Yap S, Ong MEH. Singapore Out-of-Hospital Cardiac Arrest Registry Report 2011-2018. November 2020. Republic of Singapore. Unit for Prehospital Emergency Care.
3 Baldi E, Grieco NB, Ristagno G, Alihodzic H, Canon V, Birkun A et al. The automated external defibrillator: Heterogeneity of legislation, mapping and use across Europe. new insights from the ensure study. Journal of Clinical Medicine 2021;10(21):5018. https://doi.org/10.3390/jcm10215018   DOI
4 Roh SY, Choi JI, Park SH, Kim YG, Shim J, Kim JS, Han KD, Kim YH. The 10-Year Trend of Out-of-hospital Cardiac Arrests: a Korean Nationwide Population-Based Study. Korean Circ J 2021;51(10):866-74. https://doi.org/10.4070/kcj.2021.0127   DOI
5 Kim HS, Park JH, Kim KH, Bae SH, Jang JD, Lee MS. Factors associated with survival of out-of-hospital cardiac arrest by cardiopulmonary resuscitation of bystander in South Korea. Annals of RSCB 2021;25(6):20713-21.
6 Choe MSP, Lee MJ. National Survey of awareness and training experience of automated external defibrillator. J Korean Soc Emerg Med 2019;30(4):301-8.
7 Kurohi, R. (2018, July 27). 3 Passers-by help save woman who had heart attack at Woodlands coffee shop. The Straits Times.
8 Sarkisian L, Mickley H, Schakow H, Gerke O, Starck SM, Jensen JJ et al. Longer retrieval distances to the automated external defibrillator reduces survival after out-of-hospital cardiac arrest. Resuscitation 2021;44-52. https://doi.org/10.1016/j.resuscitation.2021.11.001   DOI
9 Smith CM, Perkins GD, Vlaev I, Fothergill RT, Griffiths F. Identifying and overcoming barriers to automated external defibrillator use by goodsam volunteer first responders in out-of-hospital cardiac arrest using the theoretical domains framework and behaviour change wheel: A qualitative study. BMJ Open 2020;10(3). Available from: 10.1136/bmjopen-2019-034908   DOI
10 Hansen CM;Wissenberg M;Weeke P;Ruwald MH;Lamberts M;Lippert FK;Gislason GH;Nielsen SL;Kober L;Torp-Pedersen C;Folke F; (n.d.). Automated external defibrillators inaccessible to more than half of nearby cardiac arrests in public locations during evening, nighttime, and weekends. Circulation https://doi.org/10.1161/CIRCULATIONAHA.113.003066   DOI
11 Sakai T, Iwami T, Kitamura T, Nishiyama C, Kawamura T, Kajino K et al. Effectiveness of the new 'mobile AED map' to find and retrieve an AED: A randomised controlled trial. Resuscitation 2011;82(1):69-73. https://doi.org/10.1016/j.resuscitation.2010.09.466   DOI
12 Johnson AM, Cunningham CJ, Zegre-Hemsey JK, Jessica K, Grewe ME, DeBarmore BM et al. Out-of-hospital cardiac arrest bystander defibrillator search time and experience with and without directional assistance: a randomized simulation trial in a community setting. Simulation in Healthcare 2022;17(10)22-8. https://doi.org/10.1097/SIH.0000000000000582   DOI
13 Pulver A, Wei R, Mann C. Locating AED enabled medical drones to enhance cardiac arrest response times. Prehosp Emerg Care 2016;20(3):378-89. https://doi.org/10.3109/10903127.2015.1115932   DOI
14 Boutilier JJ, Brooks SC, Janmohamed A, Byers A, Buick JE, Zhan C et al. Optimizing a drone network to deliver automated external defibrillators. Circulation. 2017;135(25):2454-65. https://doi.org/10.1161/CIRCULATIONAHA.116.026318   DOI
15 Tan S. (2021, August 23). Enquiry about AEDs in other countries.
16 Folke F. (2020, September 16). Inviting Input for Literature Review for research on AED responder injuries.
17 Tanaka H, Ong MEH, Siddiqui FJ, Ma MHM, Kaneko H, Lee KW et al. Modifiable factors associated with survival after out-of-hospital cardiac arrest in the Pan-Asian resuscitation outcomes study. Annals of Emergency Medicine 2018;71(5). https://doi.org/10.1016/j.annemergmed.2017.07.484   DOI
18 Metelmann C, Metelmann B, Kohnen D, Brinkrolf P, Andelius L, Bottige BW et al. Smartphone-based dispatch of community first responders to out-of-hospital cardiac arrest - statements from an international consensus conference. Scand J Trauma, Resusc Emerg Med 2021;29:Article number 29. https://doi.org/10.1186/s13049-021-00841-1   DOI
19 Ming Ng W, De Souza CR, Pek PP, Shahidah N, Ng YY, Arulanandam S et al. MyResponder smartphone application to crowdsource basic life support for out-of-hospital cardiac arrest: The Singapore experience. Prehosp Emerg Care 2020;25(3):388-96. https://doi.org/10.1080/10903127.2020.1777233   DOI
20 Andelius L, Malta Hansen C, Lippert FK, Karlsson L, Torp-Pedersen C, Kjaer Ersboll A et al. Smartphone activation of citizen responders to facilitate defibrillation in out-of-hospital cardiac arrest. Journal of the American College of Cardiology 2020;76(1):43-53. https://doi.org/10.1016/j.jacc.2020.04.073   DOI
21 Pollack RA, Brown SP, Rea T, Aufderheide T, Barbic D, Buick JE et al. Impact of bystander automated external defibrillator use on survival and functional outcomes in shockable observed public cardiac arrests. Circulation 2018;137(20):2104-13. https://doi.org/10.1161/CIRCULATIONAHA.117.030700   DOI
22 Semeraro F, Greif R, Bottiger BW, Burkart R, Cimpoesu D, Georgiou M et al. European Resuscitation Council guidelines 2021: Systems saving lives. Resuscitation 2021;161:80-97. https://doi.org/10.1016/j.resuscitation.2021.02.008   DOI
23 Blom MT, Beesems SG, Homma PCM, Zijlstra JA, Hulleman M, van Hoeijen DA et al. Improved survival after out-of-hospital cardiac arrest and use of automated external defibrillators. Circulation 2014:130(21):1868-75. https://doi.org/10.1161/CIRCULATIONAHA.114.010905   DOI