Factors affecting public access defibrillator placement
As part of her work to enable data-driven placement of Public Access Defibrillators Diane Lac has completed a survey of individuals, groups and organisations across the UK who are involved in PAD installation.
Results were published in Resuscitation Plus: Diane Lac et al., ‘Factors Affecting Public Access Defibrillator Placement Decisions in the United Kingdom: A Survey Study’, Resuscitation Plus 13 (1 March 2023): 100348, https://doi.org/10.1016/j.resplu.2022.100348.
This study aimed to understand current community PAD placement strategies and identify factors which influence PAD placement decision-making in the United Kingdom (UK).
Individuals, groups and organisations involved in PAD placement in the UK were invited to participate in an online survey collecting demographic information, facilitators and barriers to community PAD placement and information used to decide where a PAD is installed in their experiences. Survey responses were analysed through descriptive statistical analysis and thematic analysis.
There were 106 included responses. Distance from another PAD (66%) and availability of a power source (63%) were most frequently used when respondents are deciding where best to install a PAD and historical occurrence of cardiac arrest (29%) was used the least. Three main themes were identified influencing PAD placement: (i) the relationship between the community and PADs emphasising community engagement to create buy-in; (ii) practical barriers and facilitators to PAD placement including securing consent, powering the cabinet, accessibility, security, funding, and guardianship; and (iii) ‘risk assessment’ methods to estimate the need for PADs including areas of high footfall, population density and type, areas experiencing health inequalities, areas with delayed ambulance response and current PAD provision.
Decision-makers want to install PADs in locations that maximise impact and benefit to the community, but this can be constrained by numerous social and infrastructural factors. The best location to install a PAD depends on local context; work is required to determine how to overcome barriers to optimal community PAD placement.
The full article is available here.
The Resuscitation Research Group at Emerge14.
On 2nd December 2022, Gareth Clegg presented on all the work undertaken throughout the year 2022 by the RRG team.
Some of the highlights included:
- Scotland’s OHCA Report 2019-22 (click here to find out more)
- Revising Chain of Survival – focus on Readiness
- Public Access Defibrillators – placement and SIMD discussion
- Play Your Part campaign (https://savealife.scot/play-your-part/)
- Minimum Viable Product (MVP) for CPR familiarisation (click here to find out more)
- GoodSAM (click here to find out more)
You can see a pdf of the presentation here.
For more information about EMEGE14 click here.
The latest OHCA data has been published by RRG and the Scottish Ambulance Service, here is a summary of the main findings:
- From 1st April 2021 to 31st May 2022 there were 3,140 cardiac arrests where resuscitation was attempted. This represents an incidence rate of 573.0 OHCA per million population of Scotland.
- Overall, 30-day survival was 9.7% (Strategy aim 15%), representing 2 55.5 survivors per million population. This is less than in 2018-19
- (11.9%), but significantly recovered after a drop in survival to 7.5% during the COVID-19 pandemic.
- Return of Spontaneous Circulation (ROSC) rate in patients with a shockable initial rhythm (Utstein comparator) was 52.3%, with a 30-day survival rate of 26.1%, the highest recorded level since 2011-12.
- Bystander CPR rate was 66.1% (Strategy aim 85%), the highest recorded since 2011-12 and having continued to rise during the COVID-19 pandemic.
- The number of Public Access Defibrillators (PAD) in communities across Scotland that are registered on the national defibrillator network (The Circuit) has more than doubled since 2019 and is now at almost 5,000. The rate of PAD deployment by the public was 8% (Strategy aim 20%).
- Scottish Index of Multiple Deprivation (SIMD) associated inequalities remain, with those living in the most deprived areas in Scotland (SIMD1) more than twice as likely to have an OHCA and 40% less likely to be alive 30 days after the event when compared to people living in the least deprived areas in Scotland (SIMD5).
- The COVID-19 pandemic had a significant impact on OHCA outcomes but we have made a substantial recovery.
The full report can be accessed here
Susan Gardner joined the RRG team in October as a CPR Project Coordinator for SALFS. Susan is responsible for community engagement and Heartstart activities across secondary schools in Scotland.
Her goal is to ensure all children and members of the public in Scotland are equipped with the life saving knowledge of CPR and have the confidence to use these skills in an out of hospital cardiac arrest situation.
She came to Save A Life For Scotland from the Scottish Ambulance Service Community Resilience department and has previous experience working as an Ambulance Technician and a Nurse within Orthopaedics at the Royal Alexandra Hospital in Paisley.
The RRG team and the SALFS project supported the launch of the GoodSAM app by the Scottish Ambulance Service on 14th October 2022 to mark the World Restart a Heart Day.
The application has been live for the last few years but only off-duty registered medical professionals could become the first responders in out-of-hospital cardiac arrest cases. The app has now opened to anyone with CPR skills in Scotland.
How does it work?
After the initial registration, the user gets an alert if they are nearby a reported cardiac arrest and they can accept or decline the call. Once on the scene, they will support the CPR delivery until the paramedics arrive.
To find out more, go to https://savealife.scot/goodsam/.