Pediatric and adult Out-of-Hospital cardiac arrest incidence within and near public schools in British Columbia: Missed opportunities for Systematic AED deployment strategies

Li Danny Liang, K. H.Benjamin Leung, Timothy C.Y. Chan, Jonathan Deakin, Matthieu Heidet, Garth Meckler, Frank Scheuermeyer, Shubhayan Sanatani, Jim Christenson, Brian Grunau

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Systematic automated external defibrillator(AED) placement in schools may improve pediatric out-of-hospital cardiac arrest(OHCA) survival. To estimate their utility, we identified school-located pediatric and adult OHCAs to estimate the potential utilization of school-located AEDs. Further, we identified all OHCAs within an AED-retrievable distance of the school by walking, biking, and driving. Methods: We used prospectively collected data from the British Columbia(BC) Cardiac Arrest Registry(2013–2020), and geo-plotted all OHCAs and schools(n = 824) in BC. We identified adult and pediatric(age < 18 years) OHCAs occurring in schools, as well as nearby OHCAs for which a school-based externally-placed AED could be retrieved by a bystander prior to emergency medical system(EMS) arrival. Results: Of 16,409 OHCAs overall in the study period, 28.6 % occurred during school hours. There were 301 pediatric OHCAs. 5(1.7 %) occurred in schools, of whom 2(40 %) survived to hospital discharge. Among both children and adults, 28(0.17 %) occurred in schools(0.0042/school/year), of whom 21(75 %) received bystander resuscitation, 4(14 %) had a bystander AED applied, and 14(50 %) survived to hospital discharge. For each AED, an average of 0.29 OHCAs/year(95 % CI 0.21–0.37), 0.93 OHCAs/year(95 % CI 0.69–1.56) and 1.69 OHCAs/year(95 % CI 1.21–2.89) would be within the potential retrieval distance of a school-located AED by pedestrian, cyclist and automobile retrieval, respectively, using the median EMS response times. Conclusion: While school-located OHCAs were uncommon, outcomes were favourable. 11.1% to 60.9% of all OHCAs occur within an AED-retrievable distance to a school, depending on retrieval method. Accessible external school-located AEDs may improve OHCA outcomes of school children and in the surrounding community.

Original languageEnglish (US)
Pages (from-to)20-25
Number of pages6
JournalResuscitation
Volume181
DOIs
StatePublished - Dec 2022
Externally publishedYes

Keywords

  • AED
  • Cost-effectiveness
  • Out-of-hospital cardiac arrest
  • Pediatric
  • School

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

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