Localization of out-of-hospital cardiac arrest in Goteborg 1994-2002 and implications for public access defibrillation.
OBJECTIVE
The purpose of this study was to report the locality of out-of-hospital cardiac arrest (OHCA) in the city of Goteborg and to identify implications for public access defibrillation (PAD).


METHODS
Ambulance run reports for the years 1994-2002 were studied retrospectively and manually to establish the location of the cardiac arrest.


RESULTS
The location could be identified in 2194 of 2197 patients (99.9%). One thousand four hundred and twenty-nine (65%) of the arrests took place in the victims' homes. Two hundred eighty-five (13%) were outdoors and 57 (3%) in cars. Fifty-one (2%) took place en route in ambulances. These arrests were regarded not to be generally suitable for PAD. One hundred thirty-five (6%) of the arrests happened in a public building. Eighteen of these 135 were in 15 different general practitioners' offices. A ferry terminal had 11 cardiac arrests. One hundred fifty (7%) of the arrests took place in different care facilities. Twenty-one (1%) patients had their cardiac arrest in public transport locations. Twenty-two (1%) patients arrested at work in 20 different sites. In total, 17% of the cardiac arrests were regarded as generally suitable for PAD. Several sites with more than one cardiac arrest in five years could be identified and 54 patients (2.5%) had their cardiac arrest in these high-incidence sites.


CONCLUSIONS
Among patients suffering from out-of-hospital cardiac arrest in Goteborg in whom resuscitation efforts were attempted 17% of all cardiac arrests were regarded as generally suitable for PAD. According to previous suggestions, the indication for public access defibrillation is in a place with a reasonable probability of use of one AED in 5 years. Several high-incidence sites that probably would benefit from defibrillator availability could be identified, and 54 patients (2.5%) arrested in these sites.
Engdahl
Johan
J
Department of Medicine, Halmstad Hospital, S-30185 Halmstad, Sweden. johan.engdahl@lthalland.se
Herlitz
Johan
J
D047548:Defibrillators / Q000191:economics / Q000600:supply & distribution*; D004554:Electric Countershock / Q000191:economics / Q000295:instrumentation*; D004632:Emergency Medical Services / Q000191:economics / Q000706:statistics & numerical data*; D017048:Health Care Costs / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006323:Heart Arrest / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D015994:Incidence; D020380:Needs Assessment; D013548:Sweden / Q000453:epidemiology