title: Temporal trends in coverage of historical cardiac arrests using a volunteer-based network of automated external defibrillators accessible to laypersons and emergency dispatch centers.
abstract: BACKGROUND
  Although increased dissemination of automated external defibrillators (AEDs) has been associated with more frequent AED use, the trade-off between the number of deployed AEDs and coverage of cardiac arrests remains unclear. We investigated how volunteer-based AED dissemination affected public cardiac arrest coverage in high- and low-risk areas.
  
  
  RESULTS
  All public cardiac arrests (1994-2011) and all registered AEDs (2007-2011) in Copenhagen, Denmark, were identified and geocoded. AED coverage of cardiac arrests was defined as historical arrests ≤100 m from an AED. High-risk areas were defined as those with ≥1 arrest every 2 years and accounted for 1.0% of the total city area. Of 1864 cardiac arrests, 18.0% (n=335) occurred in high-risk areas throughout the study period. From 2007 to 2011, the number of AEDs and the corresponding coverage of cardiac arrests increased from 36 to 552 and from 2.7% to 32.6%, respectively. The corresponding increase for high-risk areas was from 1 to 30 AEDs and coverage from 5.7% to 51.3%, respectively. Since the establishment of the AED network (2007-2011), few arrests (n=55) have occurred ≤100 m from an AED with only 14.5% (n=8) being defibrillated before the arrival of emergency medical services.
  
  
  CONCLUSIONS
  Despite the lack of a coordinated public access defibrillation program, the number of AEDs increased 15-fold with a corresponding increase in cardiac arrest coverage from 2.7% to 32.6% over a 5-year period. The highest increase in coverage was observed in high-risk areas (from 5.7% to 51.3%). AED networks can be used as useful tools to optimize AED placement in community settings.
authors.affiliation: From the Department of Cardiology, Copenhagen University Hospital Gentofte, Denmark (C.M.H., M.W., P.W., M.H.R., L.K., G.H.G., F.F.); The Emergency Medical Services, Copenhagen, Copenhagen University, Denmark (F.K.L., S.L.N., F.F.); The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (L.Z., G.H.G.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Denmark (L.K.); and The Institute of Health, Science and Technology, Aalborg University, Denmark (C.T.-P.). cmh@heart.dk.
authors.forename: Carolina Malta
authors.initials: CM
authors.lastname: Hansen
authors.affiliation: From the Department of Cardiology, Copenhagen University Hospital Gentofte, Denmark (C.M.H., M.W., P.W., M.H.R., L.K., G.H.G., F.F.); The Emergency Medical Services, Copenhagen, Copenhagen University, Denmark (F.K.L., S.L.N., F.F.); The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (L.Z., G.H.G.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Denmark (L.K.); and The Institute of Health, Science and Technology, Aalborg University, Denmark (C.T.-P.).
authors.forename: Freddy Knudsen
authors.initials: FK
authors.lastname: Lippert
authors.affiliation: From the Department of Cardiology, Copenhagen University Hospital Gentofte, Denmark (C.M.H., M.W., P.W., M.H.R., L.K., G.H.G., F.F.); The Emergency Medical Services, Copenhagen, Copenhagen University, Denmark (F.K.L., S.L.N., F.F.); The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (L.Z., G.H.G.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Denmark (L.K.); and The Institute of Health, Science and Technology, Aalborg University, Denmark (C.T.-P.).
authors.forename: Mads
authors.initials: M
authors.lastname: Wissenberg
authors.affiliation: From the Department of Cardiology, Copenhagen University Hospital Gentofte, Denmark (C.M.H., M.W., P.W., M.H.R., L.K., G.H.G., F.F.); The Emergency Medical Services, Copenhagen, Copenhagen University, Denmark (F.K.L., S.L.N., F.F.); The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (L.Z., G.H.G.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Denmark (L.K.); and The Institute of Health, Science and Technology, Aalborg University, Denmark (C.T.-P.).
authors.forename: Peter
authors.initials: P
authors.lastname: Weeke
authors.affiliation: From the Department of Cardiology, Copenhagen University Hospital Gentofte, Denmark (C.M.H., M.W., P.W., M.H.R., L.K., G.H.G., F.F.); The Emergency Medical Services, Copenhagen, Copenhagen University, Denmark (F.K.L., S.L.N., F.F.); The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (L.Z., G.H.G.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Denmark (L.K.); and The Institute of Health, Science and Technology, Aalborg University, Denmark (C.T.-P.).
authors.forename: Line
authors.initials: L
authors.lastname: Zinckernagel
authors.affiliation: From the Department of Cardiology, Copenhagen University Hospital Gentofte, Denmark (C.M.H., M.W., P.W., M.H.R., L.K., G.H.G., F.F.); The Emergency Medical Services, Copenhagen, Copenhagen University, Denmark (F.K.L., S.L.N., F.F.); The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (L.Z., G.H.G.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Denmark (L.K.); and The Institute of Health, Science and Technology, Aalborg University, Denmark (C.T.-P.).
authors.forename: Martin H
authors.initials: MH
authors.lastname: Ruwald
authors.affiliation: From the Department of Cardiology, Copenhagen University Hospital Gentofte, Denmark (C.M.H., M.W., P.W., M.H.R., L.K., G.H.G., F.F.); The Emergency Medical Services, Copenhagen, Copenhagen University, Denmark (F.K.L., S.L.N., F.F.); The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (L.Z., G.H.G.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Denmark (L.K.); and The Institute of Health, Science and Technology, Aalborg University, Denmark (C.T.-P.).
authors.forename: Lena
authors.initials: L
authors.lastname: Karlsson
authors.affiliation: From the Department of Cardiology, Copenhagen University Hospital Gentofte, Denmark (C.M.H., M.W., P.W., M.H.R., L.K., G.H.G., F.F.); The Emergency Medical Services, Copenhagen, Copenhagen University, Denmark (F.K.L., S.L.N., F.F.); The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (L.Z., G.H.G.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Denmark (L.K.); and The Institute of Health, Science and Technology, Aalborg University, Denmark (C.T.-P.).
authors.forename: Gunnar Hilmar
authors.initials: GH
authors.lastname: Gislason
authors.affiliation: From the Department of Cardiology, Copenhagen University Hospital Gentofte, Denmark (C.M.H., M.W., P.W., M.H.R., L.K., G.H.G., F.F.); The Emergency Medical Services, Copenhagen, Copenhagen University, Denmark (F.K.L., S.L.N., F.F.); The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (L.Z., G.H.G.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Denmark (L.K.); and The Institute of Health, Science and Technology, Aalborg University, Denmark (C.T.-P.).
authors.forename: Søren Loumann
authors.initials: SL
authors.lastname: Nielsen
authors.affiliation: From the Department of Cardiology, Copenhagen University Hospital Gentofte, Denmark (C.M.H., M.W., P.W., M.H.R., L.K., G.H.G., F.F.); The Emergency Medical Services, Copenhagen, Copenhagen University, Denmark (F.K.L., S.L.N., F.F.); The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (L.Z., G.H.G.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Denmark (L.K.); and The Institute of Health, Science and Technology, Aalborg University, Denmark (C.T.-P.).
authors.forename: Lars
authors.initials: L
authors.lastname: Køber
authors.affiliation: From the Department of Cardiology, Copenhagen University Hospital Gentofte, Denmark (C.M.H., M.W., P.W., M.H.R., L.K., G.H.G., F.F.); The Emergency Medical Services, Copenhagen, Copenhagen University, Denmark (F.K.L., S.L.N., F.F.); The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (L.Z., G.H.G.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Denmark (L.K.); and The Institute of Health, Science and Technology, Aalborg University, Denmark (C.T.-P.).
authors.forename: Christian
authors.initials: C
authors.lastname: Torp-Pedersen
authors.affiliation: From the Department of Cardiology, Copenhagen University Hospital Gentofte, Denmark (C.M.H., M.W., P.W., M.H.R., L.K., G.H.G., F.F.); The Emergency Medical Services, Copenhagen, Copenhagen University, Denmark (F.K.L., S.L.N., F.F.); The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (L.Z., G.H.G.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Denmark (L.K.); and The Institute of Health, Science and Technology, Aalborg University, Denmark (C.T.-P.).
authors.forename: Fredrik
authors.initials: F
authors.lastname: Folke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D019058:Community Networks / Q000639:trends*; D047548:Defibrillators / Q000706:statistics & numerical data / Q000639:trends*; D003718:Denmark / Q000453:epidemiology; D004554:Electric Countershock / Q000379:methods / Q000639:trends*; D004632:Emergency Medical Services / Q000639:trends*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D011446:Prospective Studies; D012189:Retrospective Studies; D013997:Time Factors; D014838:Volunteers
keywords: cardiopulmonary resuscitation; defibrillators; heart arrest