title: Public Access Defibrillation: Great benefit and potential but infrequently used.
abstract: BACKGROUND
  In Copenhagen, a volunteer-based Automated External Defibrillator (AED) network provides a unique opportunity to assess AED use. We aimed to determine the proportion of Out-of-Hospital Cardiac Arrest (OHCA) where an AED was applied before arrival of the ambulance, and the proportion of OHCA-cases where an accessible AED was located within 100 m. In addition, we assessed 30-day survival.
  
  
  METHODS
  Using data from the Mobile Emergency Care Unit and the Danish Cardiac Arrest Registry, we identified 521 patients with OHCA between October 1, 2011 and September 31, 2013 in Copenhagen, Denmark.
  
  
  RESULTS
  An AED was applied in 20 cases (3.8%, 95% CI [2.4 to 5.9]). Irrespective of AED accessibility, an AED was located within 100 m of a cardiac arrest in 23.4% (n=102, 95% CI [19.5 to 27.7]) of all OHCAs. However, at the time of OHCA, an AED was located within 100 m and accessible in only 15.1% (n=66, 95% CI [11.9 to 18.9]) of all cases. The 30-day survival for OHCA with an initial shockable rhythm was 64% for patients where an AED was applied prior to ambulance arrival and 47% for patients where an AED was not applied.
  
  
  CONCLUSIONS
  We found that 3.8% of all OHCAs had an AED applied prior to ambulance arrival, but 15.1% of all OHCAs occurred within 100 m of an accessible AED. This indicates the potential of utilising AED networks by improving strategies for AED accessibility and referring bystanders of OHCA to existing AEDs.
authors.affiliation: Department of Anaesthesia, Centre of Head and Orthopaedics, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen, Denmark. Electronic address: marianneagerskov@hotmail.com.
authors.forename: Marianne
authors.initials: M
authors.lastname: Agerskov
authors.affiliation: Department of Anaesthesia, Centre of Head and Orthopaedics, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen, Denmark; The Emergency Medical Services, The Capital Region of Denmark and Copenhagen, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Anne Møller
authors.initials: AM
authors.lastname: Nielsen
authors.affiliation: Department of Cardiology, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Carolina Malta
authors.initials: CM
authors.lastname: Hansen
authors.affiliation: Department of Anaesthesia, Centre of Head and Orthopaedics, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen, Denmark.
authors.forename: Marco Bo
authors.initials: MB
authors.lastname: Hansen
authors.affiliation: The Emergency Medical Services, The Capital Region of Denmark and Copenhagen, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Freddy Knudsen
authors.initials: FK
authors.lastname: Lippert
authors.affiliation: The Emergency Medical Services, The Capital Region of Denmark and Copenhagen, University of Copenhagen, Copenhagen, Denmark; Department of Cardiology, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Mads
authors.initials: M
authors.lastname: Wissenberg
authors.affiliation: The Emergency Medical Services, The Capital Region of Denmark and Copenhagen, University of Copenhagen, Copenhagen, Denmark; Department of Cardiology, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Folke
authors.affiliation: Department of Anaesthesia, Centre of Head and Orthopaedics, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen, Denmark.
authors.forename: Lars Simon
authors.initials: LS
authors.lastname: Rasmussen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000552:Ambulances; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D003718:Denmark / Q000453:epidemiology; D004554:Electric Countershock / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends
keywords: Automated external defibrillation; Cardiopulmonary resuscitation; Defibrillators; Out-of-hospital cardiac arrest; Public Access Defibrillation; Survival