Need an AED? There's a Map for That

March 01, 2012

February 29, 2012 (Philadelphia, Pennsylvania) — A group of emergency-medicine physicians is striving to identify the locations of all automated external defibrillators (AEDs) in public places in the city of Philadelphia, with the aim of publicizing the findings in the form of an AED "map" [1]. They have come up with the novel idea of running a competition for members of the public to try to identify all the existing AEDs there, called MyHeartMap Challenge.

"We have these important public-health tools out there, but when they are needed most in an emergency, they are impossible to find," says organizer Dr Raina Merchant (University of Pennsylvania Perelman School of Medicine, Philadelphia), who is the lead author of a new perspective explaining the problem in an article published online February 21, 2012 in Circulation: Cardiovascular Quality and Outcomes. "No one knows exactly where they are, and if you were to call 911 or use your phone, you couldn't locate them. Studies have definitely illustrated over the past decade that defibrillators save lives, but if we can't find them when we need them, it's sort of the same as them not being there," she told heartwire .

Defibrillators save lives, but if we can't find them when we need them, it's sort of the same as them not being there.

The aim is to eventually extend the competition to other cities in the US, and there is no reason why the concept could not be applied anywhere in the world, says Merchant. In fact, the idea was partly inspired by existing websites, such as aed4.us and aed4.eu, which show the locations of a few AEDs in the US and many more in some countries, such as the Netherlands, she notes.

No one knows where most AEDs are

In the perspective, Merchant and her coauthor, Dr David A Asch (VA Center for Health Equity Research and Promotion, Philadelphia), explain that there are approximately 300 000 out-of-hospital cardiac arrests in the US every year, and 20% of these occur in public locations. Yet survival rates for out-of-hospital arrests are "dismal," at only around 6.4%. AEDs can restart the heart and provide life-saving "talking" cardiopulmonary resuscitation (CPR) instructions. With CPR, the chance of surviving an out-of-hospital arrest rises to more than 50%, they point out.

But despite the fact that AEDs are located in many public places — such as airports, recreation centers, schools, banks, churches, etc — in practice it is difficult for people to find these in an emergency, say Merchant and Asch. "Unfortunately, these usually wall-mounted devices may be walked past daily and yet never sufficiently register in memory to be recalled when needed."

These usually wall-mounted devices may be walked past daily and yet never sufficiently register in memory to be recalled when needed.

And nobody knows where all the current devices are, they point out: not the companies that have sold the devices, nor the FDA, nor local 911 emergency dispatchers. "Imagine bystanders assisting the resuscitation of a victim in a public area, unaware that an AED is located less than 100 feet away inside a nearby store," they observe.

As important as identifying where AEDs are is knowing where they are not located, say the doctors. "The AHA recommends that AEDs should be within three minutes of an arrest victim and, by that standard, there are certainly innumerable 'AED deserts' where no device is present."

Merchant also stresses that this drive to locate and use AEDs in no way contradicts current AHA advice regarding bystander CPR — that people should just concentrate on chest compressions. "The first thing you do is call 911 and immediately start CPR. Then if someone else is available, you would have them go look for the AED. We don't want people stopping CPR to look for an AED."

First aim is to provide AED locations to 911 center

The competition in Philadelphia was launched on January 31; participants can download a mobile app and take pictures of any defibrillators they see throughout the city, providing information to Merchant and her team, who are encouraging people to use social media in the quest to find the AEDs.

The person or team who find the most AEDs will win $10 000, and there are also 200 "golden" AEDs in certain places that will net each identifier $50 for locating that one specific device, she says.

In the month since the competition launched, there have been more than 1000 entries and more than 300 teams or individuals participating, and "we have been getting really incredible data; the quality has been outstanding," Merchant says. And although she says they had "done their homework" and already knew where a lot of AEDs were in the city, "we have identified a significant number of new devices that we didn't know about, nor did the [AED] companies know about, and often employees in the businesses in which they are located had no idea that they were there," she observes.

She notes that AED companies provided funding for this project, because "they are really interested. They don't know where their actual devices are." AEDs are often purchased by distributors, who then sell them on the internet in bulk or individually. AED registration is the responsibility of the device owner, and the requirements and process differ significantly by region.

Our first focus is to create a database for the 911 center, because it turns out they don't know where these devices are, either. It's crazy.

Once all the devices in Philadelphia are located, Merchant and colleagues hope to generate an AED map that can be utilized in a number of ways. "Our first focus is to create a database for the 911 center, because it turns out they don't know where these devices are, either. It's crazy," says Merchant. Emergency personnel answering calls will then be able to direct people to the nearest AED in the event of an out-of-hospital cardiac arrest.

They also hope to eventually be able to embed the location of AEDs into commonly used applications (apps), which could be preloaded onto smart phones so that, for example, a Google-style map — as well as listing where certain shops and restaurants are in a given vicinity — would also provide information about the exact location of AEDs in that area.

"This is the sort of information that I want to be able to give my patients with heart disease and their families and spouses," says Merchant. It is also vital for doctors and other healthcare providers to know where AEDs are, should they find themselves in the position of witnessing a cardiac arrest, she adds.

Merchant received pilot funding from Physio-Control, Zoll Medical, Cardiac Science, and Philips Medical.

Comments

3090D553-9492-4563-8681-AD288FA52ACE

processing....