Strategic automated external defibrillator deployment based on geospatial analysis of historical cardiac arrest locations.
International journal of cardiology. Heart & vasculature · 2026-02-25 · Observational study
Abstract
OBJECTIVE: We hypothesized that historical out-of-hospital sudden cardiac arrest (SCA) locations over multiple years can inform deployment of automated external defibrillators (AEDs). METHODS: Consecutive SCA events attended by EMS were ascertained prospectively in two identically designed community-based studies: PRESTO (Ventura County, California, population ∼ 850,000; 2015-2023; SCA n = 2,935) and SUDS (Multnomah County, Oregon, population ∼ 800,000; 2012-2020; SCA n = 2,213). Clusters of ≥ 3 historical SCA events within 100-meters were plotted using geospatial analysis (QGIS Desktop 3.23.3). Proposed AED locations were positioned within 200-meters. An existing AED registry in Ventura County (n = 998) was also plotted using geospatial analysis. Distances between SCAs and proposed AEDs were calculated using Euclidean distances. RESULTS: In PRESTO, 97 clusters of ≥ 3 SCAs were identified, amounting to 22% (n = 653) of total SCAs, covered by 90 proposed AEDs. The mean distance between individual SCA events and the nearest AED was 99.7 (SD = 53.1) meters, representing a proposed bystander AED response time of 3.0 (SD = 1.6) minutes. Proposed bystander AED response times were significantly shorter than actual EMS response times [mean difference: 3.1 (95% CI: 2.9-3.4), p < 0.0001]. Similar results were observed in SUDS. Compared to the existing AED registry in Ventura County, 18.9% (n = 17) of our 90 proposed AEDs were within 200 m of an existing AED. Of total SCAs in Ventura County,11.4% (n = 334) were within 200 m of an existing AED. CONCLUSIONS: 16-22% of historical SCA events in Ventura and Multnomah Counties could potentially be covered by 78-90 AEDs. Outcomes studies that compare this geospatial approach to current AED location strategies are warranted.