A Real-World Insight into Public Access Defibrillator Use Over Five-Years

Background Public access defibrillators (PADs) represent unique life-saving medical devices as they may be used by untrained lay-rescuers. Collecting representative clinical data on these devices can be challenging. Here we present results from a retrospective observational cohort study, describing real-world PAD utilisation over a five-year period. Methods Data were collected between October 2012 and October 2017. Responders voluntarily submitted electronic data downloaded from HeartSine PADs, and patient demographics and other details using a case report form in exchange for a replacement battery and electrode pack. ResultsData were collected for 977 patients (692 males, 70.8%; 255 females, 26.1%; 30 unknown, 3.1%). The mean age (SD) was 59 (18) years (range <1 year-101 years). PAD usage occurred most commonly in homes (n=328, 33.6%), followed by public places (n=307, 31.4%), and medical facilities (n=128, 13.1%). Location was unknown in 40 (4.09%) events. Shocks were delivered to 354 patients. First shock success was 312 of 350 patients where it could be determined (89.1%, 95%CI=[85.4%,92.2%]). Patients with reported response times ≤5 minutes were more likely to survive to hospital admission (89/296 [30.1%] versus 40/250 [16.0%], p < 0.001). Response time was unknown for 431 events.ConclusionThis is the first study to report global PAD usage in voluntarily submitted, unselected real-world cases and demonstrates the real-world effectiveness of PADs, as confirmed by first shock success.