From the Emergency Medical Services Division (L.B., M.E.), Seattle-King
County Department of Public Health, and the Department of Medicine (M.E.,
C.F., L.C.), University of Washington, Seattle.
Background—The purpose of this study
was to describe the public locations of cardiac arrest and to estimate
the annual incidence of cardiac arrest per site to determine optimal
placement of automatic external defibrillators (AEDs). This was a
retrospective cohort study.
Methods and Results—Locations of cardiac arrest were abstracted
from data collected by emergency medical service programs in Seattle
and King County, Washington, from January 1, 1990, through December 31,
1994. Types of commercial and civic establishments were tallied and
grouped into 23 location categories consistent with Standard
Industrial Codes, and the number of sites within each location category
was determined. With the addition of "public outdoors" and
"automobiles" as categories, there were 25 location categories.
During the study period, 7185 arrests occurred, 1130 (16%) of which
were in public locations. An annual incidence of cardiac arrest per
site was calculated. Ten location categories with 172 sites were
identified as having a higher incidence of cardiac arrest (
Conclusions—Placement of 276 AEDs in the 172 higher-incidence
sites would have provided treatment for 134 cardiac arrest patients in
a 5-year period, 60% of whom were in ventricular
fibrillation. We estimate between 8 and 32 lives could be saved in 5
years. To cover the remaining 347 arrests occurring in public in a
5-year period, defibrillators would have to be placed in 71 000 sites,
not including outdoors and automobiles. Placement of AEDs in public
locations can be guided by the site-specific incidence of arrest.
© 1998 American Heart Association, Inc.
Brief Rapid Communications
Public Locations of Cardiac Arrest
Implications for Public Access Defibrillation
.03 per
year per site). Thirteen location categories had a lower incidence of
arrest (
.01 per year per site). There were 
71 000 sites within
these categories.
Key Words: heart arrest • defibrillation • survival • resuscitation
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