Abstract 1: Cardiac Arrest Density in a Metropolitan Area. Where to Place Automatic Defibrillators
Purpose: The aim of this study was to identify places in Copenhagen, Denmark where the cardiac arrest density was sufficiently high to merit placement of automatic defibrillators (AEDs).
Hypothesis: We assessed the hypothesis that placements of AEDs could be beneficial in nonresidential traffic points areas and in residential areas with a high population density, whereas business areas wouldn’t benefit from AEDs.
Methods: During the period from 1994–2005 physicians at the Copenhagen Emergency Medical Service recorded data from all out-of-hospital cardiac arrests (OHCAs) in central Copenhagen. OHCAs due to trauma, suicide, poisoning, dead on arrival or judged terminal ill by the doctor on location were excluded. The locations of OHCAs were divided into residential areas and nonresidential areas, and the type of civic and commercial establishment was categorized and analyzed according to the incidence of cardiac arrests per site. OHCAs in business areas versus residential areas and OHCAs in high density residential areas were analyzed.
Results: A total of 4925 OHCAs were included over a 10 year period in Copenhagen. 3991 sites had a single cardiac arrest, accounting for 81,0% of the OHCAs. 325 sites were characterized as high incidence locations with more than one cardiac arrest per 5 year (14,2% of OHCAs). 33 sites (4,8 % of OHCAs) had at least one arrest every second year, of these sites, nursing homes and elderly centers accounted for 68% of the OHCAs. Ventricular fibrillation occured among 19,4% and a total of 14,8% were alive at hospital admission. The Copenhagen Airport had the highest incidence of arrest (10 arrests every 5 year ), followed by Copenhagen Central Station (8,5 arrests every 5 year).
Conclusions: In conclusion, we found several high-incidence sites of OHCAs that could benefit from placement of AEDs. Overall, we found that cardiac arrests occurred in 2 types of places: In nonresidential areas with an extreme population density including the airport, the main train stations and major traffic junctions. The cardiac arrest density was also sufficiently high to merit AEDs in selected residential areas with a high population density. On the contrary, the density of cardiac arrests was low in business areas and did not merit automatic defibrillators.