New research shows that publicly accessible AEDs are not located in the areas that need them most

Pawin aed defibrillator heart attack cardiac

Publicly accessible defibrillators are disproportionately lacking in the most deprived areas of England, according to new research led by the University of Warwick.

In the study, published in the journal Resuscitation, the authors obtained details of the location of automated external defibrillators (AEDs) registered with ten of the eleven English ambulance services using internet sources and information from individual services.

The study is part of a project at the University of Warwick investigating where defibrillators should be installed to optimise their accessibility. Neighbourhood characteristics of lower layer super output areas (LSOAs) were obtained from the Office for National Statistics. Comparisons were made between LSOAs with and without a registered AED.

The data revealed that, whereas almost 80% of all out-of-hospital cardiac arrests occur in residential areas, public-access AEDs are located less frequently in these areas. Across the country, AED locations are in areas with a significantly lower residential population density, but higher workplace population density. These locations had a significantly greater proportion of people aged 65 years and over, and had populations that were predominantly from a White ethnic background, with fewer people identifying themselves as mixed race or from non-White ethnic backgrounds.

The locations with an AED also had a significantly larger population in management/professional occupations, but a smaller proportion were in routine and manual occupations, unemployed, and in unclassified occupations.

The proportion of people with higher educational qualifications was also significantly higher, and the proportion of people not living as a couple was significantly lower.

More machines in more affluent areas

Areas containing at least one AED were also more affluent, with a lower proportion of households categorised as deprived.

Only 27.4% of areas in the lowest decile of the index of multiple deprivation had at least one defibrillator, compared with about 45% in the highest decile.

Commenting on the findings, lead author Dr Terry Brown from Warwick Clinical Trials Unit said: ‘We know that cardiac arrests occur more often in deprived areas, but registered defibrillators are more likely to be found in areas where the population is more affluent, predominantly identify as White ethnic, and with high socioeconomic occupations. The question is whether this is because they’re not registered in more deprived areas, or because there aren’t any.

‘Any future programme that aims to get defibrillators out there should be targeted to the areas that need them most. In particular, they should be put in more deprived communities, and in accessible locations in residential areas, given that more than 80% of out of hospital cardiac arrests happen in the home. There should be a more evidence-based distribution programme to ensure they are accessible.’

Also noting the results, Sue Hampshire, Director of Clinical and Service Development at Resuscitation Council UK, said: ‘The findings of this important study show that there are currently unacceptable inequalities in the provision and availability of public access defibrillators across the country. Out-of-hospital cardiac arrests are more likely to happen in the areas with neighbourhood characteristics where AED provision is currently lower. If more lives are going to be saved through CPR and defibrillation, a more evidence-based and coordinated approach to their placement is needed and we encourage community groups and other organisations to make use of guidance and existing evidence.’

This article originally appeared on Univadis, part of the Medscape Professional Network.


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