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Emergency medicine
Protocol
Public health surveillance of automated external defibrillators in the USA: protocol for the dynamic automated external defibrillator registry study
  1. JoAnn Broeckel Elrod1,
  2. Raina Merchant2,3,
  3. Mohamud Daya4,
  4. Scott Youngquist5,
  5. David Salcido6,7,
  6. Terence Valenzuela8,9,
  7. Graham Nichol1
  1. 1Department of Medicine, University of Washington-Harborview Center for Prehospital Emergency Care, University of Washington, Seattle, Washington, USA
  2. 2Salt Lake City Fire Department, University of Utah School of Medicine, Salt Lake City, Utah, USA
  3. 3Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, USA
  4. 4Department of Emergency Medicine, Oregon Health and Sciences University, Portland, Oregon, USA
  5. 5Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  6. 6Tucson Fire Department, University of Arizona, Tucson, Arizona, USA
  7. 7Department of Emergency Medicine, University of Arizona, Tucson, Arizona, USA
  8. 8Department of Emergency Medicine, University of Pennsylvania, Pennsylvania, USA
  9. 9Penn Medicine Social Media and Health Innovation Laboratory, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  1. Correspondence to Professor Graham Nichol; nichol{at}uw.edu

Abstract

Introduction Lay use of automated external defibrillators (AEDs) before the arrival of emergency medical services (EMS) providers on scene increases survival after out-of-hospital cardiac arrest (OHCA). AEDs have been placed in public locations may be not ready for use when needed. We describe a protocol for AED surveillance that tracks these devices through time and space to improve public health, and survival as well as facilitate research.

Methods and analysis Included AEDs are installed in public locations for use by laypersons to treat patients with OHCA before the arrival of EMS providers on scene. Included cases of OHCA are patients evaluated by organised EMS personnel and treated for OHCA. Enrolment of 10 000 AEDs annually will yield precision of 0.4% in the estimate of readiness for use. Enrolment of 2500 patients annually will yield precision of 1.9% in the estimate of survival to hospital discharge. Recruitment began on 21 Mar 2014 and is ongoing. AEDs are found by using multiple methods. Each AED is then tagged with a label which is a unique two-dimensional (2D) matrix code; the 2D matrix code is recorded and the location and status of the AED tracked using a smartphone; these elements are automatically passed via the internet to a secure and confidential database in real time. Whenever the 2D matrix code is rescanned for any non-clinical or clinical use of an AED, the user is queried to answer a finite set of questions about the device status. The primary outcome of any clinical use of an AED is survival to hospital discharge. Results are summarised descriptively.

Ethics and dissemination These activities are conducted under a grant of authority for public health surveillance from the Food and Drug Administration. Results are provided periodically to participating sites and sponsors to improve public health and quality of care.

  • STATISTICS & RESEARCH METHODS
  • PUBLIC HEALTH

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2016-014902

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    Footnotes

    • Twitter Follow Graham Nichol @grahamnichol

    • Collaborators Ben Eloff, PhD.

    • Contributors GN and RM contributed to the study conception and design. MD, SY, DS, TV and RM contributed to acquisition of data. GN, JBE, MD, SY, DS, TV and RM participated in drafting the article, revising it for critically important intellectual content and gave final approval of the submitted version.

    • Funding This work is supported by 1U01FD004587-04 from the Food and Drug Administration, Silver Spring, Maryland and ZOLL Medical Corporation, Chelmsford, MA.

    • Competing interests The Dynamic AED Registry is funded by the Food and Drug Administration, Silver Spring, Maryland and ZOLL Medical Corporation, Chelmsford, Massachusetts.

    • Provenance and peer review Not commissioned; externally peer reviewed.