Outcomes of Out-of-Hospital Cardiac Arrest After Implementing a Public Access Defibrillation Program Supported by Local Communities in Sungai Kolok, Narathiwat

Abstract

Introduction
Out of hospital cardiac arrest (OHCA) often involves shockable rhythms treatable with automated external defibrillator (AED), is in the chain of survival. Su-ngaikolok residents have recognized and implemented AED according to the guidelines of the public access defibrillation program.

Objective
This study analyzes OHCA cases before and after AED installation, AED usage patterns, survival rates of OHCA patients in Su-ngaikolok district.

Methods
OHCA patient data was retrospectively collected, comparing cases before (n=67) and after (n=91) AED installation from October 2016 to February 2022. Statistical analysis employed chi-square tests and independent t-tests.

Results
The sample (n = 158) mainly comprised males, aged over 60 years, with incidents occurring at home. Initial cardiac rhythms were predominantly asystole or pulseless electrical activity (PEA). Comparing before and after AED installation, there were significant associations with advanced life support ambulance transportation, witness transports, responder AED training and onset to AED (p-value < .05). Survival rates showed improvement: return of spontaneous circulation (ROSC) from 37.3% to 46.2% (p-value .266), survival to admission from 28.4% to 29.7% (p-value .858) and survival to discharge from 1.5% to 7.7% (p-value .078) respectively. Following AED installation, the usage rate was 49.5%, with mobile AEDs accounting for 93.3% and fixed location AEDs 6.7%, corresponding to usage rates of 10.5 and 0.075 times per year, respectively. When comparing variables affecting survival to discharge, it was found that AED usage patterns, CPR duration and initial cardiac rhythms (asystole, PEA 14.29%, ventricular tachycardia, ventricular fibrillation 85.71%) have a statistically significant ( p-value < .05).

Conclusions:
AED usage. Using a mobile AED yields 140 times higher than fixed location Proper installation in suitable locations is crucial for successful OHCA response.