Poor Actual Availability of Publicly Accessible Automated External Defibrillators Limit Their Value in the Treatment of Out-of-Hospital Cardiac Arrest

Aim: 20% of out-of-hospital cardiac arrests (OHCA) in New Zealand occur in public spaces, of which automated external defibrillators (AEDs) are utilised in only 6%. We sought to determine the actual availability of publicly listed AEDs in urban Nelson. Method: Publicly accessible AEDs in urban Nelson were identified via an online database (AEDlocations.co.nz). Each site was visited once over four consecutive weekdays within the hours of 0900-1700. A site was categorised as highly inaccessible if the AED was not accessible to the public at all during the visit. Available devices were categorised as 1) 24/7 or time-limited; 2) Visible and directly accessible to public or dependent on an attendant; and - of the attendant-dependent sites - 3) Whether the first attendant(s) encountered knew the location of the AED (immediate) or not (delayed). Results: 108 operating AED sites were identified over a 67 km2 urban area. 87 AEDs were on private premises. 21 were on premises of government-affiliated organisations (public schools, civic buildings etc.). Proportions of each accessibility category were: Highly inaccessible (11%); time-limited attendant-dependent access (49%); time-limited direct access (28%); 24/7 attendant dependent access (9%); 24/7 direct access (3%). Of attendant-dependent sites, access was delayed in 10%. Of the 21 AEDs in government affiliated agencies, 13 were time-limited attendant-dependent (12 immediate, 1 delayed) with none directly accessible 24/7. Conclusion: Most AEDs surveyed, including those in public institutions, had limited public availability. Making existing AED resources more readily available to the public could improve rates of early defibrillation in OHCA.