Out-of-Hospital Cardiac Arrest Ambulance Delay Zones and AED Placement in a Southern Brazilian City

Marcos Rogério Bitencourt (), Mariá Romanio Bitencourt, Lincoln Luís Silva, Amanda Gubert Alves dos Santos, Pedro Iora, José Anderson Labbado, Mauricio Medeiros Lemos, Luiz Gustavo de Paulo, Júlia Loverde Gabella, Juliana Lourenço Lopes Costa, Hideky Ikeda Dolci, Vinicius Giacomin, Sandra Marisa Pelloso, Maria Dalva de Barros Carvalho and Luciano de Andrade
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Marcos Rogério Bitencourt: Post Graduate Program in Health Sciences, State University of Maringá, Maringá 87020-900, Paraná, Brazil
Mariá Romanio Bitencourt: Department of Medicine, State University of Maringá, Maringá 87020-900, Paraná, Brazil
Lincoln Luís Silva: Post Graduate Program in Health Sciences, State University of Maringá, Maringá 87020-900, Paraná, Brazil
Amanda Gubert Alves dos Santos: Department of Health Sciences, Centro Universitário Integrado, Campo Mourão 87309-701, Paraná, Brazil
Pedro Iora: Department of Medicine, State University of Maringá, Maringá 87020-900, Paraná, Brazil
José Anderson Labbado: Post Graduate Program in Health Sciences, State University of Maringá, Maringá 87020-900, Paraná, Brazil
Mauricio Medeiros Lemos: Post Graduate Program in Health Sciences, State University of Maringá, Maringá 87020-900, Paraná, Brazil
Luiz Gustavo de Paulo: Department of Medicine, Centro Universitário de Maringá, Maringá 87050-900, Paraná, Brazil
Júlia Loverde Gabella: Department of Medicine, State University of Maringá, Maringá 87020-900, Paraná, Brazil
Juliana Lourenço Lopes Costa: Department of Medicine, Centro Universitário de Maringá, Maringá 87050-900, Paraná, Brazil
Hideky Ikeda Dolci: Department of Medicine, Centro Universitário de Maringá, Maringá 87050-900, Paraná, Brazil
Vinicius Giacomin: Post Graduate Program in Health Sciences, State University of Maringá, Maringá 87020-900, Paraná, Brazil
Sandra Marisa Pelloso: Post Graduate Program in Health Sciences, State University of Maringá, Maringá 87020-900, Paraná, Brazil
Maria Dalva de Barros Carvalho: Post Graduate Program in Health Sciences, State University of Maringá, Maringá 87020-900, Paraná, Brazil
Luciano de Andrade: Post Graduate Program in Health Sciences, State University of Maringá, Maringá 87020-900, Paraná, Brazil

IJERPH, 2025, vol. 22, issue 2, 1-15

Abstract: Out-of-hospital cardiac arrests (OHCAs) have high mortality rates, worsened by limited access to automated external defibrillators (AEDs). This study analyzed OHCA response times, identified areas with prolonged ambulance travel times, and proposed optimal AED locations in a medium-sized city in southern Brazil. Data from 278 non-traumatic OHCA cases (2019–2022) in patients over 18 years old, with ambulance response times under 20 min, were included. Spatial survival analysis assessed the probability of exceeding the recommended 5-min (300 s) ambulance response time. The maximal covering location problem identified 100 strategic AED sites within a 150-s reach for bystanders. AED and ambulance travel times were compared using the Wilcoxon test ( p < 0.01). Defibrillation occurred in 89 cases (31.01%), and bystander CPR was performed in 149 cases (51.92%). Despite these efforts, 77% of patients died. The median ambulance response time was 11.63 min, exceeding 5 min in most cases, particularly at peak times like 11 a.m. AED placement in selected locations could cover 76% of OHCA occurrences, with a mean AED travel time of 320 s compared to 709 s for ambulances. Strategic AED placement could enhance early defibrillation and improve survival outcomes.

Keywords: out-of-hospital cardiac arrest; cardiopulmonary resuscitation; automated external defibrillators; spatial analysis; computer simulation (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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