Factors influencing the delivery of automated external defibrillators by lay rescuers to the scene of out-of-hospital cardiac arrests in schools

Abstract

Aim

Timely use of automated external defibrillators by lay rescuers significantly improves the chances of survival in out-of-hospital cardiac arrest cases. We aimed to identify the factors influencing whether lay rescuers bring automated external defibrillators to the scene of nontraumatic out-of-hospital cardiac arrests in schoolchildren in Japan.

Methods

Data on out-of-hospital cardiac arrests among schoolchildren from April 2008 to December 2021 were obtained from the database of the Stop and Prevent cardIac aRrest, Injury, and Trauma in Schools study. A multivariate Modified Poisson regression analysis was performed to evaluate the factors influencing whether a lay rescuer brought an automated external defibrillator to the scene of out-of-hospital cardiac arrest and the year-by-year changes in automated external defibrillator delivery for each factor were assessed.

Results

Of the 333 nontraumatic out-of-hospital cardiac arrests across the entire study period, lay rescuers brought automated external defibrillators in 85.3% of cases. Female patients and incidents occurring during non-sports activities had lower proportions of automated external defibrillator delivery. Significant year-by-year improvements in automated external defibrillator delivery were observed, with the overall proportion increasing from 73.7% in 2008–2010 to 93.3% in 2020–2021. However, the trend was less pronounced for female students, non-sports activities, and incidents occurring in classrooms/other locations than their counterparts.

Conclusions

AED delivery to the scene of OHCA in schools has improved overall, with the proportion increasing from 73.7% in 2008–2010 to 93.3% in 2020–2021. However, there is still room for improvement, particularly in female patients, and incidents during non-sports activities.