Abstract 182: Survival Outcome Analysis of Public Automated External Defibrillators in Taiwan

Background: Public access defibrillation (PAD) increases survival in out-of-hospital cardiac arrest (OHCA) patients. However, native reports on PAD survival in Taiwan has not yet been described. Public automated external defibrillators (AED) installation at places with high incidence of cardiac arrests were required by law since 2013. A compulsory National AED Registry was set that registered all public AEDs. Incident reports and ECG tracings from those cardiac arrests were mandatory once public AEDs were use. Objective: We aimed to describe survival outcomes of PAD, including sustained return of spontaneous circulation (ROSC), survival to discharge, and Cerebral Performance Category (CPC). The effects of shockable rhythm and bystander CPR on survival along with survival of different public locations were analyzed. Method: Data was collected prospectively from July 2013 to August 2016 by PAD registry of Ministry of Health and Welfare, including incident reports and uploaded ECGs. Survival data were acquired from Taiwan Cardiac Arrests Registry and through contacting individual EMS systems. Outcomes were examined by locations, initial rhythms and bystander CPR. Results: A total of 344 AED utilization was recorded, in which 231 had complete ECG records. Overall shockable rate was 32.9 % (n=76), and bystander CPR rate was 69.3% (n=160). 152 cases had complete outcomes data. Sustain ROSC was 43.5% (69.6% in shockable group (n=46) and 70.3% in shockable plus B-CPR group (n=37)). Forty-two cases (29.4%) survived to discharge or transfer (mean age 53.5 (±21.9 year), male 78.6%). Most surviving patients had good neurological recovery. (CPC1:71.8%, n=28; CPC2:10.3%, n=4). For those with shockable rhythm and received B-CPR, survival to discharge (STD) were 56.8% and CPC1-2 54.1% . ROSC were highest among “Public Baths or Hot Spring Resorts” (60%), followed by “Traffic Hubs” (53.3%), “Schools/Large Gathering Venues” (47.6%), “Hotels” (46.7%), and “Others” (36.8%). Conclusions: Overall survival rates of PAD patients were three-fold compared to data from best performing EMS in Taiwan. PAD also doubled the survival for those with shockable rhythms. Policy facilitating PAD deployment and utilization have made a difference and should be continued and optimized.