Deployment of automated external defibrillators by a supermarket chain

Abstract

Objective: Automated external defibrillator (AED) installation has become commonplace in various public locations. However, AED retrievals involving actual shocks may still be very infrequent in many settings despite significant initial/ongoing costs for equipment acquisition, pad/battery expiry replacements and initial/refresher training for designated rescuers. The purpose here was to track frequencies of AED/CPR applications and shocks delivered following AED installations and related employee training throughout a multi-state retail store chain.

Design: Prospective 92-month observational study conducted across a large retail chain to document frequencies of AED device retrievals/applications, CPR performance, shocks delivered, and respective patient and scene characteristics.

Setting: 1358 retail stores and two-dozen warehouses/offices located in multiple states.

Subjects: Persons collapsing with possible cardiopulmonary arrest on corporate properties.

Interventions: AED installation and on-going training of employees in CPR/AED use.

Results: Among 396 reported AED retrievals/applications (>4/month), 75 % occurred inside stores and the remainder in parking lots/sidewalks/other venues. Among these, 294 persons (ages 1-93 years; 74 % men) received basic CPR and/or AED shocks (>3 cases/month), performed most often by store employees. CPR-patient median age was 60 years (IQR:45-70) for men and 58 (IQR:38-68) for women. AEDs delivered 157 shocks during 112 events (>1 case/month); 71 % involved one shock, 20 % two, 9 % three and one involved four shocks. Documented ages for shocked patients (80 % men) ranged 32-90 years with men's median age 62 (IQR:55-70) and women's 61 (IQR:55-65). In one state's retrospective sub-analysis of shockable cases, hospital outcome records were matched to 37 patients with the majority (at least 19 confirmed) surviving to successful hospital discharge.

Conclusions: For this multi-state retail chain, AED installation and employee CPR/AED training appeared to be well-justified considering that AEDs were retrieved/applied frequently systemwide, quite often involving defibrillatory shocks that were associated with survival for many patients. Investigators encourage comparable businesses to adopt/study similar employee-based programs nationwide.

Keywords: Automated external defibrillator; Cardiopulmonary resuscitation; Emergency medical services; Multi-location retail chain; Out-of-hospital cardiac arrest; Public access defibrillation.