An evaluation of the Public Access Defibrillation (PAD) Demonstration

3.2 PAD locations

Page last updated: August 2008

3.2.1 Findings from the 2004 review
3.2.2 Update: evidence published since 2004

3.2.1 Findings from the 2004 review

The 2004 review examined a number of studies of PAD programs that emphasised the importance of strategic placement of AEDs to maximise utility. From an epidemiological perspective based on Australian and overseas research, the review states:
  • Approximately 40% of cardiac arrests occur in non-residential locations (based on overseas findings), the estimate for Australia is somewhat lower at 25%

  • The five most common locations for out-of-home cardiac arrests are airports, gaols, shopping centres, sports venues and industrial sites

  • Between 5 and 32 lives could have been saved if AEDs had been placed in these high-risk locations during the five year period covered by the study (no AEDs were present at the time that that study was conducted)

  • There is an inverse relationship between population density and the overall incidence of cardiac arrests – that is, the more dense the population in a given area, the lower the incidence of cardiac arrest. However, this relationship is reversed for out-of-home cardiac arrests – the higher the population density, the greater the incidence of out-of-home cardiac arrests.
The review concludes:

About half of public places have more than one cardiac arrest within a three to five year period. Within each community where PAD is to be implemented, specific sites which have higher incidence of cardiac arrest should be identified to guide placement of AEDs. Airports, shopping centres, transit areas and sporting venues are likely to be associated with higher incidence of cardiac arrest (Jacobs 2004, p.16).

3.2.2 Update: evidence published since 2004

Reed et al. (2006) published a study that examined epidemiological data to determine the optimal location and number of AEDs for PAD and related programs. Reed concluded that the greatest rates of treatable cardiac arrests occurred in fitness centres and golf courses. However, the greatest survival rates from cardiac arrest were noted for different locations: recreational complexes, public transportation facilities and fitness centres. The difference between incidence and survival was attributed to the rate of volunteer presence and intervention.