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Optimizing automated external defibrillator incremental deployment to improve out-of-hospital cardiac arrest
Pengfei Cheng1, Ding Luo2, Hua Zhang3,4
1Faculty of Medicine, Macau University of Science and Technology, Taipa, Macau.
Resuscitation Plus
|July 25, 2026
Summary
Optimizing automated external defibrillator (AED) placement is crucial for improving out-of-hospital cardiac arrest (OHCA) survival. Strategic AED deployment, guided by spatial analysis, maximizes coverage gains and identifies optimal locations, especially in resource-limited urban areas.
Area of Science:
- Emergency Medicine
- Public Health
- Spatial Analysis
Background:
- Public access defibrillation (PAD) using automated external defibrillators (AEDs) is vital for out-of-hospital cardiac arrest (OHCA) response.
- Current AED network effectiveness in urban settings is often limited, with insufficient data on incremental deployment gains and saturation points, particularly in resource-constrained cities.
Purpose of the Study:
- To evaluate the impact of incremental automated external defibrillator (AED) deployment on coverage gains for out-of-hospital cardiac arrest (OHCA) events.
- To identify saturation thresholds and optimal placement locations for AEDs in an urban environment using spatial analysis.
Main Methods:
- A retrospective spatial analysis of Utstein-compliant OHCA registry data from Haikou City, China (2015-2021).
- Assessment of AED coverage using Euclidean distance within response radii of 100-500m.
- Simulation of incremental AED deployment using the maximal covering location problem (MCLP) model and geographic information system (GIS) methods.
Main Results:
- Baseline AED coverage was limited (14.6% within 100m; 45.7% within 500m) for 5792 OHCA events.
- Incremental deployment yielded rapid initial coverage gains, followed by diminishing returns and saturation, with significantly more AEDs needed for saturation at shorter radii.
- Optimized deployment prioritized locations like restaurants and commercial/industrial settings, showing lower marginal gains from existing AEDs in residences or transportation hubs.
Conclusions:
- Existing AED networks often exhibit spatial mismatches with OHCA demand, limiting effectiveness.
- Maximal Covering Location Problem (MCLP)-guided deployment demonstrates significant early coverage improvements but diminishing returns, advocating for phased, locally-tailored expansion.
- Strategic AED placement is essential for maximizing emergency access, especially in resource-constrained urban settings.
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