Optimal in-hospital defibrillator placement.
Resuscitation
; 151: 91-98, 2020 06.
Article
em En
| MEDLINE
| ID: mdl-32268160
ABSTRACT
AIMS:
To determine if mathematical optimization of in-hospital defibrillator placements can reduce in-hospital cardiac arrest-to-defibrillator distance compared to existing defibrillators in a single hospital.METHODS:
We identified treated IHCAs and defibrillator placements in St. Michael's Hospital in Toronto, Canada from Jan. 2013 to Jun. 2017 and mapped them to a 3-D computer model of the hospital. An optimization model identified an equal number of optimal defibrillator locations that minimized the average distance between IHCAs and the closest defibrillator using a 10-fold cross-validation approach. The optimized and existing defibrillator locations were compared in terms of average distance to the out-of-sample IHCAs. We repeated the analysis excluding intensive care units (ICUs), operating theatres (OTs), and the emergency department (ED). We also re-solved the model using fewer defibrillators to determine when the average distance matched the performance of existing defibrillators.RESULTS:
We identified 433 treated IHCAs and 53 defibrillators. Of these, 167 IHCAs and 31 defibrillators were outside of ICUs, OTs, and the ED. Optimal defibrillator placements reduced the average IHCA-to-defibrillator distance from 16.1â¯m to 2.7â¯m (relative decrease of 83.0%; Pâ¯=â¯0.002) compared to existing defibrillator placements. For non-ICU/OT/ED IHCAs, the average distance was reduced from 24.4â¯m to 11.9â¯m (relative decrease of 51.3%; Pâ¯=â¯0.002. 8-9 optimized defibrillator locations were sufficient to match the average IHCA-to-defibrillator distance of existing defibrillator placements.CONCLUSIONS:
Optimization-guided placement of in-hospital defibrillators can reduce the distance from an IHCA to the closest defibrillator. Equivalently, optimization can match existing defibrillator performance using far fewer defibrillators.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Desfibriladores
/
Parada Cardíaca Extra-Hospitalar
Limite:
Humans
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Resuscitation
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Canadá