JAMDA
Volume 8, Issue 6 , Pages 413-415, July 2007

Lack of Early Defibrillation Capability and Automated External Defibrillators in Nursing Homes

  • Jonathan Fisher, MD, MPH

      Affiliations

    • Beth Israel Deaconess Medical Center, Boston, MA
    • Corresponding Author InformationAddress correspondence to Jonathan Fisher, MD, MPH, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, One Deaconess Rd, WCC2, Boston, MA 02215.
    • ,
  • Brendan Anzalone, DO

      Affiliations

    • Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC
    • , Capt, U.S.A.F., M.C.
  • Jonathan McGhee, DO

      Affiliations

    • Department of Emergency Medicine; Christiana Care Health System, Newark, DE
    • ,
  • Brett Sylvia, BS

      Affiliations

    • Tufts University School of Medicine, Boston, MA.
    • ,
  • Edward A. Ullman, MD

      Affiliations

    • Beth Israel Deaconess Medical Center, Boston, MA

Objective

To determine the availability of early defibrillation and automated external defibrillators in nursing homes in selected cities.

Design

A standardized telephone survey was conducted of all skilled nursing facilities to characterize early defibrillation capabilities.

Setting

The study involved nursing homes in Philadelphia, Omaha, Seattle, and Boston.

Participants

All skilled nursing facilities not physically attached to hospitals in the selected cities based on listings from the Centers for Medicare and Medicaid Services as of January 2004.

Measurements

Each site was queried as to whether or not they had an automated external defibrillator (AED), if they were physically freestanding facilities, if a manual defibrillator was present, and if staff were present 24 hours a day to use the defibrillator. Early defibrillation was defined as the presence of either a manual defibrillator or AED in addition to 24-hour trained staff availability.

Results

There were 126 nursing homes identified from the Medicare listing and 81% (102) responded to our phone survey. After exclusion of nonfreestanding facilities, 90 nursing homes (71.4%) were available for analysis. Overall, 16.7% (95% CI 8.8–24.5) of nursing homes reported early defibrillation capabilities via manual defibrillator or AEDs; 6.7% (95% CI 1.4–11.9) of nursing homes reported AEDs; 10.0% (95% CI 3.7–16.3) of nursing homes reported manual defibrillators. Nursing homes in Seattle had a higher rate of early defibrillation capability than the other 3 cities.

Conclusion

Despite the fact that nursing homes have been identified as locations with multiple cardiac arrests, the early defibrillation capabilities and prevalence of AEDs in this setting remains low. AEDs may play a role in improving survival from cardiac arrest in nursing homes. The placement of AEDs in nursing homes needs further consideration and study.

Keywords: Cardiac arrest, nursing home, automated external defibrillation

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 The views expressed in this article are those of the author and do not reflect the official policy or position of the United States Air Force, Department of Defense, or the U.S. Government.

PII: S1525-8610(07)00207-1

doi:10.1016/j.jamda.2007.04.001

JAMDA
Volume 8, Issue 6 , Pages 413-415, July 2007

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