IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v22y2025i2p173-d1578087.html
   My bibliography  Save this article

Out-of-Hospital Cardiac Arrest Ambulance Delay Zones and AED Placement in a Southern Brazilian City

Author

Listed:
  • Marcos Rogério Bitencourt

    (Post Graduate Program in Health Sciences, State University of Maringá, Maringá 87020-900, Paraná, Brazil)

  • Mariá Romanio Bitencourt

    (Department of Medicine, State University of Maringá, Maringá 87020-900, Paraná, Brazil)

  • Lincoln Luís Silva

    (Post Graduate Program in Health Sciences, State University of Maringá, Maringá 87020-900, Paraná, Brazil
    Department of Emergency Medicine, Duke University School of Medicine, Durham, NC 27708, USA)

  • Amanda Gubert Alves dos Santos

    (Department of Health Sciences, Centro Universitário Integrado, Campo Mourão 87309-701, Paraná, Brazil)

  • Pedro Iora

    (Department of Medicine, State University of Maringá, Maringá 87020-900, Paraná, Brazil)

  • José Anderson Labbado

    (Post Graduate Program in Health Sciences, State University of Maringá, Maringá 87020-900, Paraná, Brazil)

  • Mauricio Medeiros Lemos

    (Post Graduate Program in Health Sciences, State University of Maringá, Maringá 87020-900, Paraná, Brazil)

  • Luiz Gustavo de Paulo

    (Department of Medicine, Centro Universitário de Maringá, Maringá 87050-900, Paraná, Brazil)

  • Júlia Loverde Gabella

    (Department of Medicine, State University of Maringá, Maringá 87020-900, Paraná, Brazil)

  • Juliana Lourenço Lopes Costa

    (Department of Medicine, Centro Universitário de Maringá, Maringá 87050-900, Paraná, Brazil)

  • Hideky Ikeda Dolci

    (Department of Medicine, Centro Universitário de Maringá, Maringá 87050-900, Paraná, Brazil)

  • Vinicius Giacomin

    (Post Graduate Program in Health Sciences, State University of Maringá, Maringá 87020-900, Paraná, Brazil)

  • Sandra Marisa Pelloso

    (Post Graduate Program in Health Sciences, State University of Maringá, Maringá 87020-900, Paraná, Brazil)

  • Maria Dalva de Barros Carvalho

    (Post Graduate Program in Health Sciences, State University of Maringá, Maringá 87020-900, Paraná, Brazil)

  • Luciano de Andrade

    (Post Graduate Program in Health Sciences, State University of Maringá, Maringá 87020-900, Paraná, Brazil
    Department of Medicine, State University of Maringá, Maringá 87020-900, Paraná, Brazil)

Abstract

Out-of-hospital cardiac arrests (OHCAs) have high mortality rates, worsened by limited access to automated external defibrillators (AEDs). This study analyzed OHCA response times, identified areas with prolonged ambulance travel times, and proposed optimal AED locations in a medium-sized city in southern Brazil. Data from 278 non-traumatic OHCA cases (2019–2022) in patients over 18 years old, with ambulance response times under 20 min, were included. Spatial survival analysis assessed the probability of exceeding the recommended 5-min (300 s) ambulance response time. The maximal covering location problem identified 100 strategic AED sites within a 150-s reach for bystanders. AED and ambulance travel times were compared using the Wilcoxon test ( p < 0.01). Defibrillation occurred in 89 cases (31.01%), and bystander CPR was performed in 149 cases (51.92%). Despite these efforts, 77% of patients died. The median ambulance response time was 11.63 min, exceeding 5 min in most cases, particularly at peak times like 11 a.m. AED placement in selected locations could cover 76% of OHCA occurrences, with a mean AED travel time of 320 s compared to 709 s for ambulances. Strategic AED placement could enhance early defibrillation and improve survival outcomes.

Suggested Citation

  • Marcos Rogério Bitencourt & Mariá Romanio Bitencourt & Lincoln Luís Silva & Amanda Gubert Alves dos Santos & Pedro Iora & José Anderson Labbado & Mauricio Medeiros Lemos & Luiz Gustavo de Paulo & Júli, 2025. "Out-of-Hospital Cardiac Arrest Ambulance Delay Zones and AED Placement in a Southern Brazilian City," IJERPH, MDPI, vol. 22(2), pages 1-15, January.
    • Handle: RePEc:gam:jijerp:v:22:y:2025:i:2:p:173-:d:1578087
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/22/2/173/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/22/2/173/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. F. Javier Otamendi & David García-Heredia, 2015. "Isochrones as Indicators of the Influence of Traffic in Public Health: A Visual Simulation Application in Ávila, Spain," IJERPH, MDPI, vol. 12(10), pages 1-21, October.
    2. Kavitha Ramanathan & Mani Thenmozhi & Sebastian George & Shalini Anandan & Balaji Veeraraghavan & Elena N. Naumova & Lakshmanan Jeyaseelan, 2020. "Assessing Seasonality Variation with Harmonic Regression: Accommodations for Sharp Peaks," IJERPH, MDPI, vol. 17(4), pages 1-14, February.
    3. Richard Church & Charles R. Velle, 1974. "The Maximal Covering Location Problem," Papers in Regional Science, Wiley Blackwell, vol. 32(1), pages 101-118, January.
    4. Musrat Gul Bhellar & Mir Aftab Hussain Talpur & Shabir Hussain Khahro & Tauha Hussain Ali & Yasir Javed, 2023. "Visualizing Travel Accessibility in a Congested City Center: A GIS-Based Isochrone Model and Trip Rate Analysis Considering Sustainable Transportation Solutions," Sustainability, MDPI, vol. 15(23), pages 1-23, December.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Tammy Drezner & Zvi Drezner, 2019. "Cooperative Cover of Uniform Demand," Networks and Spatial Economics, Springer, vol. 19(3), pages 819-831, September.
    2. Alan T. Murray, 2016. "Maximal Coverage Location Problem," International Regional Science Review, , vol. 39(1), pages 5-27, January.
    3. Huizhu Wang & Jianqin Zhou, 2023. "Location of Railway Emergency Rescue Spots Based on a Near-Full Covering Problem: From a Perspective of Diverse Scenarios," Sustainability, MDPI, vol. 15(8), pages 1-16, April.
    4. Eliş, Haluk & Tansel, Barbaros & Oğuz, Osman & Güney, Mesut & Kian, Ramez, 2021. "On guarding real terrains: The terrain guarding and the blocking path problems," Omega, Elsevier, vol. 102(C).
    5. Li, Xin & Pan, Yanchun & Jiang, Shiqiang & Huang, Qiang & Chen, Zhimin & Zhang, Mingxia & Zhang, Zuoyao, 2021. "Locate vaccination stations considering travel distance, operational cost, and work schedule," Omega, Elsevier, vol. 101(C).
    6. Mehdi Ansari & Juan S. Borrero & Leonardo Lozano, 2023. "Robust Minimum-Cost Flow Problems Under Multiple Ripple Effect Disruptions," INFORMS Journal on Computing, INFORMS, vol. 35(1), pages 83-103, January.
    7. Hamid Mousavi & Soroush Avakh Darestani & Parham Azimi, 2021. "An artificial neural network based mathematical model for a stochastic health care facility location problem," Health Care Management Science, Springer, vol. 24(3), pages 499-514, September.
    8. Jiwon Baik & Alan T. Murray, 2022. "Locating a facility to simultaneously address access and coverage goals," Papers in Regional Science, Wiley Blackwell, vol. 101(5), pages 1199-1217, October.
    9. Chen, Liang & Chen, Sheng-Jie & Chen, Wei-Kun & Dai, Yu-Hong & Quan, Tao & Chen, Juan, 2023. "Efficient presolving methods for solving maximal covering and partial set covering location problems," European Journal of Operational Research, Elsevier, vol. 311(1), pages 73-87.
    10. Ospina, Juan P. & Duque, Juan C. & Botero-Fernández, Verónica & Montoya, Alejandro, 2022. "The maximal covering bicycle network design problem," Transportation Research Part A: Policy and Practice, Elsevier, vol. 159(C), pages 222-236.
    11. Fadda, Edoardo & Manerba, Daniele & Cabodi, Gianpiero & Camurati, Paolo Enrico & Tadei, Roberto, 2021. "Comparative analysis of models and performance indicators for optimal service facility location," Transportation Research Part E: Logistics and Transportation Review, Elsevier, vol. 145(C).
    12. Arana-Jiménez, Manuel & Blanco, Víctor & Fernández, Elena, 2020. "On the fuzzy maximal covering location problem," European Journal of Operational Research, Elsevier, vol. 283(2), pages 692-705.
    13. Sadeghi, Mohammad & Yaghoubi, Saeed, 2024. "Optimization models for cloud seeding network design and operations," European Journal of Operational Research, Elsevier, vol. 312(3), pages 1146-1167.
    14. Erhan Erkut & Armann Ingolfsson & Güneş Erdoğan, 2008. "Ambulance location for maximum survival," Naval Research Logistics (NRL), John Wiley & Sons, vol. 55(1), pages 42-58, February.
    15. Gentile, José & Alves Pessoa, Artur & Poss, Michael & Costa Roboredo, Marcos, 2018. "Integer programming formulations for three sequential discrete competitive location problems with foresight," European Journal of Operational Research, Elsevier, vol. 265(3), pages 872-881.
    16. Robin Buter & Arthur Nazarian & Hendrik Koffijberg & Erwin W. Hans & Remy Stieglis & Rudolph W. Koster & Derya Demirtas, 2024. "Strategic placement of volunteer responder system defibrillators," Health Care Management Science, Springer, vol. 27(4), pages 503-524, December.
    17. Sandeepan Roy & Avijit Maji, 2019. "Optimization of High-Speed Railway Station Location Selection Based on Accessibility and Environmental Impact," ADBI Working Papers 953, Asian Development Bank Institute.
    18. Terance J. Rephann, 2008. "Spatial Analysis in Veterans Cemetery Location," Working Papers 2008-03, Center for Economic and Policy Studies.
    19. Fatih Rahim & Canan Sepil, 2014. "A location-routing problem in glass recycling," Annals of Operations Research, Springer, vol. 223(1), pages 329-353, December.
    20. Nelas, José & Dias, Joana, 2020. "Optimal Emergency Vehicles Location: An approach considering the hierarchy and substitutability of resources," European Journal of Operational Research, Elsevier, vol. 287(2), pages 583-599.

    More about this item

    Keywords

    ;
    ;
    ;
    ;
    ;

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:22:y:2025:i:2:p:173-:d:1578087. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.