Public Cardiac Arrest Characteristics in Enclosed Pedestrian Networks

Minha Lee, Derya Demirtas, Jason E. Buick, Amy Ng, Michael J. Feldman, Sheldon Cheskes, Laurie J. Morrison, Timothy C.Y. Chan

Research output: Contribution to journalMeeting AbstractAcademic

Abstract

Background: Cities around the world have underground or above-ground enclosed networks for pedestrian travel, representing unique environments for studying out-of-hospital cardiac arrest (OHCA) and resuscitation. The characteristics of OHCAs that occur in such networks are unknown.

Objective: To determine whether cardiac arrests occurring in enclosed pedestrian networks are different from those in the encompassing city, using the PATH network in Toronto, the largest underground shopping complex in the world, as a model site.

Methods: We identified all atraumatic, public-location OHCAs in Toronto from Apr. 2006 – Mar. 2015, and classified them according to location: Toronto, downtown, and PATH-accessible. PATH-accessible OHCAs are those that occur within the PATH network between the first underground and second above-ground floor. We collected demographic, prehospital intervention, and survival data for each OHCA. Statistical analysis was performed using t-tests and chi-squared tests.

Results: We identified 2621 atraumatic public OHCAs, of which 521 were in downtown and 50 were PATH-accessible. Compared to Toronto overall, PATH-accessible OHCAs had significantly higher proportions of bystander witnessed interventions, initial shockable rhythm, and overall survival, with all differences being statistically significant. Similar significant differences were observed when comparing PATH-accessible to downtown OHCAs. There were no significant differences in demographics and survival among patients with initial shockable rhythm.

Conclusion: This study suggests that OHCAs in enclosed pedestrian networks are uniquely different from other public settings. Bystander resuscitation efforts are significantly more frequent and survival rates are higher. Urban planners in similar networks worldwide should consider these findings when deciding on AED placement and how to cue bystander response.
Original languageEnglish
Article number22984
JournalCirculation
Volume132
Issue number23
DOIs
Publication statusPublished - 2015
EventResuscitation Science Symposium 2015 - Orange County Convention Center, Orlando, United States
Duration: 7 Nov 20159 Nov 2015

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Heart Arrest
Out-of-Hospital Cardiac Arrest
Resuscitation
Survival
Demography
Cues
Survival Rate
Pedestrians

Cite this

Lee, M., Demirtas, D., Buick, J. E., Ng, A., Feldman, M. J., Cheskes, S., ... Chan, T. C. Y. (2015). Public Cardiac Arrest Characteristics in Enclosed Pedestrian Networks. Circulation, 132(23), [22984]. https://doi.org/10.1161/CIR.0000000000000334
Lee, Minha ; Demirtas, Derya ; Buick, Jason E. ; Ng, Amy ; Feldman, Michael J. ; Cheskes, Sheldon ; Morrison, Laurie J. ; Chan, Timothy C.Y. / Public Cardiac Arrest Characteristics in Enclosed Pedestrian Networks. In: Circulation. 2015 ; Vol. 132, No. 23.
@article{c652f0f61cde4aabba6b8c60fb8a1eee,
title = "Public Cardiac Arrest Characteristics in Enclosed Pedestrian Networks",
abstract = "Background: Cities around the world have underground or above-ground enclosed networks for pedestrian travel, representing unique environments for studying out-of-hospital cardiac arrest (OHCA) and resuscitation. The characteristics of OHCAs that occur in such networks are unknown.Objective: To determine whether cardiac arrests occurring in enclosed pedestrian networks are different from those in the encompassing city, using the PATH network in Toronto, the largest underground shopping complex in the world, as a model site.Methods: We identified all atraumatic, public-location OHCAs in Toronto from Apr. 2006 – Mar. 2015, and classified them according to location: Toronto, downtown, and PATH-accessible. PATH-accessible OHCAs are those that occur within the PATH network between the first underground and second above-ground floor. We collected demographic, prehospital intervention, and survival data for each OHCA. Statistical analysis was performed using t-tests and chi-squared tests.Results: We identified 2621 atraumatic public OHCAs, of which 521 were in downtown and 50 were PATH-accessible. Compared to Toronto overall, PATH-accessible OHCAs had significantly higher proportions of bystander witnessed interventions, initial shockable rhythm, and overall survival, with all differences being statistically significant. Similar significant differences were observed when comparing PATH-accessible to downtown OHCAs. There were no significant differences in demographics and survival among patients with initial shockable rhythm.Conclusion: This study suggests that OHCAs in enclosed pedestrian networks are uniquely different from other public settings. Bystander resuscitation efforts are significantly more frequent and survival rates are higher. Urban planners in similar networks worldwide should consider these findings when deciding on AED placement and how to cue bystander response.",
author = "Minha Lee and Derya Demirtas and Buick, {Jason E.} and Amy Ng and Feldman, {Michael J.} and Sheldon Cheskes and Morrison, {Laurie J.} and Chan, {Timothy C.Y.}",
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language = "English",
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Lee, M, Demirtas, D, Buick, JE, Ng, A, Feldman, MJ, Cheskes, S, Morrison, LJ & Chan, TCY 2015, 'Public Cardiac Arrest Characteristics in Enclosed Pedestrian Networks' Circulation, vol. 132, no. 23, 22984. https://doi.org/10.1161/CIR.0000000000000334

Public Cardiac Arrest Characteristics in Enclosed Pedestrian Networks. / Lee, Minha; Demirtas, Derya; Buick, Jason E.; Ng, Amy; Feldman, Michael J.; Cheskes, Sheldon; Morrison, Laurie J.; Chan, Timothy C.Y.

In: Circulation, Vol. 132, No. 23, 22984, 2015.

Research output: Contribution to journalMeeting AbstractAcademic

TY - JOUR

T1 - Public Cardiac Arrest Characteristics in Enclosed Pedestrian Networks

AU - Lee, Minha

AU - Demirtas, Derya

AU - Buick, Jason E.

AU - Ng, Amy

AU - Feldman, Michael J.

AU - Cheskes, Sheldon

AU - Morrison, Laurie J.

AU - Chan, Timothy C.Y.

N1 - Late-Breaking Clinical Trial Abstracts

PY - 2015

Y1 - 2015

N2 - Background: Cities around the world have underground or above-ground enclosed networks for pedestrian travel, representing unique environments for studying out-of-hospital cardiac arrest (OHCA) and resuscitation. The characteristics of OHCAs that occur in such networks are unknown.Objective: To determine whether cardiac arrests occurring in enclosed pedestrian networks are different from those in the encompassing city, using the PATH network in Toronto, the largest underground shopping complex in the world, as a model site.Methods: We identified all atraumatic, public-location OHCAs in Toronto from Apr. 2006 – Mar. 2015, and classified them according to location: Toronto, downtown, and PATH-accessible. PATH-accessible OHCAs are those that occur within the PATH network between the first underground and second above-ground floor. We collected demographic, prehospital intervention, and survival data for each OHCA. Statistical analysis was performed using t-tests and chi-squared tests.Results: We identified 2621 atraumatic public OHCAs, of which 521 were in downtown and 50 were PATH-accessible. Compared to Toronto overall, PATH-accessible OHCAs had significantly higher proportions of bystander witnessed interventions, initial shockable rhythm, and overall survival, with all differences being statistically significant. Similar significant differences were observed when comparing PATH-accessible to downtown OHCAs. There were no significant differences in demographics and survival among patients with initial shockable rhythm.Conclusion: This study suggests that OHCAs in enclosed pedestrian networks are uniquely different from other public settings. Bystander resuscitation efforts are significantly more frequent and survival rates are higher. Urban planners in similar networks worldwide should consider these findings when deciding on AED placement and how to cue bystander response.

AB - Background: Cities around the world have underground or above-ground enclosed networks for pedestrian travel, representing unique environments for studying out-of-hospital cardiac arrest (OHCA) and resuscitation. The characteristics of OHCAs that occur in such networks are unknown.Objective: To determine whether cardiac arrests occurring in enclosed pedestrian networks are different from those in the encompassing city, using the PATH network in Toronto, the largest underground shopping complex in the world, as a model site.Methods: We identified all atraumatic, public-location OHCAs in Toronto from Apr. 2006 – Mar. 2015, and classified them according to location: Toronto, downtown, and PATH-accessible. PATH-accessible OHCAs are those that occur within the PATH network between the first underground and second above-ground floor. We collected demographic, prehospital intervention, and survival data for each OHCA. Statistical analysis was performed using t-tests and chi-squared tests.Results: We identified 2621 atraumatic public OHCAs, of which 521 were in downtown and 50 were PATH-accessible. Compared to Toronto overall, PATH-accessible OHCAs had significantly higher proportions of bystander witnessed interventions, initial shockable rhythm, and overall survival, with all differences being statistically significant. Similar significant differences were observed when comparing PATH-accessible to downtown OHCAs. There were no significant differences in demographics and survival among patients with initial shockable rhythm.Conclusion: This study suggests that OHCAs in enclosed pedestrian networks are uniquely different from other public settings. Bystander resuscitation efforts are significantly more frequent and survival rates are higher. Urban planners in similar networks worldwide should consider these findings when deciding on AED placement and how to cue bystander response.

U2 - 10.1161/CIR.0000000000000334

DO - 10.1161/CIR.0000000000000334

M3 - Meeting Abstract

VL - 132

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 23

M1 - 22984

ER -