Abstract Body: Background: Rapid defibrillation by the public with automated external defibrillators (AEDs) is critical to improving out-of-hospital cardiac arrest (OHCA) survival. Concerns about theft, vandalism, and misuse of AEDs have led to the implementation of security measures, including the use of locked cabinets to house these devices in public areas.
Aim: This scoping review aims to systematically explore the existing literature on the impact of locked cabinets for AEDs during emergencies.
Methods: A search of Medline, Embase, Cochrane, CINAHL and Google Scholar (20 pages) was performed on May 25th 2024. Studies of any design (e.g., experimental, observational, qualitative) that evaluated the impact of locked cabinets on AED accessibility and effectiveness during emergencies. Data were charting was iterative, and after reading included studies the studies were grouped by the outcomes studied.
Results: We screened 2,096 titles and found 10 relevant studies: 8 observational studies and 2 OHCA simulation studies. Four papers were only published as conference abstract and no studies reported on patient outcomes. Data were reported on varying numbers of AEDS (ranging from 39 to 31,938) which were located inside buildings and public spaces. Overall theft and vandalism rates were very low, with the majority of studies reporting rates of <2%. Although in some studies it was unclear if the AED was stolen, or whether it had been used in an emergency and not returned. The impact of locking AEDs in cabinets was reported in one study, and showed minimal impact on rates of theft and vandalism (0.34% vs. 0.12%, p< 0.01). Two OHCA simulation studies conducted at AED locations showed significantly slower AED retrieval when AEDs were locked away. One survey of first responders reported that 50% (25/50) were injured while accessing an AED, which required breaking glass.
Conclusion: Rates of theft and vandalism of AEDs located in private and public locations are low overall and in unlocked cabinets. Further research is needed on the impact of locked AEDs on patient outcomes.