Key result
Optimized public access defibrillation programs boost bystander AED use up to ~17% in archipelagic regions.
Why the study?
In archipelagic countries like Indonesia, geographical barriers and transport delays prolong EMS response times and reduce survival after OHCA due to VF, prompting a synthesis of evidence on the feasibility and effectiveness of PAD programs in island environments.
Does the implementation of Public Access Defibrillation (PAD) programs reduce time to first shock and improve survival in patients with ventricular fibrillation-induced out-of-hospital cardiac arrest in archipelagic and remote settings?
Does the implementation of Public Access Defibrillation (PAD) programs reduce time to first shock and improve survival in patients with ventricular fibrillation-induced out-of-hospital cardiac arrest in archipelagic and remote settings?
Tailored Public Access Defibrillation programs integrating strategic AED placement at maritime hubs, dispatcher-linked registries, community responder networks, and drone delivery offer a viable strategy to overcome prolonged EMS transit times and improve OHCA survival in archipelagic nations like Indonesia.
May support drone-enhanced PAD programs in archipelagic regions; leaves open survival impact and requires prospective trials.
Out-of-hospital cardiac arrest (OHCA) due to ventricular fibrillation (VF) requires rapid defibrillation. In archipelagic countries like Indonesia, geographical barriers and transport delays prolong emergency medical services (EMS) response times, reducing survival rates. To synthesize current evidence on the feasibility and effectiveness of Public Access Defibrillation (PAD) programs in reducing time to first shock in island environments. A narrative review was conducted by examining literature on OHCA, VF pathophysiology, PAD delivery models, and resuscitation strategies in remote or archipelagic settings. Conventional EMS alone is inadequate in island regions due to prolonged transit times. PAD programs effectively reduce shock delays through strategic automated external defibrillator (AED) placement (e.g., ports, ferries, transit hubs), community responder training, mobile dispatch applications, and drone delivery. Integrating AED registries with EMS dispatchers significantly enhances bystander intervention and patient outcomes. PAD is a viable, life-saving strategy for archipelagic nations like Indonesia when tailored to local geography. Recommendations: Staged implementation should begin in high-density transit and maritime corridors, supported by local feasibility studies and policy frameworks.
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Yaqinah et al. (2026) conducted a review in Out-of-hospital cardiac arrest (OHCA) due to ventricular fibrillation. Public Access Defibrillation (PAD) programs (static public AEDs, volunteer responder apps, drone delivery, and integrated EMS registries) vs. Conventional emergency medical services (EMS) alone or unmapped AED placement was evaluated. Public Access Defibrillation programs using strategic AED placement, registry integration, and drones reduce shock delays and increase bystander AED use up to 16.5% in archipelagic regions.
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