Abstract Sat606: Real-Time Geolocation Digital Platforms for the Availability of Automated External Defibrillators in Out-of-Hospital Cardiac Arrest: A Systematic Review

Abstract

Background: Out-of-Hospital Cardiac Arrest (OHCA) is a leading cause of mortality worldwide, with survival heavily dependent on rapid Automated External Defibrillator (AED) access. While geolocation-based digital platforms have emerged to optimize AED deployment, their real-world availability and impact remain unclear. Research Question: What real-time digital geolocation platforms exist to improve the availability of AEDs in cases of OHCA? Aim: This systematic review identifies real-time digital geolocation platforms designed to improve AED availability in OHCA cases. Methods: A systematic search was conducted on April 21, 2025, in PubMed, Scopus, Embase, and Web of Science. Gray literature, reference lists, and the first 15 pages of Google Scholar were also screened. The review followed PRISMA 2020 guidelines. Risk of bias was assessed using ROBINS-I for observational studies and RoB 2.0 for the randomized controlled trial (RCT). Results: We included eighteen studies (17 observational, 1 RCT) included smartphone apps (n=6), drones (n=3), dispatch systems (n=5), hybrid platforms (n=2), and geographic information system models (n=2). Platforms reduced response times (3.17–10.83 min); drones fastest (3.17–5.50 min), saving 3.42 min versus Emergency Medical Services (EMS). Survival improved 1–20.4% (highest with bystander alerts, mostly through smartphone apps); AED use pre-EMS increased 1–49.5%. Drones achieved 67.5% coverage; bystander cardiopulmonary resuscitation (CPR) rose to 14–59.8% (30.9% retrieved AEDs when alerted). Analysis showed 67% Return of Spontaneous Circulation (ROSC) with guided CPR and 49.5% urban AED retrieval, versus rural delays (466.6±252.6 vs. 402.4±163.3 seconds) and lower AED use (9.4% vs. 18.5%). RoB 2.0 showed moderate risk for RCT; ROBINS-I showed 88% moderate, 12% serious risk for observational studies. Conclusions: Real-time geolocation platforms could improve OHCA outcomes by enhancing AED availability, reducing response times, and increasing survival. Drones achieved fastest responses; smartphone alerts showed highest survival improvements. Urban-rural disparities exist. Despite limitations, these platforms represent promising advancements requiring standardized implementation.