Impact of AEDs and training of smartphone activated volunteers in residential areas on OHCA: a nationwide stepped-wedge implementation trial

Pek, PP; Fook-Chong, SMC; Sudharshan, P; Ge, Y; Ng, YY; Leong, BS; Mao, DR; Chia, MYC; Ng, WM; Gan, HN; Doctor, NE; Tham, LP; Shahidah, N; White, AE; Hong, D; Ong, MEH

doi:10.1016/j.resuscitation.2025.110826

Acute cardiac care & resuscitation

Impact of automated external defibrillator (AEDs) and training of smartphone activated volunteers in residential areas on out-of-hospital cardiac arrest (OHCA): a nationwide stepped-wedge implementation trial

ResuscitationPublished 12 Sep 2025Stepped-wedge cluster non-randomised implementation trial

Primary result · Bystander AED applicationResultAdjusted odds ratio 3.94 95% CI 3.28–4.74

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Authors' conclusion

The implementation of AED installation in residential areas and training of smartphone activated volunteers increased bystander AED application; the impact was higher for OHCAs occurring in residential compared to public locations.

Study context

Population: OHCAs in Singapore, 1 April 2010 – 31 December 2020OHCAs analysed
Participants: 18,086 ohcas

Comparison: AED installation in residential areas plus training of smartphone-activated volunteers vs control
Interventionn = 8,180
Controln = 9,906reference
Primary endpoint: Bystander AED application

Methodological detailsnationwide

Nationwide

Primary result

As reported in the abstract

Adjusted odds ratio

3.94

95% CI 3.28–4.74

P < 0.05

Interventionvs Control

aOR 3.94 (95% CI 3.28–4.74); P < 0.05

Secondary outcomes

Outcome	← Lower odds with intervention ←→ Higher odds with intervention →	aOR (95% CI)
Bystander AED application, by location of arrest (stratified analysis)Interventionvs ControlResidential locations	0.050.21520	10.31 (6.94–15.33)
Bystander AED application, by location of arrest (stratified analysis)Interventionvs ControlPublic locations	0.050.21520	2.84 (2.24–3.59)
	0.050.21520Adjusted odds ratio (log scale)

Original publication

Impact of AEDs and training of smartphone activated volunteers in residential areas on OHCA: a nationwide stepped-wedge implementation trial. Resuscitation. Published 12 September 2025. doi:10.1016/j.resuscitation.2025.110826

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