Maritime Use of Automated External Defibrillators (AED): Retrospective Assessment of Availability and Effectiveness

Abstract Introduction: For the treatment of sudden cardiac death, the prompt deployment of an automated external defibrillator (AED) has been shown to significantly improve survival rates (1). Since 2007, the availability of AEDs on seagoing vessels flying the German flag has been legally mandated. This study aims to assess the availability of AEDs on such vessels and their utilization in emergency situations on board. Subjects and Methods: A monocentric retrospective analysis was conducted to evaluate the utilization of AEDs on board. A total of 43 nautical officers completed a questionnaire covering an observational period of the past 10 years. The ship officers were interviewed on board vessels in the Port of Hamburg between August and December 2018, corresponding to an observation period of 8600 seafarer-years. Results: An AED was present on 100% of German-flagged seagoing vessels and 52.2% of non-German-flagged seagoing vessels. Of the 43 health officers surveyed, 38 did not use an AED. Among living patients, four officers used the AED once to deliver a shock, while one respondent used it twice. The five early defibrillations performed occurred following observed cardiovascular arrests and correspond to an annual prevalence of sudden cardiac death of 6 per 100,000 seafarers. Three patients (60%) were successfully defibrillated. Conclusions: The medical requirements for German-flagged ships are playing a pioneering role internationally in the equipping of seagoing vessels with AEDs. Given the unique conditions at sea and the lack of timely on-site emergency medical care – both of great importance – the availability of an AED on board appears to be highly beneficial.