Aug 13, 2004

Public-access defibrillation and survival after out-of-hospital cardiac arrest

The New England Journal of Medicine
Alfred P HallstromPublic Access Defibrillation Trial Investigators

Abstract

The rate of survival after out-of-hospital cardiac arrest is low. It is not known whether this rate will increase if laypersons are trained to attempt defibrillation with the use of automated external defibrillators (AEDs). We conducted a prospective, community-based, multicenter clinical trial in which we randomly assigned community units (e.g., shopping malls and apartment complexes) to a structured and monitored emergency-response system involving lay volunteers trained in cardiopulmonary resuscitation (CPR) alone or in CPR and the use of AEDs. The primary outcome was survival to hospital discharge. More than 19,000 volunteer responders from 993 community units in 24 North American regions participated. The two study groups had similar unit and volunteer characteristics. Patients with treated out-of-hospital cardiac arrest in the two groups were similar in age (mean, 69.8 years), proportion of men (67 percent), rate of cardiac arrest in a public location (70 percent), and rate of witnessed cardiac arrest (72 percent). No inappropriate shocks were delivered. There were more survivors to hospital discharge in the units assigned to have volunteers trained in CPR plus the use of AEDs (30 survivors among 128 arrests) than there w...Continue Reading

Mentioned in this Paper

Ophthalmoplegia
Emergency Care
Complex (molecular entity)
Hospitalization
Survival Analysis
Basic Cardiac Life Support
Shock
Housing
Cardiopulmonary
Multi-Angle Laser Light Scattering

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