The effectiveness and cost effectiveness of public-access defibrillation.

Clinical Cardiology
Roger A Winkle

Abstract

Many sudden cardiac deaths are due to ventricular fibrillation (VF). The use of defibrillators in hospitals or by outpatient emergency medical services (EMS) personnel can save many cardiac-arrest victims. Automated external defibrillators (AEDs) permit defibrillation by trained first responders and laypersons. AEDs are available at most public venues, and vast sums of money are spent installing and maintaining these devices. AEDs have been evaluated in a variety of public and private settings. AEDs accurately identify malignant ventricular tachyarrhythmias and frequently result in successful defibrillation. Prompt application of an AED shows a greater number of patients in VF compared with initial rhythms documented by later-arriving EMS personnel. Survival is greatest when the AED is placed within 3 to 5 minutes of a witnessed collapse. Community-based studies show increased cardiac-arrest survival when first responders are equipped with AEDs rather than waiting for paramedics to defibrillate. Wide dissemination of AEDs throughout a community increases survival from cardiac arrest when the AED is used; however, the AEDs are utilized in a very small percentage of all out-of-hospital cardiac arrests. AEDs save very few lives in...Continue Reading

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