Public access defibrillator use increasing

November 09, 2003

Orlando, Fla. - Use of portable defibrillators by non-emergency responders on victims of cardiac arrest doubled during a four-year period in Seattle and King County, Washington. Survival rates were similar to or better than those of people treated by emergency medical service workers, researchers reported at the American Heart Association's Scientific Sessions 2003.

Public access defibrillation (PAD) is when someone other than a traditional emergency medical worker applies an automated external defibrillator (AED) to treat out-of-hospital cardiac arrest. Cardiac arrest occurs when the heart suddenly stops beating normally and cannot pump blood to the rest of the body, causing death within minutes, unless the patient gets cardiopulmonary resuscitation (CPR). For many victims, an electrical shock to the heart from an AED is their only chance for survival.

"PAD was used in only a small proportion of all treated out-of-hospital arrests, but the proportion increased over time," said Thomas D. Rea, M.D., M.P.H., an epidemiologist at the Division of Emergency Medical Services, Public Health for Seattle and King County, Wash.

Researchers tracked out-of-hospital cardiac arrests treated by public access defibrillation between January 1, 1999 and December 31, 2002 in Seattle and King County. They wanted to determine how frequently public defibrillators were used.

PAD accounted for 1.3 percent (50 people) of 3,754 cardiac arrests treated during the study period, increasing from 0.82 percent in 1999 to 2.05 percent in 2002.

For those treated with PAD, survival was 50 percent according to hospital discharge data.

"This survival rate is encouraging," said Rea, though he added that the study was not designed to determine whether PAD improves survival.

Businesses and other entities in the community that bought their own AEDs and trained responders registered with the Seattle area's voluntary Community Responder AED Program. In all, 457 AEDs were registered, and more than 4,000 people were trained to use them.

"The primary aim of the PAD program was to make sure that, in a cardiac arrest, everything was in place so the victim would have the best chance at survival," Rea said.

About 250,000 U.S. residents die from sudden cardiac arrest each year, according to the American Heart Association. This is about half of all deaths from coronary heart disease.
Co-authors are Linda Culley, B.A.; John A. Murray, M.D.; Barbara Welles, R.N.; Carol E. Fahrenbruch, B.S., M.S.P.H.; Michele Olsufka, R.N.; Mickey S. Eisenberg, M.D., Ph.D. and Michael K. Copass, M.D.

American Heart Association

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