Public Access Defibrillation

In theUnitedStates, 50 to60people suffer acardiac arrest each hour, amounting to approximately 250,000 deaths every year. In the first 5 minutes of a cardiac arrest, ventricular tachycardia and ventricular fibrillation (VF) are the most frequent cardiac arrhythmias encountered. Despite emergency medical response systems, the long-term survival fromout-of-hospital cardiac arrest remains poor in most United States cities. Paramount to achieving successful resuscitation of a cardiac arrest victim is providing early defibrillation. The likelihood of survival decreases by 7% to 10% for every 1-minute delay in defibrillation. If defibrillation is delayed more than 10 minutes, the likelihood of survival is very poor. Modern living with vertical high-rise buildings, heavy traffic, and sprawling suburbs pose significant obstacles to emergency medical services (EMS) within cities. In 1995, in response to the abysmal survival of out-ofhospital cardiac arrest, the American Heart Association challenged the medical industry to develop a defibrillator that could be placed in public settings, used safely by lay responders, and provide earlier defibrillation to cardiac-arrest victims. Over the last decade, there have been significant technological advancements in automated external defibrillators (AEDs) and clinical studies have demonstrated their benefits and limitations in public locations. This article discusses the modern AED and the data to support public access defibrillation (PAD).