A population-based investigation of public access defibrillation: Role of emergency medical services care

Abstract Background Although strategic use of public access defibrillation (PAD) can improve cardiac arrest survival, little is known about temporal trends in PAD deployment and use or how PAD affects the role of emergency medical services (EMS). We sought to determine the frequency, circumstances, and time trends of PAD AED and determine implications of PAD use for EMS providers. Methods The investigation was a population-based cohort study of treated out-of-hospital cardiac arrest from a heterogeneous metropolitan setting between January 1, 1999 and December 31, 2006. The study focused on cases where a PAD AED was applied. Results During the 8-year period, a PAD AED was applied in 1.5% (157/10,332) of all arrests and 4.4% (122/2759) of ventricular fibrillation arrests. PAD application increased over time overall (0.6% in 1999 to 2.4% in 2006) and among ventricular fibrillation arrests (1.8% in 1999 to 8.2% in 2006) ( p Conclusion PAD AED increased over time. Most PAD patients were pulseless upon EMS arrival and required basic and advanced resuscitation care by EMS; yet most subsequently achieved spontaneous circulation.