Abstract
Background - Disappointing survival rates from out-of-hospital cardiac arrests encourage strategies for faster defibrillation, such as use of automated external defibrillators (AEDs) by nonconventional responders. Methods and Results - AEDs were provided to all Miami-Dade County, Florida, police. AED-equipped police (P-AED) and conventional emergency medical rescue (EMS) responders are simultaneously deployed to possible cardiac arrests. Times from 9-1-1 contact to the scene were compared for P-AED and concurrently deployed EMS, and both were compared with historical EMS experience. Survival with P-AED was compared with outcomes when EMS was the sole responder. Among 420 paired dispatches of P-AED and EMS, the mean±SD P-AED time from 9-1-1 call to arrival at the scene was 6.16±4.27 minutes, compared with 7.56±3.60 minutes for EMS (P<0.001). Police arrived first to 56% of the calls. The time to first responder arrival among P-AED and EMS was 4.88±2.88 minutes (P<0.001), compared with a historical response time of 7.64±3.66 minutes when EMS was the sole responder. A 17.2% survival rate was observed for victims with ventricular fibrillation or pulseless ventricular tachycardia (VT/VF), compared with 9.0% for standard EMS before P-AED implementation (P=0.047). However, VT/VF benefit was diluted by the observation that 61% of the initial rhythms were nonshockable, reducing the absolute survival benefit among the total study population to 1.6% (P-AED, 7.6%; EMS, 6.0%). Conclusions - P-AED establishes a layer of responders that generate improved response times and survival from VT/VF. There was no benefit for victims with nonshockable rhythms.
Original language | English (US) |
---|---|
Pages (from-to) | 1058-1064 |
Number of pages | 7 |
Journal | Circulation |
Volume | 106 |
Issue number | 9 |
DOIs | |
State | Published - Aug 27 2002 |
Externally published | Yes |
Keywords
- Death, sudden
- Defibrillation
- Heart arrest
- Resuscitation
- Tachycardia
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Physiology (medical)