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The Effect of the AED and AED Programs on Survival of Individuals, Groups and Populations

  • Nathan Allen Stokes (a1), Andrea Scapigliati (a2), Antoine R. Trammell (a3) and David C. Parish (a4)
  • DOI:
  • Published online: 21 August 2012

The automated external defibrillator (AED) is a tool that contributes to survival with mixed outcomes. This review assesses the effectiveness of the AED, consistencies and variations among studies, and how varying outcomes can be resolved.


A worksheet for the International Liaison Committee on Resuscitation (ILCOR) 2010 science review focused on hospital survival in AED programs was the foundation of the articles reviewed. Articles identified in the search covering a broader range of topics were added. All articles were read by at least two authors; consensus discussions resolved differences.


AED use developed sequentially. Use of AEDs by emergency medical technicians (EMTs) compared to manual defibrillators showed equal or superior survival. AED use was extended to trained responders likely to be near victims, such as fire/rescue, police, airline attendants, and casino security guards, with improvement in all venues but not all programs. Broad public access initiatives demonstrated increased survival despite low rates of AED use. Home AED programs have not improved survival; in-hospital trials have had mixed results. Successful programs have placed devices in high-risk sites, maintained the AEDs, recruited a team with a duty to respond, and conducted ongoing assessment of the program.


The AED can affect survival among patients with sudden ventricular fibrillation (VF). Components of AED programs that affect outcome include the operator, location, the emergency response system, ongoing maintenance and evaluation. Comparing outcomes is complicated by variations in definitions of populations and variables. The effect of AEDs on individuals can be dramatic, but the effect on populations is limited.

StokesNA, ScapigliatiA, TrammellAR, ParishDC. The Effect of the AED and AED Programs on Survival of Individuals, Groups and Populations. Prehosp Disaster Med.2012;27(5):16.

Corresponding author
Correspondence: Nathan Allen Stokes, MD, NREMT-P Department of Emergency Medicine Emory University School of Medicine 49 Jesse Hill Jr Dr SE Atlanta, GA 30303 USA E-mail
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2.CS Beck , WH Pritchard , HS Feil . Ventricular fibrillation of long duration abolished by electric shock. JAMA. 1947;135(15):985.

3.PM Zoll , AJ Linenthal , W Gibson , MH Paul , LR Norman . Termination of ventricular fibrillation in man by externally applied electric countershock. N Engl J Med. 1956;254(16):727-732.

6.LB Rose , E Press . Cardiac defibrillation by ambulance attendants. JAMA. 1972;219(1):63-68.

7.I Kassanoff , W Whaley , WH Walter 3rd, et al. Stadium coronary care. A concept in emergency health care delivery. JAMA. 1972;221(4):397-399.

9.M Heber . Out-of-hospital resuscitation using the “heart-aid”, an automated external defibrillator-pacemaker. Int J Cardiol. 1983;3(4):456-458.

10.National Academy of Sciences - National Research Council: Standards guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiac care (ECC). JAMA. 1986;255(21):2905-2989.

12.ME Mancini , J Soar , F Bhanji , et al. Part 12: Education, implementation, and teams: 2010 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Circulation. 2010;122(16 Suppl 2):S539-S581. Accessed November 30, 2010.

13.KR Stults , DD Brown , RE Kerber . Efficacy of an automated external defibrillator in the management of out-of-hospital cardiac arrest: validation of the diagnostic algorithm and initial clinical experience in a rural environment. Circulation. 1986;73(4):701-709.

14.J Jakobsson , N Rehnqvist , O Nyqvist . Clinical experience with three different defibrillators for resuscitation of out of hospital cardiac arrest. Resuscitation. 1990;19(2):167-173.

16.T Schneider , PR Martens , H Paschen , et al. Multicenter, randomized, controlled trial of 150-J biphasic shocks compared with 200- to 360-J monophasic shocks in the resuscitation of out-of-hospital cardiac arrest victims. Optimized Response to Cardiac Arrest (ORCA) Investigators. Circulation. 2000;102(15):1780-1787.

18.D Jost , H Degrange , C Verret , et al. DEFI 2005: a randomized controlled trial of the effect of automated external defibrillator cardiopulmonary resuscitation protocol on outcome from out-of-hospital cardiac arrest. Circulation. 2010;121(14):1614-1622.

19.ML Weisfeldt , CM Sitlani , JP Ornato , et al. Survival after application of automatic external defibrillators before arrival of the emergency medical system: evaluation in the resuscitation outcomes consortium population of 21 million. J Am Coll Cardiol. 2010;55(16):1713-1720.

21.MA Peberdy , LV Ottingham , WJ Groh , et al. Adverse events associated with lay emergency response programs: the public access defibrillation trial experience. Resuscitation. 2006;70(1):59-65.

22.AM Zafari , SK Zarter , V Heggen , et al. A program encouraging early defibrillation results in improved in-hospital resuscitation efficacy. J Am Coll Cardiol. 2004;44(4):846-852.

23.C Hanefeld , C Lichte , I Mentges-Schroter , C Sirtl , A Mugge . Hospital-wide first-responder automated external defibrillator programme: 1 year experience. Resuscitation. 2005;66(2):167-170.

24.MS Forcina , AY Farhat , WW O'Neil , DE Haines . Cardiac arrest survival after implementation of automated external defibrillator technology in the in-hospital setting. Crit Care Med. 2009;37(4):1229-1236.

26.PS Chan , HM Krumholz , JA Spertus , et al. Automated external defibrillators and survival after in-hospital cardiac arrest. JAMA. 2010;304(1):2129-2136.

27.PS Chan , R Jain , BK Nallmothu , RA Berg , C Sasson . Rapid response teams: a systematic review and meta-analysis. Arch Intern Med. 2010;170(1):18-26.

29.MS Eisenberg , MK Copass , AP Hallstrom , et al. Treatment of out-of-hospital cardiac arrests with rapid defibrillation by emergency medical technicians. N Engl J Med. 1980;302(25):1379-1383.

30.LF Vukov , RD White , JW Bachman , PC O'Brien . New perspectives on rural EMT defibrillation. Ann Emerg Med. 1988;17(4):318-321.

31.BE Haynes , A Mendoza , M McNeil , J Schroeder , DR Smiley . A statewide early defibrillation initiative including laypersons and outcome reporting. JAMA. 1991;266(4):545-547.

32.RD White , BR Asplin , TF Bugliosi , DG Hankins . High discharge survival rate after out-of-hospital ventricular fibrillation with rapid defibrillation by police and paramedics. Ann Emerg Med. 1996;28(5):480-485.

33.IG Stiell , GA Wells , BJ Field , et al. Improved out-of-hospital cardiac arrest survival through the inexpensive optimization of an existing defibrillation program: OPALS study phase II. Ontario Prehospital Advanced Life Support. JAMA.. 1999;281(13):1175-1181.

34.A Capucci , D Aschieri , MF Piepoli , GH Bardy , E Iconomu , M Arvedi . Tripling survival from sudden cardiac arrest via early defibrillation without traditional education in cardiopulmonary resuscitation. Circulation. 2002;106(9):1065-1070.

35.R Cappato , A Curnis , P Marzollo , et al. Prospective assessment of integrating the existing emergency medical system with automated external defibrillators fully operated by volunteers and laypersons for out-of-hospital cardiac arrest: the Brescia Early Defibrillation Study (BEDS). Eur Heart J. 2006;27(5):553-561.

36.K Kajino , T Iwami , RA Berg , et al. Comparison of neurological outcomes following witnessed out-of-hospital ventricular fibrillation defibrillated with either biphasic or monophasic automated external defibrillators. Emerg Med J. 2009;26(7):492-496.

37.MS Eisenberg , J Moore , RO Cummins , et al. Use of the automatic external defibrillator in homes of survivors of out-of-hospital ventricular fibrillation. Am J Cardiol. 1989;63(7):443-446.

38.GH Bardy , KL Lee , DB Mark , et al. Home use of automated external defibrillators for sudden cardiac arrest. N Engl J Med. 2008;358(17):1793-1804.

39.MF O'Rourke , E Donaldson , JS Geddes . An airline cardiac arrest program. Circulation. 1997;96(9):2849-2853.

40.RL Page , JA Joglar , RC Kowal , et al. Use of automated external defibrillators by a U.S. airline. N Engl J Med. 2000;343(17):1210-1216.

41.SL Caffrey , PJ Willoughby , PE Pepe , LB Becker . Public use of automated external defibrillators. N Engl J Med. 2002;347(16):1242-1247.

42.TD Valenzuela , DJ Roe , G Nichol , LL Clark , DW Spaite , RG Hardman . Outcomes of rapid defibrillation by security officers after cardiac arrest in casinos. NEngl J Med. 2000;343(17):1206-1209.

43.JA Drezner , AL Rao , J Heistand , MK Bloomingdale , KG Harmon . Effectiveness of emergency response planning for sudden cardiac arrest in United States high schools with automated external defibrillators. Circulation. 2009;120(6):518-525.

44.MC Colquhoun , DA Chamberlain , RG Newcombe , et al. A national scheme for public access defibrillation in England and Wales: early results. Resuscitation. 2008;78(3):275-280.

45.LL Culley , TD Rea , JA Murray , et al. Public access defibrillation in out-of-hospital cardiac arrest: a community-based study. Circulation. 2004;109(15):1859-1863.

46.R Fleischhackl , B Roessler , H Domanovits , et al. Results from Austria's nationwide public access defibrillation (ANPAD) programme collected over 2 years. Resuscitation. 2008;77(2):195-200.

47.CS Davies , M Colquhoun , S Graham , T Evans , D Chamberlain . Defibrillator Advisory Committee. Defibrillators in public places: the introduction of a national scheme for public access defibrillation in England. Resuscitation. 2002;52(1):13-21.

48.R Whitfield , M Colquhoun , D Chamberlain , R Newcombe , CS Davies , R Boyle . The Department of Health national defibrillator programme: analysis of downloads from 250 deployments of public access defibrillators. Resuscitation. 2005;64:269-277.

49.M Kuisma , M Castren , K Nurminen . Public access defibrillation in Helsinki--costs and potential benefits from a community-based pilot study. Resuscitation. 2003;56(2):149-152.

50.T Sakai , T Iwami , T Kitamura , et al. Effectiveness of the new ‘mobile AED map’ to find and retrieve an AED: a randomised controlled trial. Resuscitation. 2011;82(1):69-73.

51.AC Scholten , JG van Manen , WE van der Worp , MJ Ijzerman , CJ Doggen . Early cardiopulmonary resuscitation and use of automated external defibrillators by laypersons in out-of-hospital cardiac arrest using an SMS alert service. Resuscitation. 2011;82:1273-1278.

53.B McNally , A Stokes , A Crouch , AL Kellermann , CARES Surveillance Group. CARES: Cardiac Arrest Registry to Enhance Survival. Ann Emerg Med. 2009;54(5):674-683. e2.

54.W Dickey , AA Adgey . Mortality within hospital after resuscitation from ventricular fibrillation outside hospital. Br Heart J. 1992;67(4):334-338.

55.JL Jacoby , M Cesta , MB Heller , P Salen , J Reed . Synchronized emergency department cardioversion of atrial dysrhythmias saves time, money and resources. J Emerg Med. 2005;28(1):27-30.

56.T Kitamura , T Iwami , T Kawamura , et al. Nationwide public-access defibrillation in Japan. N Engl J Med. 2010;362(11):994-1004.

57.JP Pell , A Walker , SM Cobbe . Cost-effectiveness of automated external defibrillators in public places: Con. Curr Opin Cardiol. 2007;22(1):5-10.

58.F Folke , FK Lippert , SL Nielsen , et al. Location of cardiac arrest in a city center: strategic placement of automated external defibrillators in public locations. Circulation. 2009;120(6):510-517.

59.DL Atkins . Realistic expectations for public access defibrillation programs. Curr Opin Crit Care. 2010;16(3):191-195.

60.LS Gold , M Eisenberg . Cost-effectiveness of automated external defibrillators in public places: Pro. Curr Opin Cardiol. 2007;22(1):1-4.

61.WJ Groh , A Birnbaum , A Barry , et al. Characteristics of volunteers responding to emergencies in the public access defibrillation trial. Resuscitation. 2007;72(2):193-199.

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