Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-10-31T21:53:23.918Z Has data issue: false hasContentIssue false

27 - Public access defibrillation

from Part IV - Therapy of sudden death

Published online by Cambridge University Press:  06 January 2010

Roger D. White
Affiliation:
College of Medicine, Mayo Clinic, Rochester, Minnesota, MN, USA
Mick Colquhoun
Affiliation:
Resuscitation Council, Tavistock Sq., London, UK
Sian Davies
Affiliation:
Department of Health, London, UK
Mary Ann Peberdy
Affiliation:
Department of Medicine and Emergency Medicine, Virginia Commonwealth University, Richmond, VA, USA
Sergio Timerman
Affiliation:
Resuscitation Department, Heart Institute of Sao Paolo, Brazil
Norman A. Paradis
Affiliation:
University of Colorado, Denver
Henry R. Halperin
Affiliation:
The Johns Hopkins University School of Medicine
Karl B. Kern
Affiliation:
University of Arizona
Volker Wenzel
Affiliation:
Medizinische Universität Innsbruck, Austria
Douglas A. Chamberlain
Affiliation:
Cardiff University
Get access

Summary

Introduction

The development of automated external defibrillators (AEDs) enabled the potential life-saving benefit of rapid defibrillation to be extended into locations outside traditional boundaries. Defibrillation with these devices could now be provided by minimally medically trained persons such as firefighters and police officers. The survival benefit from AED deployment by such users led to the presumption that even more rapid defibrillation might be provided by placement of AEDs in public settings where large numbers of persons are present, and where defibrillation might be accomplished by even less-trained persons, and possibly even by persons not trained at all in AED use. And thus emerged the initiative known as public access defibrillation, or PAD. In this chapter, experience with PAD is described in several different settings, fortunately with acquisition and reporting of data to permit analysis of outcomes. Experience to date is surely encouraging, yet questions remain. Pell and colleagues have raised such questions pertaining to cost-effectiveness and have recommended expansion of first-responder defibrillation such as by police or firefighters and bystander cardiopulmonary resuscitation as more defensible options to PAD.

In the PAD Trial reported by Peberdy in this chapter the low number of events is disheartening in light of the magnitude of the commitment in terms of numbers of persons trained and devices deployed, and the multiple locations in which AEDs were deployed. This observation may reflect yet another reality: the incidence of ventricular fibrillation (VF) as the presenting rhythm in out-of-hospital arrest settings is declining at an impressive rate, as reported now by several cardiac arrest investigators.

Type
Chapter
Information
Cardiac Arrest
The Science and Practice of Resuscitation Medicine
, pp. 496 - 505
Publisher: Cambridge University Press
Print publication year: 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×