Public can help increase cardiac arrest survival

AORN Journal, Feb, 2004

Twenty percent to 25% of out-of-hospital, sudden cardiac deaths occur in public places where bystanders may be able to help until emergency medical services (EMS) arrive, according to Nov 11, 2003, news releases from the American Heart Association and the National Heart, Lung, and Blood Institute. The majority of sudden cardiac deaths result from ventricular fibrillation. The most important factor in surviving ventricular fibrillation is how quickly a defibrillator can be used to shock the heart back to its normal rhythm.

A randomized, controlled trial of public access defibrillation was conducted at 933 sites in the United States and Canada. Sites were chosen on the basis that they did not have immediate access to EMS but had an EMS response time of less than 15 minutes and by a projected 50% probability that at least one cardiac arrest would occur there during the study period. Sites included apartment complexes, shopping centers, senior centers, office buildings, and sports venues.

Volunteers at one-half of the sites were trained to use cardiopulmonary resuscitation (CPR) in addition to calling 911. Volunteers at the other one-half of the sites were trained to use CPR and automated external defibrillators (AEDs) in addition to calling 911. The AEDs used were lightweight and portable so that they could be transported within three minutes to a person needing resuscitation. More than 20,000 volunteers were trained, and more than 1,600 AEDs were put in place.

During an average of 21.5 months, 29 people who suffered cardiac arrest survived to hospital discharge after being treated with CPR and an AED compared to 15 people who received CPR only. Results of this study apply only to sites in which ENS services can respond within 15 minutes and are not applicable to more isolated settings, such as ferry boats or rural areas. The results also are not applicable to home settings where the majority of cardiac arrests occur.

Study Shows Increased Survival for CPR Emergency Response Plans that Include AEDs (news release, Orlando, Fla: American Heart Association, Nov 11, 2003) http://www.americanheart.org/presenter.jhtml?identifier=3016931 (accessed 2 Jan 2004); Public Access Defibrillation by Trained Community Volunteers Increases Survival for Victims of Cardiac Arrest (news release, Orlando, Fla: National Heart, Lung, and Blood Institute, Nov 11, 2003) http://www.nhlbi.nih.gov/new/press/03-11-11.htm (accessed 5 Jan 2004).