Early Defibrillation Boosts Survival in Cardiac Arrest

Defibrillation prior to arrival of emergency personnel nearly doubles survival rate

WEDNESDAY, April 14 (HealthDay News) -- People who have out-of-hospital cardiac arrest (OHCA) and are resuscitated with an automatic external defibrillator (AED) prior to the arrival of emergency medical services (EMS) personnel have nearly twice the survival rate of those who don't get AED resuscitation, according to a study in the April 20 issue of the Journal of the American College of Cardiology.

Myron L. Weisfeldt, M.D., of Johns Hopkins University in Baltimore, and colleagues studied 13,769 OHCAs not caused by trauma, and the resuscitation efforts prior to EMS arrival at Resuscitation Outcomes Consortium (ROC) sites. The researchers compared outcomes for those who received bystander cardiopulmonary resuscitation (CPR) and AED application and assessed the association between early AED use and survival to hospital discharge.

The researchers found that 32 percent received CPR before EMS arrival but no AED application, and 2.1 percent received AED application before EMS arrival. The AED was applied by: health care workers (32 percent), lay volunteers (35 percent), police (26 percent), or unknown (7 percent). Survival to hospital discharge was 7 percent overall but was improved with early resuscitation: 9 percent for those who received CPR but no AED, 24 percent with AED application (with or without shock), and 38 percent with AED shock delivery. After adjusting for CPR, time to EMS arrival, age and sex, and other variables, AED application was associated with a greater likelihood of survival (odds ratio, 1.75) compared to no AED.

"Application of an AED in communities is associated with nearly a doubling of survival after out-of-hospital cardiac arrest. These results reinforce the importance of strategically expanding community-based AED programs," the authors write.

Several study authors reported financial ties to medical device companies, and some ROC site EMS have received equipment or concessions from AED manufacturers.

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