This Article Full Text Full Text (PDF) All Versions of this Article: 109/15/1859    most recent 01.CIR.0000124721.83385.B2v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Culley, L. L. Articles by Copass, M. K. Search for Related Content PubMed PubMed Citation Articles by Culley, L. L. Articles by Copass, M. K. Related Collections CPR and emergency cardiac care

(Circulation. 2004;109:1859-1863.)
© 2004 American Heart Association, Inc.

Clinical Investigation and Reports

Public Access Defibrillation in Out-of-Hospital Cardiac Arrest

A Community-Based Study

Linda L. Culley, BA; Thomas D. Rea, MD, MPH; John A. Murray, MD; Barbara Welles, RN; Carol E. Fahrenbruch, BS, MSPH; Michele Olsufka, RN; Mickey S. Eisenberg, MD, PhD; Michael K. Copass, MD

From Public Health–Seattle and King County, Emergency Medical Services Division (L.L.C., T.D.R., B.W., J.A.M., M.S.E.); Seattle Medic One (C.E.F., M.O., M.K.C.); and the Department of Medicine, University of Washington (T.D.R., J.A.M., M.S.E., C.E.F., M.O., M.K.C.), Seattle, Wash.

Correspondence to Linda Culley, Public Health Seattle and King County, Emergency Medical Services Division, 999 Third Ave, Suite 700, Seattle, WA 98104-4039. E-mail Linda.Culley{at}metrokc.gov

Received September 3, 2003; de novo received November 18, 2003; accepted January 27, 2004.

Background— The dissemination and use of automated external defibrillators (AEDs) beyond traditional emergency medical services (EMS) into the community has not been fully evaluated. We evaluated the frequency and outcome of non-EMS AED use in a community experience.

Methods and Results— The investigation was a cohort study of out-of-hospital cardiac arrest cases due to underlying heart disease treated by public access defibrillation (PAD) between January 1, 1999, and December 31, 2002, in Seattle and surrounding King County, Washington. Public access defibrillation was defined as out-of-hospital cardiac arrest treated with AED application by persons outside traditional emergency medical services. The EMS of Seattle and King County developed a voluntary Community Responder AED Program and registry of PAD AEDs. During the 4 years, 475 AEDs were placed in a variety of settings, and more than 4000 persons were trained in cardiopulmonary resuscitation and AED operation. A total of 50 cases of out-of-hospital cardiac arrest were treated by PAD before EMS arrival, which represented 1.33% (50/3754) of all EMS-treated cardiac arrests. The proportion treated by PAD AED increased each year, from 0.82% in 1999 to 1.12% in 2000, 1.41% in 2001, and 2.05% in 2002 (P=0.019, test for trend). Half of the 50 persons treated with PAD survived to hospital discharge, with similar survival for nonmedical settings (45% [14/31]) and out-of-hospital medical settings (58% [11/19]).

Conclusions— PAD was involved in only a small but increasing proportion of out-of-hospital cardiac arrests.

Key Words: heart arrest • defibrillation • automated external defibrillator • cardiopulmonary resuscitation

This article has been cited by other articles:

				W. Rosamond, K. Flegal, K. Furie, A. Go, K. Greenlund, N. Haase, S. M. Hailpern, M. Ho, V. Howard, B. Kissela, et al. Heart Disease and Stroke Statistics--2008 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee Circulation, January 29, 2008; 117(4): e25 - e146. [Full Text] [PDF]

				K. Lotfi, L. White, T. Rea, L. Cobb, M. Copass, L. Yin, L. Becker, and M. Eisenberg Cardiac Arrest in Schools Circulation, September 18, 2007; 116(12): 1374 - 1379. [Abstract] [Full Text] [PDF]

				W. Rosamond, K. Flegal, G. Friday, K. Furie, A. Go, K. Greenlund, N. Haase, M. Ho, V. Howard, B. Kissela, et al. Heart Disease and Stroke Statistics--2007 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee Circulation, February 6, 2007; 115(5): e69 - e171. [Full Text] [PDF]

				T. Thom, N. Haase, W. Rosamond, V. J. Howard, J. Rumsfeld, T. Manolio, Z.-J. Zheng, K. Flegal, C. O'Donnell, S. Kittner, et al. Heart Disease and Stroke Statistics--2006 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee Circulation, February 14, 2006; 113(6): e85 - e151. [Full Text] [PDF]

				Part 1: Introduction Circulation, November 29, 2005; 112(22_suppl): III-1 - III-4. [Full Text] [PDF]

				Public Access Defibrillation Is Increasing and Looking Good Journal Watch Emergency Medicine, June 16, 2004; 2004(616): 7 - 7. [Full Text]