Public Access Defibrillation
A Statement for Healthcare Professionals From the American Heart Association Task Force on Automatic External Defibrillation
In October 1993 the American Heart Association appointed the Task Force on Automatic External Defibrillation. The task force was charged with conducting a conference on automatic external defibrillation, evaluating research needed for broader community use of automatic external defibrillators, and overseeing evaluation of the feasibility and desirability of their use by healthcare professionals and the lay public.
In December 1994 a conference on public access defibrillation was held in Washington, DC. More than 300 persons attended, representing science, industry, the healthcare professions, law, and the federal government. During the meeting the participants reached a consensus on the general proposition of greater public access to defibrillation and the need for broad-based clinical research, public and professional education, and legislative reform. Following the conference, members of the task force, with input from others in the field of emergency cardiac care, wrote this statement, which was approved by the AHA Board of Directors in June 1995.
Early bystander cardiopulmonary resuscitation (CPR) and rapid defibrillation are the two major contributors to survival of adult victims of sudden cardiac arrest. The AHA supports efforts to provide prompt defibrillation to victims of cardiac arrest. Automatic external defibrillation is one of the most promising methods for achieving rapid defibrillation. In public access defibrillation, the technology of defibrillation and training in its use are accessible to the community. The AHA believes that this is the next step in strengthening the chain of survival. Public access defibrillation will involve considerable societal change and will succeed only through the strong efforts of the AHA and others with a commitment to improving emergency cardiac care.
Public access defibrillation will include
• Performance of defibrillation by laypersons at home and by firefighters, police, security personnel, and nonphysician care providers in the community
• Exploration of the use of bystander-initiated automatic external defibrillation in rural communities and congested urban areas where resuscitation strategies have had little success
The AHA can also play a major role by
• Increasing public awareness that defibrillation improves the rate of survival from an often fatal condition that each day affects 1000 Americans
• Ensuring that objective, current research data are used to guide implementation of these changes in performance and teaching of CPR
• Working with medical manufacturers, legislators, and governmental agencies to promote safety and efficacy, reduce cost, and update training requirements to facilitate implementation of public access defibrillation. Broader use of automatic external defibrillators should also lead to readiness tests and features that deter both misuse and misapplication.
Meaningful change will occur only with the broad public support that has traditionally characterized the AHA’s efforts in the fight against heart disease and stroke.
The Public Access Defibrillation Conference was made possible by the financial support of the National Heart, Lung, and Blood Institute; the American College of Cardiology; the American Red Cross; the American Medical Association; the AHA Councils on Clinical Cardiology, Cardiovascular Nursing, Cardiopulmonary and Critical Care, and Cardiovascular Disease in the Young; the Citizens CPR Foundation; and the North American Society of Pacing and Electrophysiology.
A related report is printed in this issue of Circulation, beginning on page 2740.
“Public Access Defibrillation” was approved by the American Heart Association Board of Directors in June 1995.
Requests for reprints should be sent to the American Heart Association, Emergency Cardiac Care Department, 7272 Greenville Avenue, Dallas, TX 75231-4596.
- Copyright © 1995 by American Heart Association