Document Type
Journal Article
Date of this Version
8-12-2004
Publication Source
The New England Journal of Medicine
Volume
351
Issue
7
Start Page
637
Last Page
646
DOI
10.1056/NEJMoa040566
Abstract
Background
The rate of survival after out-of-hospital cardiac arrest is low. It is not known whether this rate will increase if laypersons are trained to attempt defibrillation with the use of automated external defibrillators (AEDs).
Methods
We conducted a prospective, community-based, multicenter clinical trial in which we randomly assigned community units (e.g., shopping malls and apartment complexes) to a structured and monitored emergency-response system involving lay volunteers trained in cardiopulmonary resuscitation (CPR) alone or in CPR and the use of AEDs. The primary outcome was survival to hospital discharge.
Results
More than 19,000 volunteer responders from 993 community units in 24 North American regions participated. The two study groups had similar unit and volunteer characteristics. Patients with treated out-of-hospital cardiac arrest in the two groups were similar in age (mean, 69.8 years), proportion of men (67 percent), rate of cardiac arrest in a public location (70 percent), and rate of witnessed cardiac arrest (72 percent). No inappropriate shocks were delivered. There were more survivors to hospital discharge in the units assigned to have volunteers trained in CPR plus the use of AEDs (30 survivors among 128 arrests) than there were in the units assigned to have volunteers trained only in CPR (15 among 107; P=0.03; relative risk, 2.0; 95 percent confidence interval, 1.07 to 3.77); there were only 2 survivors in residential complexes. Functional status at hospital discharge did not differ between the two groups.
Conclusions
Training and equipping volunteers to attempt early defibrillation within a structured response system can increase the number of survivors to hospital discharge after out-of-hospital cardiac arrest in public locations. Trained laypersons can use AEDs safely and effectively.
Copyright/Permission Statement
From The New England Journal of Medicine, The Public Access Defibrillation Trial Investigators, Public-Access Defibrillation and Survival After Out-of-Hospital Cardiac Arrest, 351, 637-646. Copyright © 2004 Massachusetts Medical Society. Reprinted with permission.
Recommended Citation
Hallstrom, A. P., Ornato, J. P., Weisfeldt, M. L., Travers, A. H., Christenson, J., McBurnie, M., Zalenski, R. J., Becker, L. B., Schron, E. B., Proschan, M. A., The Public Access Defibrillation Trial Investigators, & Riegel, B. (2004). Public-Access Defibrillation and Survival After Out-of-Hospital Cardiac Arrest. The New England Journal of Medicine, 351 (7), 637-646. http://dx.doi.org/10.1056/NEJMoa040566
Date Posted: 01 June 2016
This document has been peer reviewed.
Comments
Barbara Riegel is not listed as an individual author on this paper but is part of the Public Access Defibrillation Trial Investigators. A full list of Public Access Defibrillation Trial Investigators members for this paper can be found in the Appendix.