title: Public access defibrillation.
abstract: Very early defibrillation, within the first few minutes of VF cardiac arrest, results in significantly improved survival rates [1,10-12,34]. Most EMS systems cannot consistently provide defibrillation within the first few minutes following cardiac arrest. Defibrillation within the first few minutes following collapse is potentially achievable through the use of AEDs and PAD [9-14,62]. The delivery of defibrillation with AEDs has been made more efficient through the use of impedance-compensated defibrillation, larger pad sizes, and biphasic waveforms [34]. The technology is simple and easy to use. Preliminary cost-effectiveness analysis indicates that PAD and first-responder defibrillation are economically as attractive as other interventions in cardiac arrest [44]. Effective PAD requires significant investment in time, energy, informed planning, and rigorous quality improvement; however, the benefits are enormous. Reported VF survival rates can approach 50% or higher [11,12,62]. PAD provides the potential opportunity to transform cardiac arrest into a survivable event for most victims by making the community the ultimate coronary care unit.
authors.affiliation: Department of Emergency Medicine, Medical College of Wisconsin, Froedtert Hospital East, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA.
authors.forename: Alexander L
authors.initials: AL
authors.lastname: Sommers
authors.forename: John R
authors.initials: JR
authors.lastname: Slaby
authors.forename: Tom P
authors.initials: TP
authors.lastname: Aufderheide
mesh_terms: D001331:Automation; D004554:Electric Countershock / Q000295:instrumentation / Q000379:methods*; D004632:Emergency Medical Services / Q000379:methods*; D004867:Equipment Design; D005392:First Aid / Q000295:instrumentation / Q000379:methods*; D006297:Health Services Accessibility; D006801:Humans; D017063:Outcome Assessment, Health Care