Out-of-hospital early defibrillation successfully challenges sudden cardiac arrest: the Piacenza Progetto Vita project.
BACKGROUND
Early defibrillation is the most important intervention influencing survival following sudden cardiac arrest (SCA). In order to improve public access to early defibrillation, in North America several experiences of out-of-hospital early defibrillation by non-medical volunteers have been successfully implemented and demonstrated to improve survival.


METHODS
Since 1999, in Piacenza, we have established "Progetto Vita", the first experience of out-of-hospital early defibrillation by non-medical volunteers in a medium-size European city. Thirty-nine semiautomatic external defibrillators were placed in Piacenza, Italy (266,531 inhabitants) and distributed in 12 high-risk locations, 12 lay-staffed ambulances and 15 police-cars. A total of 1285 lay volunteers were trained by the emergency medical system to intervene in all cases of suspected SCA.


RESULTS
During the first 15 months, 203 codes for suspected SCA were dispatched; 197 were confirmed SCA. The overall survival was 5.6% (11/197): survival improved from 2.9% (4/134) with emergency medical system intervention to 11.1% (7/63) when the "Progetto Vita" was activated (p < 0.05). The survival rate on "shockable" rhythm was 43.7% in the group of patients treated by volunteers vs 16.6% in those treated by emergency medical system aid (p = 0.05).


CONCLUSIONS
The widespread use of semiautomatic external defibrillators allows early defibrillation by non-medical volunteers and more than triples the survival rate following out-of-hospital SCA.
Capucci
Alessandro
A
Division of Cardiology, Guglielmo da Saliceto Hospital, Via Taverna, 49 29100 Piacenza. progettovita@hotmail.com
Aschieri
Daniela
D
Piepoli
Massimo F
MF
D004554:Electric Countershock; D004632:Emergency Medical Services; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006801:Humans; D015996:Survival Rate; D014838:Volunteers