title: Public access defibrillation in out-of-hospital cardiac arrest: a community-based study.
abstract: 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.
  
  
  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.
authors.affiliation: Public Health Seattle and King County, Emergency Medical Services Division, 999 Third Ave, Suite 700, Seattle, WA 98104-4039, USA. Linda.Culley@metrokc.gov
authors.forename: Linda L
authors.initials: LL
authors.lastname: Culley
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Rea
authors.forename: John A
authors.initials: JA
authors.lastname: Murray
authors.forename: Barbara
authors.initials: B
authors.lastname: Welles
authors.forename: Carol E
authors.initials: CE
authors.lastname: Fahrenbruch
authors.forename: Michele
authors.initials: M
authors.lastname: Olsufka
authors.forename: Mickey S
authors.initials: MS
authors.lastname: Eisenberg
authors.forename: Michael K
authors.initials: MK
authors.lastname: Copass
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003153:Community Health Services / Q000706:statistics & numerical data*; D004554:Electric Countershock / Q000706:statistics & numerical data*; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014861:Washington