title: Can lay responder defibrillation programmes improve survival to hospital discharge following an out-of-hospital cardiac arrest?
abstract: BACKGROUND
  The importance of early defibrillation in improving outcomes and reducing morbidity following out-of-hospital cardiac arrest underscores the importance of examining novel approaches to treatment access. The increasing evidence to support the importance of early defibrillation has increased attention on the potential for lay responders to deliver this therapy.
  
  
  OBJECTIVE
  This paper seeks to critically review the literature that evaluates the impact of lay responder defibrillator programs on survival to hospital discharge following an out-of-hospital cardiac arrest in the adult population.
  
  
  METHODS
  The electronic databases, Medline and CINAHL, were searched using keywords including; "first responder", "lay responder", "defibrillation" and "cardiac arrest". The reference lists of retrieved articles and the Internet were also searched. Articles were included in the review if they reported primary data, in the English language, which described the effect of a lay responder defibrillation program on survival to hospital discharge from out-of-hospital cardiac arrest in adults.
  
  
  RESULTS
  Eleven studies met the inclusion criteria. The small number of published studies, heterogeneity of study populations and study outcome methods prohibited formal meta-analysis. Therefore, narrative analysis was undertaken. Studies included in this report provided inconsistent findings in relation to survival to hospital discharge following out-of-hospital cardiac arrest.
  
  
  CONCLUSIONS
  Although there are limited data, the role of the lay responder appears promising in improving the outcome from out-of-hospital cardiac arrest following early defibrillation. Despite the inherent methodological difficulties in studying this population, future research should address outcomes related to morbidity, mortality and cost-effectiveness.
authors.affiliation: School of Nursing (SON), College of Health and Science (CHS), University of Western Sydney (UWS), Baulkham Hills, NSW 2153, Australia. l.m.smith@uws.edu.au
authors.forename: Leigh M
authors.initials: LM
authors.lastname: Smith
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Davidson
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Halcomb
authors.forename: Sharon
authors.initials: S
authors.lastname: Andrew
mesh_terms: D047548:Defibrillators; D004554:Electric Countershock / Q000379:methods; D004638:Emergency Treatment; D006297:Health Services Accessibility; D006323:Heart Arrest / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D010351:Patient Discharge; D014838:Volunteers