title: Should we use automated external defibrillators in hospital wards?
abstract: Automated external defibrillators (AEDs) have shown to improve survival after cardiopulmonary arrest (CPA) in many, but not all clinical settings. A recent study reported that the use of AEDs in-hospital did not improve survival. The current retrospective study reports the results of an in-hospital AED programme in a university hospital, and focuses on the quality of AED use. At Ghent University Hospital 30 AEDs were placed in non-monitored hospital wards and outpatient clinics treating patients with non-cardiac problems. Nurses were trained to use these devices. From November 2006 until March 2011, the AEDs were used in 23 of 39 CPA cases, in only one patient the presenting heart rhythm was ventricular fibrillation and this patient survived. Pulseless electrical activity was present in 14 patients (four survived) and asystole in eight patients (one survived). AEDs were attached to eight patients without CPA, and in 16 patients with CPA AED was not used. The quality of AED use was often suboptimal as illustrated by external artifacts during the first rhythm analysis by the AED in 30% (7/23) and more than 20 seconds delay before restart of chest compressions after the AED rhythm analysis in 50% (9/18). The literature data, supported by our results, indicate that in-hospital AED programmes are unlikely to improve survival after CPA. Moreover, their use is often suboptimal. Therefore, if AEDs are introduced in a hospital, initial training, frequent retraining and close follow-up are essential.
authors.affiliation: Department of Management, Innovation and Entrepreneurship, Ghent University, Tweekerkenstraat 2, Ghent, Belgium melissa.deregge@ugent.be
authors.forename: M
authors.initials: M
authors.lastname: De Regge
authors.forename: K G
authors.initials: KG
authors.lastname: Monsieurs
authors.forename: K
authors.initials: K
authors.lastname: Vandewoude
authors.forename: P A
authors.initials: PA
authors.lastname: Calle
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D047548:Defibrillators; D005260:Female; D006323:Heart Arrest / Q000401:mortality* / Q000628:therapy; D006757:Hospital Units; D006801:Humans; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D055815:Young Adult