title: [Implementation of a national automated external defibrillator program in Portugal].
abstract: OBJECTIVE
  To describe the stages of development and implementation of an automated external defibrillator (AED) program within the Emergency Medical Service System and in public places in Portugal.
  
  
  METHODS
  Description of the implementation process in terms of logistics, training and supervision of activity.
  
  
  RESULTS
  By the end of 2012 there were 442 emergency ambulances equipped with AEDs included in the AED program of the National Institute for Medical Emergencies (INEM). Between 2010 and 2012, 2130 emergency medical technicians were trained and considered qualified to use AEDs. With regard to AED programs in public places, by the end of 2012 there were 207 licensed programs, covering 302 public places, 66 patient transport ambulances, 463 AEDs and 6133 AED operators. Between 2010 and 2012, 19 organizations were licensed to provide training in basic life support and AEDs. In INEM's AED program in 2012, AEDs were used 3250 times, with shockable rhythms in 12.5% of cases (407). Of these, a pulse was restored in 38.6% (157) after a shock, with recovery of spontaneous circulation in 45.9% of these (72). Survival to hospital discharge was 26% (19 cases).
  
  
  CONCLUSIONS
  Implementation of the program followed recommended scientific criteria, and the results obtained, following significant growth in early access to AEDs, are satisfactory and in line with those in other countries. Strengthening the chain of survival requires the involvement of the community in general and in particular the widespread learning of basic life support measures, which must be the next step for all partners in the Emergency Medical Service System.
authors.affiliation: Instituto Nacional de Emergência Médica (INEM), Conselho Directivo e Escola Superior de Enfermagem de Lisboa, Lisboa, Portugal. Electronic address: miguel.soares.oliveira@gmail.com.
authors.forename: Miguel
authors.initials: M
authors.lastname: Soares-Oliveira
authors.affiliation: Instituto Nacional de Emergência Médica (INEM), Delegação Regional Sul, Lisboa, Portugal.
authors.forename: Raquel
authors.initials: R
authors.lastname: Ramos
mesh_terms: D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D047548:Defibrillators; D004632:Emergency Medical Services / Q000458:organization & administration*; D006801:Humans; D011174:Portugal; D016730:Program Development; D012189:Retrospective Studies
keywords: Cadeia de sobrevivência; Chain of survival; Defibrillation; Desfibrilhação; Morte súbita cardíaca; Sudden cardiac death