title: Public access defibrillation: improving accessibility and outcomes.
abstract: Worldwide, out-of-hospital cardiac arrest (OHCA) remains a serious problem. Public access defibrillation (PAD) has been shown to be effective in improving survival in OHCA with good neurological outcome.
  
  
  
  Original articles, reviews and national/international guidelines.
  
  
  
  Limitations to how much we can improve ambulance response times mean that the public have an essential role to play in OHCA survival. Training of laypersons in the use of automated external defibrillators (AEDs) has been shown to improve outcomes. Placement of AEDs should be related to underlying population demographics.
  
  
  
  Placements of AEDs face cost constraints. PAD programs also face challenges in the upkeep of AEDs. Concerns about legal liability for lay rescuers to act remain.
  
  
  
  Systematic programs should be in place to train the public in PAD. All AEDs should be listed in national registries and available for usage in an emergency.
  
  
  
  'Smart' technology is being developed to improve accessibility of AEDs.
authors.affiliation: Department of Acute and Emergency Care, Khoo Teck Puat Hospital, Singapore.
authors.forename: Renhao Desmond
authors.initials: RD
authors.lastname: Mao
authors.affiliation: Department of Emergency Medicine, Singapore General Hospital, Singapore marcus.ong.e.h@sgh.com.sg.
authors.forename: Marcus Eng Hock
authors.initials: ME
authors.lastname: Ong
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation* / Q000379:methods / Q000401:mortality; D003256:Community Participation / Q000706:statistics & numerical data; D047548:Defibrillators / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000458:organization & administration* / Q000592:standards*; D006801:Humans; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000628:therapy*; D058996:Quality Improvement; D015996:Survival Rate; D061665:Time-to-Treatment / Q000458:organization & administration / Q000706:statistics & numerical data; D016896:Treatment Outcome
keywords: automated external defibrillator; out-of-hospital cardiac arrest; placement; public access defibrillation