Document Type

Article

Original Publication Date

2004

Journal/Book/Conference Title

The New England Journal of Medicine

Volume

351

Issue

7

First Page

637

Last Page

646

DOI of Original Publication

10.1056/NEJMoa040566

Comments

Originally published at http://dx.doi.org/10.1056/NEJMoa040566

Date of Submission

January 2015

Abstract

BACKGROUND

The rate of survival after out-of-hospital cardiac arrest is low. It is not known whether this rate will increase if laypersons are trained to attempt defibrillation with the use of automated external defibrillators (AEDs).

Full Text of Background...

METHODS

We conducted a prospective, community-based, multicenter clinical trial in which we randomly assigned community units (e.g., shopping malls and apartment complexes) to a structured and monitored emergency-response system involving lay volunteers trained in cardiopulmonary resuscitation (CPR) alone or in CPR and the use of AEDs. The primary outcome was survival to hospital discharge.

Full Text of Methods...

RESULTS

More than 19,000 volunteer responders from 993 community units in 24 North American regions participated. The two study groups had similar unit and volunteer characteristics. Patients with treated out-of-hospital cardiac arrest in the two groups were similar in age (mean, 69.8 years), proportion of men (67 percent), rate of cardiac arrest in a public location (70 percent), and rate of witnessed cardiac arrest (72 percent). No inappropriate shocks were delivered. There were more survivors to hospital discharge in the units assigned to have volunteers trained in CPR plus the use of AEDs (30 survivors among 128 arrests) than there were in the units assigned to have volunteers trained only in CPR (15 among 107; P=0.03; relative risk, 2.0; 95 percent confidence interval, 1.07 to 3.77); there were only 2 survivors in residential complexes. Functional status at hospital discharge did not differ between the two groups.

Full Text of Results...

CONCLUSIONS

Training and equipping volunteers to attempt early defibrillation within a structured response system can increase the number of survivors to hospital discharge after out-of-hospital cardiac arrest in public locations. Trained laypersons can use AEDs safely and effectively.

Full Text of Discussion...

Read the Full Article...

Rights

From The New England Journal of Medicine, Hallstrom, A., Ornato, J.P., Public-access defibrillation and survival after out-of-hospital cardiac arrest, Vol. 351, Page 637, Copyright © 2015 Massachusetts Medical Society. Reprinted with permission.

Is Part Of

VCU Medical Center Publications

Share

COinS