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Automated external defibrillation by first-responders

Prescrire International

|August 27, 2010

Summary

Automated external defibrillators (AEDs) used by trained first-responders improve survival rates for adults experiencing cardiopulmonary arrest. While risks exist, AEDs offer a favorable risk-benefit balance for public cardiac emergencies.

Area of Science:

Emergency Medicine
Cardiology
Public Health

Background:

Cardiopulmonary arrest (CPA) is a critical medical emergency.
Out-of-hospital cardiac arrest survival rates remain low.
Early defibrillation is crucial for improving outcomes.

Purpose of the Study:

To evaluate the impact of automated external defibrillators (AEDs) on survival in adult CPA patients treated by first-responders.
To assess the risks associated with AED use.

Main Methods:

Literature review using the Prescrire methodology.
Analysis of studies on AED use by trained first-responders.
Examination of reported risks and device malfunctions.

Main Results:

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AEDs demonstrate high sensitivity and specificity in detecting ventricular fibrillation.
Trained first-responder use of AEDs is linked to increased survival for out-of-hospital cardiac arrest.
AEDs may treat approximately 20% of cardiac arrest victims, potentially increasing survival from 5% to 6.5%.

Conclusions:

Automated external defibrillators present a favorable risk-benefit profile when used by trained personnel.
Specific training enhances first-responder effectiveness and adherence to the chain of survival.
Potential risks include skin burns, user shock, implantable defibrillator interactions, and device malfunctions.