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Public access defibrillation (PAD) by bystanders using automated external defibrillators (AEDs) before emergency medical services (EMS) arrive significantly improves survival for out-of-hospital cardiac arrest (OHCA) patients with ventricular fibrillation (VF). This trend is increasing over time.

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Area of Science:

  • Emergency Medicine
  • Cardiology
  • Public Health

Background:

  • Bystanders are crucial for public access defibrillation (PAD) during out-of-hospital cardiac arrest (OHCA).
  • Dual dispatch of first responders (FR) with emergency medical services (EMS) can reduce defibrillation times.
  • This study examines automated external defibrillator (AED) use in OHCAs before EMS arrival.

Purpose of the Study:

  • To describe the utilization of AEDs in OHCAs prior to EMS arrival.
  • To compare bystander/FR defibrillation with EMS defibrillation.
  • To assess the impact of early defibrillation on survival rates.

Main Methods:

  • Analysis of OHCA cases with shockable rhythms receiving AED use before EMS arrival (2008-2015, western Sweden).
  • Data sourced from the Swedish Register for Cardiopulmonary Resuscitation (SRCR).
  • Comparison of on-site bystander/FR defibrillation versus EMS defibrillation.

Main Results:

  • 162 of 6675 OHCA cases (24% with VF) received pre-EMS AED defibrillation (46% on-site).
  • Pre-EMS AED use increased from 5% (2008) to 20% (2015).
  • 30-day survival for VF patients rose from 22% to 28%, highest with on-site AED use (68%).

Conclusions:

  • AED use before EMS arrival in OHCAs has increased.
  • This rise in early defibrillation is linked to improved 30-day survival for VF patients.
  • On-site AED application before EMS arrival yields the highest survival rates.