a1 Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia USA
a2 Institute of Anesthesiology and Intensive Care, Department of Cardiovascular Medicine, Catholic University School of Medicine, Rome, Italy
a3 Division of General Medicine, Emory University School of Medicine, Atlanta, Georgia USA
a4 Internal Medicine, Mercer University School of Medicine, Macon, Georgia USA
The automated external defibrillator (AED) is a tool that contributes to survival with mixed outcomes. This review assesses the effectiveness of the AED, consistencies and variations among studies, and how varying outcomes can be resolved.
A worksheet for the International Liaison Committee on Resuscitation (ILCOR) 2010 science review focused on hospital survival in AED programs was the foundation of the articles reviewed. Articles identified in the search covering a broader range of topics were added. All articles were read by at least two authors; consensus discussions resolved differences.
AED use developed sequentially. Use of AEDs by emergency medical technicians (EMTs) compared to manual defibrillators showed equal or superior survival. AED use was extended to trained responders likely to be near victims, such as fire/rescue, police, airline attendants, and casino security guards, with improvement in all venues but not all programs. Broad public access initiatives demonstrated increased survival despite low rates of AED use. Home AED programs have not improved survival; in-hospital trials have had mixed results. Successful programs have placed devices in high-risk sites, maintained the AEDs, recruited a team with a duty to respond, and conducted ongoing assessment of the program.
The AED can affect survival among patients with sudden ventricular fibrillation (VF). Components of AED programs that affect outcome include the operator, location, the emergency response system, ongoing maintenance and evaluation. Comparing outcomes is complicated by variations in definitions of populations and variables. The effect of AEDs on individuals can be dramatic, but the effect on populations is limited.
NA Stokes, A Scapigliati, AR Trammell, DC Parish. The effect of the AED and AED programs on survival of individuals, groups and populations. Prehosp Disaster Med. 2012;27(5):1–6 .
(Received November 04 2011)
(Accepted June 10 2012)
(Revised June 21 2012)
(Online publication August 21 2012)
Funding: The authors report that there was no funding for this research, and there are no conflicts of interest to disclose.