Lack of Integration of Automated External Defibrillators with EMS Response May Reduce Lifesaving Potential of Public-Access Defibrillation

Abstract

Objectives. Automated external defibrillators (AEDs) used for public-access defibrillation (PAD) allow for rapid defibrillation, particularly if the AEDs are incorporated into an organized response plan. This project was undertaken to determine how many PAD AEDs were in North Carolina, how many were properly registered, andhow many were integrated into the emergency medical services (EMS) response. Methods. Data were collected for this prospective, descriptive study via phone survey, e-mail survey, and/or direct personal interview. Four sources were utilized: 1) state office of EMS AED registration database, 2) AED sales representatives, 3) county EMS agency representatives, and4) American Heart Association (AHA) training center instructors andregional faculty. The primary endpoint was determining the proportion of AEDs placed in unregistered locations. Results. The state EMS office provided the state registry of AED locations. One-hundred percent of state-recognized AED vendors andcounty EMS agencies provided data. Twelve of 55 (22%) AHA personnel provided data. Eight hundred eighty-one unique locations were identified. Although AED sales are required by law to be registered, the office of EMS database contained only 99 of the 552 (18%) unique PAD locations identified by the study. Conclusions. A large number of unregistered AEDs are being placed in communities. AEDs placed as part of an organized PAD program improve the rates of survival from sudden cardiac death. In the absence of registration, it is difficult to determine the extent to which these AEDs are part of an organized PAD program.

Keywords:

• heart arrest
• electric countershock
• public policy
• automated external defibrillator

Notes

*During the study period, the e-mail survey was forwarded to an unknown number of individuals by the original recipients; only four of these “secondary contacts” responded. As the affiliation with the AHA could be determined only for those who responded, only these four were added to the original number of 51 contacts.