Community Lay Rescuer Automated External Defibrillation Programs

Abstract

Abstract-Cardiovascular disease is a leading cause of death for adults Ն40 years of age. The American Heart Association (AHA) estimates that sudden cardiac arrest is responsible for about 250 000 out-of-hospital deaths annually in the United States. Since the early 1990s, the AHA has called for innovative approaches to reduce time to cardiopulmonary resuscitation (CPR) and defibrillation and improve survival from sudden cardiac arrest. In the mid-1990s, the AHA launched a public health initiative to promote early CPR and early use of automated external defibrillators (AEDs) by trained lay responders in community (lay rescuer) AED programs. Between 1995 and 2000, all 50 states passed laws and regulations concerning lay rescuer AED programs. In addition, the Cardiac Arrest Survival Act (CASA, Public Law 106-505) was passed and signed into federal law in 2000. The variations in state and federal legislation and regulations have complicated efforts to promote lay rescuer AED programs and in some cases have created impediments to such programs. Since 2000, most states have reexamined lay rescuer AED statutes, and many have passed legislation to remove impediments and encourage the development of lay rescuer AED programs. The purpose of this statement is to help policymakers develop new legislation or revise existing legislation to remove barriers to effective community lay rescuer AED programs. Important areas that should be considered in state legislation and regulations are highlighted, and sample legislation sections are included. Potential sources of controversy and the rationale for proposed legislative components are noted. This statement will not address legislation to support home AED programs. Such recommendations may be made after the conclusion of a large study of home AED use. (Circulation. 2006;113:1260-1270.)

Location of Cardiac Arrest in a City Center

“…5 The second category matched the AHA guideline of placing AEDs in areas with at least 1 cardiac arrest every 5 years. 10 The 100-m radius was considered the maximum distance a publicly placed AED could be transported by laypersons in a 1 1 ⁄2-min brisk walk in the event of nearby cardiac arrest in accordance with the AHA recommendations. 10 The European Grid System, a defined and harmonized grid net for Europe with standardized size and location of grid cells, 13 was used to count cardiac arrests in all 100ϫ100-m grid cells included in the study area.…”

“…The ERC recommends AED placement in areas with at least 1 cardiac arrest every 2 years, 9 whereas the AHA proposes AED placement in areas with at least 1 cardiac arrest every 5 years. 10 This disparity reflects the current uncertainty for appropriate AED placement. Furthermore, few studies have addressed the actual distribution and localization of AEDs in communities without predefined highincidence sites of cardiac arrests.…”

Lutar contra a mortalidade por doenças cardiovasculares: um desafio para a sociedade!

“…Deverão ser incentivadas todas as iniciativas que aumentem o conhecimento da população em geral sobre as causas subjacentes à morte súbita e a sua ligação a arritmias cardíacas. A legislação a implementar deve favorecer o desenvolvimento de programas na comunidade que promovam o acesso imediato de vítimas de paragem cardíaca a manobras de suporte básico de vida efetuadas por testemunhas e o acesso mais rápido possível a desfibrilhação precoce 13 .…”

Diagnostic Accuracy of Commercially Available Automated External Defibrillators

“…However, it is often difficult to shorten the time from the cardiac arrest to the defibrillation utilizing the emergency medical service. An automated external defibrillator (AED) allows bystander rescuers to defibrillate out‐of‐hospital ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) before the emergency medical service arrives 17, 18, 19, 20, 21, 22, 23, 24, 25. In fact, nationwide dissemination of publicly accessible AEDs in Japan resulted in an earlier administration of shocks by bystanders and has improved the rate of survival 26, 27.…”