Impact of Community-Wide Police Car Deployment of Automated External Defibrillators on Survival From 8 Cardiac Arrest

Background—Disappointing survival rates from out-of-hospital cardiac arrests encourage strategies for faster defibrilla-tion, such as use of automated external defibrillators (AEDs) by nonconventional responders. Methods and Results—AEDs were provided to all Miami-Dade County, Florida, police. AED-equipped police (P-AED) and conventional emergency medical rescue (EMS) responders are simultaneously deployed to possible cardiac arrests. Times from 9-1-1 contact to the scene were compared for P-AED and concurrently deployed EMS, and both were compared with historical EMS experience. Survival with P-AED was compared with outcomes when EMS was the sole responder. Among 420 paired dispatches of P-AED and EMS, the meanSD P-AED time from 9-1-1 call to arrival at the scene was 6.164.27 minutes, compared with 7.563.60 minutes for EMS (P0.001). Police arrived first to 56% of the calls. The time to first responder arrival among P-AED and EMS was 4.882.88 minutes (P0.001), compared with a historical response time of 7.643.66 minutes when EMS was the sole responder. A 17.2 % survival rate was observed for victims with ventricular fibrillation or pulseless ventricular tachycardia (VT/VF), compared with 9.0 % for standard EMS before P-AED implementation (P0.047). However, VT/VF benefit was diluted by the observation that 61 % of the initial rhythms were nonshockable, reducing the absolute survival benefit among the total study population to 1.6 % (P-AED, 7.6%; EMS, 6.0%). Conclusions—P-AED establishes a layer of responders that generate improved response times and survival from VT/VF