Automatic External Defibrillator: Training and Practical Issues

Sudden cardiac death is the single most important cause of death in the industrialized countries. In general, traditional Emergency Medical Systems (EMS) have been only minimally effective in treating out-of-hospital cardiac arrest, and this occurred mainly due to unacceptably long times from patient collapse to defibrillation. The use of automated external defibrillators (AED) by non-medical personnel, offers an appealing solution of this problem. It can be used safely and effectively by a variety of crews of social security services and public responders who have the potential of approaching the victims of cardiac arrest earlier than the ambulance crews. Therefore time to defibrillation may be shortened. For public access defibrillation (PAD) programs to be effective, they should be integrated into an emergency medical system strategy for treating patients with cardiac arrest. All aspects of implementation should be planned very carefully. Recommended elements for PAD programs include a planned and practiced approach, training of anticipated rescuers in cardiopulmonary resuscitation (CPR) / AED, link with the local EMS, continuous program review and quality improvement. Emphasis should be placed not only on making potential rescuers familiar with CPR/AED practice, but also in giving detailed directives for successful resuscitation of cardiac arrest victims in the specific location where the PAD program has been implemented