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(Circulation. 2002;106:1030.)
© 2002 American Heart Association, Inc.

Editorial

Automated External Defibrillator Use by Police Responders

Where Do We Go From Here?

José A. Joglar, MD; Richard L. Page, MD

From the Department of Internal Medicine (Cardiology, Clinical Cardiac Electrophysiology), The University of Texas Southwestern Medical Center at Dallas.

Reprint requests to Richard L. Page, MD, Division of Cardiology, Department of Medicine, University of Washington School of Medicine, 1959 NE YPacific St, Room AA502, Health Sciences Bldg, Box 356422, Seattle, WA 98195-6422. E-mail rpage@u.washington.edu

Key Words: Editorials • death, sudden • defibrillation • heart arrest • resuscitation

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Sudden cardiac death (SCD) remains a major public health problem. More than 250 000 deaths in the United States are attributed to SCD annually, and recent statistics demonstrate that in 1999, there were 341 780 cases of out-of-hospital cardiac arrest, accounting for 47% of all cardiac-related deaths.¹ Despite improvements in emergency systems across the country and advances in the prevention and treatment of cardiovascular diseases, the proportion of SCDs has increased 12% over the past decade,² making the development of better therapeutic approaches for of out-of-hospital arrest of primary concern.

See p 1058

An early step in improving survival after sudden cardiac events was the development of the "chain of survival,"³ defined as early access, early cardiopulmonary resuscitation (CPR), early defibrillation, and early advanced care. Strong evidence supports this concept. Approximately 85% of victims of cardiac arrest demonstrate ventricular tachyarrhythmias immediately after collapse,⁴ and a survival rate up to 80% has been reported when CPR and defibrillation are administered within minutes of a witnessed cardiac arrest.⁵ Furthermore, the majority of survivors of this event are patients who demonstrate ventricular fibrillation on arrival of emergency personnel. Because of this, over the past 2 decades, community-based strategies focusing on early defibrillation have emerged, most recently by employing the automated external defibrillator (AED).

Early evidence that the AED could be incorporated into an emergency response system was demonstrated in Seattle. In a landmark trial,⁶ provision of AEDs to firefighters resulted in improved survival as compared with CPR alone until the arrival of a . . . [Full Text of this Article]