This Article Free upon publication Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Smith, S. C. Articles by Hamburg, R. S. Search for Related Content PubMed PubMed Citation Articles by Smith, S. C., Jr Articles by Hamburg, R. S. Related Collections AHA Statements and Guidelines

(Circulation. 1998;97:1321-1324.)
© 1998 American Heart Association, Inc.

Special Reports

Automated External Defibrillators

Time for Federal and State Advocacy and Broader Utilization

Sidney C. Smith, Jr, MD; ; Richard S. Hamburg, MPA

Correspondence to Richard S. Hamburg, MPA, 1150 Connecticut Ave, Room 810, Washington, DC.

Key Words: defibrillation • death, sudden • fibrillation

	Introduction

 
More than 6 years ago, the AHA published Improving Survival From Sudden Cardiac Arrest: The "Chain of Survival" Concept. The paper identified the idea that

all communities should adopt the principle of early defibrillation. This principle applies to all personnel who are expected, as part of their professional duties, to perform basic CPR: They must carry an AED and be trained to operate it. Health professionals who have a duty to respond to a person in cardiac arrest should have a defibrillator available either immediately or within 1 to 2 minutes. Responsible personnel should authorize and implement more widespread use of automated external defibrillation by community responders and allied health responders.¹

	Current EMT and First Responder Preparedness

 
A 1995 poll of state EMS directors, published in the Journal of Emergency Medical Services, identified obstacles to implementation of early defibrillation programs. Among the major obstacles was a lack of enabling state legislation (34% of respondents).² According to a subsequent 1996 survey of state EMS directors, fewer than half of EMTs and fewer than one quarter of non-EMT first responders in the United States were trained and equipped to defibrillate.³

Unfortunately, the nature of prehospital medical care (including training, equipment, and standards of care) varies widely from state to state, which results in inconsistent care for the public. The 1996 poll of state EMS directors, released in January 1997, found that only 27 states permitted, through enabling legislation, non-EMT first responders to use AEDs. In only 6 states are lay rescuers allowed to use AEDs: California, Florida, . . . [Full Text of this Article]

This article has been cited by other articles:

				R. J. Myerburg, J. Fenster, M. Velez, D. Rosenberg, S. Lai, P. Kurlansky, S. Newton, M. Knox, and A. Castellanos Impact of Community-Wide Police Car Deployment of Automated External Defibrillators on Survival From Out-of-Hospital Cardiac Arrest Circulation, August 27, 2002; 106(9): 1058 - 1064. [Abstract] [Full Text] [PDF]

				T. S. Takata, R. L. Page, and J. A. Joglar Automated External Defibrillators: Technical Considerations and Clinical Promise Ann Intern Med, December 4, 2001; 135(11): 990 - 998. [Abstract] [Full Text] [PDF]

				M. S. Eisenberg and T. J. Mengert Cardiac Resuscitation N. Engl. J. Med., April 26, 2001; 344(17): 1304 - 1313. [Full Text] [PDF]

				J. P. Marenco, P. J. Wang, M. S. Link, M. K. Homoud, and N. A. M. Estes III Improving Survival From Sudden Cardiac Arrest: The Role of the Automated External Defibrillator JAMA, March 7, 2001; 285(9): 1193 - 1200. [Abstract] [Full Text] [PDF]

				R. L. Page, J. A. Joglar, R. C. Kowal, J. D. Zagrodzky, L. L. Nelson, K. Ramaswamy, S. J. Barbera, M. H. Hamdan, and D. K. McKenas Use of Automated External Defibrillators by a U.S. Airline N. Engl. J. Med., October 26, 2000; 343(17): 1210 - 1216. [Abstract] [Full Text] [PDF]