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Automated external defibrillators

Authors
Thomas D Rea, MD, MPH
Mickey S Eisenberg, MD, PhD
Section Editor
Richard L Page, MD
Deputy Editor
Brian C Downey, MD, FACC

INTRODUCTION

Sudden cardiac arrest (SCA) refers to the sudden cessation of cardiac activity with hemodynamic collapse and is most often due to sustained ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT). SCA is a major public health challenge, accounting for approximately 5 to 15 percent of total mortality in industrialized nations [1-3]. (See "Overview of sudden cardiac arrest and sudden cardiac death".)

Survival from SCA remains poor. In most studies, fewer than 10 percent of patients in any cardiac rhythm and 20 percent of patients whose initial rhythm is VF survive the event [2-5]. These low survival rates are observed even with in-hospital arrests [6]. (See "Prognosis and outcomes following sudden cardiac arrest in adults".)

Although several interventions can improve the likelihood of VF resuscitation, the single most important is early delivery of an external electric shock to reset the cardiac rhythm and restore spontaneous circulation [7,8]. Early defibrillation is consistently associated with a greater likelihood of survival, which decreases by approximately 5 to 10 percent with each additional minute from collapse to defibrillation [7]. The benefit of early defibrillation is best illustrated by the outcomes following defibrillation at casinos; 74 percent with witnessed VF survived when a shock was delivered within three minutes from collapse [9].

This topic will review the development, use, allocation, and efficacy of automated external defibrillators (AEDs). Other aspects of electrical cardioversion and defibrillation are discussed separately, as are basic and advanced cardiovascular life support. (See "Basic principles and technique of electrical cardioversion and defibrillation" and "Cardioversion for specific arrhythmias" and "Basic life support (BLS) in adults" and "Advanced cardiac life support (ACLS) in adults" and "Supportive data for advanced cardiac life support in adults with sudden cardiac arrest".)

AED TRAINING and OPERATION

AED training — AEDs are designed to be straightforward to operate, and multiple studies have demonstrated that laypersons can operate them safely and effectively [10-14]. Nevertheless, they can be challenging to use, especially for the layperson [15-17].

              

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Literature review current through: Nov 2016. | This topic last updated: Thu Dec 24 00:00:00 GMT+00:00 2015.
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