Survival of people with out-of-hospital cardiac arrest is not improved by equipping first responders with an automated external defibrillator

Abstract

Question

Will the use of automated external defibrillators by the police or firefighters result in better clinical outcomes for people with an out-of-hospital cardiac arrest?

Study design

Cross-over randomised controlled trial.

Main results

There was no significant difference in hospital discharge rates for people experiencing a cardiac arrest between areas in which firefighters and police officers were equipped with automated external defibrillators (AEDs) and those areas in which they were not (see Table 1). AEDs significantly improved the return of spontaneous circulation and admission to hospital.

Table 1 Clinical outcomes by treatment group in people experiencing a cardiac arrest.
Outcome	AEDs used (n=243)	AEDs not used (n=226)	Odds ratio, AED used versus AED not used; (95% CI), P-value
Hospital discharge	44 (18%)	33 (15%)	1.3 (0.8 to 2.2), 0.33
Return of spontaneous circulation	139 (57%)	108 (48%)	1.5 (1.0 to 2.2), 0.05
Hospital admission	103 (42%)	74 (33%)	1.5 (1.1 to 1.6), 0.02

Authors’ conclusions

Survival to hospital discharge in people experiencing an out-of-hospital cardiac arrest was not improved by equipping first responders with automated external defibrillators.