Public Access Defibrillation

A Statement for Healthcare Professionals From the American Heart Association Task Force on Automatic External Defibrillation

In October 1993 the American Heart Association appointed the Task Force on Automatic External Defibrillation. The task force was charged with conducting a conference on automatic external defibrillation, evaluating research needed for broader community use of automatic external defibrillators, and overseeing evaluation of the feasibility and desirability of their use by healthcare professionals and the lay public.

In December 1994 a conference on public access defibrillation was held in Washington, DC. More than 300 persons attended, representing science, industry, the healthcare professions, law, and the federal government. During the meeting the participants reached a consensus on the general proposition of greater public access to defibrillation and the need for broad-based clinical research, public and professional education, and legislative reform. Following the conference, members of the task force, with input from others in the field of emergency cardiac care, wrote this statement, which was approved by the AHA Board of Directors in June 1995.

Early bystander cardiopulmonary resuscitation (CPR) and rapid defibrillation are the two major contributors to survival of adult victims of sudden cardiac arrest. The AHA supports efforts to provide prompt defibrillation to victims of cardiac arrest. Automatic external defibrillation is one of the most promising methods for achieving rapid defibrillation. In public access defibrillation, the technology of defibrillation and training in its use are accessible to the community. The AHA believes that this is the next step in strengthening the chain of survival. Public access defibrillation will involve considerable societal change and will succeed only through the strong efforts of the AHA and others with a commitment to improving emergency cardiac care.

Public access defibrillation will include:

• Performance of defibrillation by laypersons at home and by firefighters, police, security personnel, and non-physician care providers in the community.
• Exploration of the use of bystander-initiated automatic external defibrillation in rural communities and congested urban areas where resuscitation strategies have had little success.

The AHA can also play a major role by:

• Increasing public awareness that defibrillation improves the rate of survival from an often fatal condition that each day affects 1000 Americans.
• Ensuring that objective, current research data are used to guide implementation of these changes in performance and teaching of CPR.
• Working with medical manufacturers, legislators, and governmental agencies to promote safety and efficacy, reduce cost, and update training requirements to facilitate implementation of public access defibrillation. Broader use of automatic external defibrillators should also lead to readiness tests and features that deter both misuse and misapplications.

Meaningful change will occur only with the broad public support that has traditionally characterized the AHA’s efforts in the fight against heart disease and stroke.