The Effectiveness of using Automatic External Defibrillators in the Treatment of Cardiac Arrest in Public Places

Introduction: Ischaemic heart disease is the leading cause of death in the world. In Europe approximately 400,000 cardiac arrests occur every year. Defibrillation constitutes a vital link in the chain of survival and is one of the few interventions that appear to contribute to improving the outcome of cardiac arrest. Every minute of delay in defibrillation reduces the chance of survival by 10-12%. Aim: Review of the recent literature on the importance of having automated external defibrillators (AED) in public areas, and their use by caregivers. Method: An extensive search was conducted of research studies published in Greek and English between 2000 and 2014 in the databases Medline, Scopus and PubMed, using the key-words “automated external defibrillator”, “cardiac arrest”, “chain of survival and strategic points”. Results: The literature review showed that the availability of direct defibrillation is a fundamental determinant of survival after cardiac arrest. Those countries where the system of prehospital emergency care, i.e., the emergency medical services (EMS), is based on an organized network of trained citizens with an important number of available AEDs, were able to significantly reduce the application time of defibrillation, resulting in a great improvement of the survival rate (by 49-74%), when the shock was applied within the first 3 minutes of collapse. Conclusions: There is a great need for AEDs to be placed in crowded public places such as airports, sports facilities and casinos and on aeroplanes, where cardiac arrest may occur in the presence of witnesses, allowing immediate defibrillation within the first minutes. The development of education in cardiopulmonary resuscitation (CPR) using AEDs should be encouraged by the state, so that AEDs can be used by ordinary citizens in the crucial several minutes before the arrival of specialized assistance.