Results from Austria's nationwide public access defibrillation (ANPAD) programme collected over 2 years

Abstract

To analyse 2 years of experience after introducing automated external defibrillators (AED) all over Austria. This observational study evaluated the number of privately purchased devices and the rate of local bystander-triggered AED deployments from November 2002 to December 2004. As outcome measurements, the hospital discharge rate and neurological condition were recorded. Arrival times of the emergency medical service (EMS) on scene and the time intervals until shock decisions were made were calculated. Shock decisions were verified according to ECG downloads. Results were compared with historical data if applicable. During the study period, 1865 devices were installed. Seventy-three AED deployments were recorded. Eleven cases were excluded from the study because bystanders were part of the local EMS. Seventeen out of the remaining 62 (27%) compared to a historical 27 out of 623 (4.3%) individuals were discharged alive from hospital. Fourteen out of 26 (54%) patients who were found with a shockable rhythm survived to hospital discharge. Fifteen of our patients survived in good neurological condition (CPC I and II), two suffered from severe neurological deficit (CPC III and IV) and 45 people died. The median "call-to-AED advice interval" was 3.5 min (IQR 2-6 min; N=24). In two cases, the AED made inappropriate decisions because of artefacts. Compared to historical data, short 'intervals to shock' delivery and the frequent start of basic life support resulted in an increased hospital discharge rate in good neurological condition. Despite the relatively high number of installed devices, the number of patients reached remained small.