More than 6 years ago, the AHA published Improving Survival From Sudden Cardiac Arrest: The “Chain of Survival” Concept. The paper identified the idea that all communities should adopt the principle of early defibrillation. This principle applies to all personnel who are expected, as part of their professional duties, to perform basic CPR: They must carry an AED and be trained to operate it. Health professionals who have a duty to respond to a person in cardiac arrest should have a defibrillator available either immediately or within 1 to 2 minutes. Responsible personnel should authorize and implement more widespread use of automated external defibrillation by community responders and allied health responders.1 A 1995 poll of state EMS directors, published in the Journal of Emergency Medical Services , identified obstacles to implementation of early defibrillation programs. Among the major obstacles was a lack of enabling state legislation (34% of respondents).2 According to a subsequent 1996 survey of state EMS directors, fewer than half of EMTs and fewer than one quarter of non-EMT first responders in the United States were trained and equipped to defibrillate.3 Unfortunately, the nature of prehospital medical care (including training, equipment, and standards of care) varies widely from state to state, which results in inconsistent care for the public. The 1996 poll of state EMS directors, released in January 1997, found that only 27 states permitted, through enabling legislation, non-EMT first responders to use AEDs. In only 6 states are lay rescuers allowed to use AEDs: California, Florida, Maine, Maryland, North Dakota, and Texas. Individual recommendations by the state EMS directors included (1) the development of model legislation; (2) fostering of federal initiatives to fund the purchase of AEDs; and (3) training of all non-EMT firefighters, police officers, and other public safety first responders in …