Small Benefit Found for Public Defibrillators

Making defibrillators widely available in public places such as airports and shopping centers is not justified by the small improvement in survival, according to a study in the September 7, 2002, issue of the British Medical Journal (BMJ).

Based on records of out-of-hospital cardiac arrests due to heart disease from 1991-1998, researchers in Scotland estimate that out of 15,189 cases of cardiac arrest, 79% occurred in sites unsuitable for the location of public access defibrillators. Only 3% occurred in possibly suitable sites, such as buses and multistory car parks, while 18% occurred in suitable sites, such as shops, offices, and sports centers. A similar study found that of 7,185 cardiac arrests during a five-year period, only 16% occurred in public locations.
As a result, the researchers predict that public-access defibrillators placed only in suitable sites would increase the survival rate from 5.0-6.3%.

The increase in survival is less that what could be achieved by expanding early defibrillation to nonambulance first responders, say the authors, such as emergency services or community programs, or bystander resuscitation. However, the benefit of defibrillators in the hands of untrained volunteers remains to be proved.




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British Medical Journal