The North Carolina Automated External Defibrillator Location Project: Recommendations for Use of Automated External Defibrillators in the Resuscitation of Victims of Out-of-Hospital Sudden Cardiac Death

Purpose: The study was undertaken to determine the current level of Automated External Defibrillator (AED) preparedness in North Carolina and to evaluate potential alternatives for future actions in the area of AED deployment and Public Access Defibrillation (PAD). Methods: A literature review was conducted to evaluate the efficacy and costeffectiveness of treatment options for out-of-hospital sudden cardiac death (SCD). Primary data were obtained via phone and electronic mail surveys of state and county EMS officials, commercial AED vendors, and American Heart Association Training Centers. Results: Review of the literature indicates successful defibrillatory treatment of SCD must be accomplished within 10 minutes of collapse. With few exceptions, most communities cannot achieve such a prompt response with traditional EMS service. Communities with AED-equipped first responders accomplish such a prompt response with greater frequency than those without such responders. PAD allows for prompt defibrillation and a markedly increased probability of survival for SCD victims in public places; only 3% of all SCDs occur in such public places. In North Carolina, in addition to 282 EMS agencies and Fire Departments, 600 locations were found to have at least 1 AED, many of which have the possibility of PAD. None of the 9-1-1 centers in the state had the locations of AEDs entered into Computer Automated Dispatch (CAD), 33% percent of counties did not have an AED or other defibrillator on all first-responding fire or EMS vehicles, and 45% of counties are unable to provide instructions for use of an AED over the phone. Conclusions: All first-responding EMS units and fire engines need to be equipped with AEDs. Those AEDs located in areas for potential PAD need to have their location registered with 9-1-1 dispatch in order to ensure they are used in the event of a near-by SCD. Emergency Medical Dispatchers must be prepared to provide instructions for use of an AED to the untrained bystander. More research is needed before recommendations regarding placement of additional AEDs for PAD can be made.