The in-hospital spread of automated external defibrillators (AEDs) is aimed to allow for a shock-delivery within three minutes. However, it has to be questioned if the implementation of AED alone really contributes to a ‘heart-safe hospital’. We performed a cohort study of 1008 in-hospital emergency calls in a university tertiary care hospital, analysing cardiopulmonary resuscitation (CPR) cases with and without AED use. In total, 484 patients (48%) had cardiac arrest and received CPR. Response time of the emergency team was 4.3 ± 4.0 minutes. Only 8% percent of the CPR cases had a shockable rhythm. In three of 43 placements a shock was delivered by the AED. There were no differences in survival between patients with CPR only and CPR with AED use. Our data do not support the use of an AED for in-hospital CPR if a professional response team is rapidly available.
WeaverW.D., CopassM.K., BufiD., RayR., HallstromA.P., CobbL.A.Improved neurologic recovery and survival after early defibrillation. Circulation1984; 69: 943–948.
2.
ValenzuelaT.D., RoeD.J., CretinS., SpaiteD.W., LarsenM.P.Estimating effectiveness of cardiac arrest interventions: a logistic regression survival model. Circulation1997; 96: 3308–3313.
3.
PerkinsG.D., LallR., QuinnT.Mechanical versus manual chest compression for out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomised controlled trial. Lancet2015; 385: 947–955.
4.
LinkM.S., AtkinsD.L., PassmanR.S.Part 6: electrical therapies: automated external defibrillators, defibrillation, cardioversion, and pacing: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation2010; 122: S706–S719.
5.
WeilM.H., FriesM.In-hospital cardiac arrest. Crit Care Med2005; 33: 2825–2830.
6.
ChanP.S., KrumholzH.M., SpertusJ.A.Automated external defibrillators and survival after in-hospital cardiac arrest. JAMA2010; 304: 2129–2136.
7.
PeberdyM.A., CretikosM., AbellaB.S.Recommended guidelines for monitoring, reporting, and conducting research on medical emergency team, outreach, and rapid response systems: an Utstein-style scientific statement: a scientific statement from the International Liaison Committee on Resuscitation (American Heart Association, Australian Resuscitation Council, European Resuscitation Council, Heart and Stroke Foundation of Canada, InterA. Circulation2007; 116: 2481–2500.
8.
PrioriS.G., BossaertL.L., ChamberlainD.A.Policy statement: ESC-ERC recommendations for the use of automated external defibrillators (AEDs) in Europe. Resuscitation2004; 60: 245–252.
9.
ValenzuelaT.D., RoeD.J., NicholG., ClarkL.L., SpaiteD.W., HardmanR.G.Outcomes of rapid defibrillation by security officers after cardiac arrest in casinos. N Engl J Med2000; 343: 1206–1209.
10.
DeakinC.D., NolanJ.P., SundeK., KosterR.W.European Resuscitation Council Guidelines for Resuscitation 2010 Section 3. Electrical therapies: automated external defibrillators, defibrillation, cardioversion and pacing. Resuscitation2010; 81: 1293–1304.
11.
KällestedtM.L.S., BerglundA., EnlundM., HerlitzJ.In-hospital cardiac arrest characteristics and outcome after defibrillator implementation and education: from 1 single hospital in Sweden. Am J Emerg Med2012; 30: 1712–1718.
12.
SpearpointK.G., GruberP.C., BrettS.J.Impact of the Immediate Life Support course on the incidence and outcome of in-hospital cardiac arrest calls: an observational study over 6 years. Resuscitation2009; 80: 638–643.
13.
JonesD.A., DeVitaM.A., BellomoR.Rapid-response teams. N Engl J Med2011; 365: 139–146.
WallmullerC., MeronG., KurkciyanI., SchoberA., StratilP., SterzF.Causes of in-hospital cardiac arrest and influence on outcome. Resuscitation2012; 83: 1206–1211.
16.
SandroniC., NolanJ., CavallaroF., AntonelliM.In-hospital cardiac arrest: incidence, prognosis and possible measures to improve survival. Intensive Care Med2007; 33: 237–245.
17.
BergumD., NordsethT., Mjolstad OleC., SkogvollE., HaugenB.O.Causes of in-hospital cardiac arrest–incidences and rate of recognition. Resuscitation2015; 87: 63–68.
