Public-access defibrillation and survival after out-of-hospital cardiac arrest[1]
Summary
The Public Access Defibrillation (PAD) trial: prospective multicenter RCT randomizing 993 community units (shopping malls, apartment complexes, public venues) across 24 North American regions to volunteer responders trained in CPR alone versus CPR plus AED use — over 19,000 volunteers. Survival to hospital discharge doubled in CPR+AED units (30 survivors among 128 arrests vs 15 among 107; relative risk 2.0; 95% CI 1.07-3.77; P=0.03). Only 2 survivors occurred in residential complexes; 70% of treated arrests were in public locations and 72% witnessed. No inappropriate shocks were delivered; trained laypersons used AEDs safely and effectively.
So what
The randomized-trial anchor for every venue AED program: lay volunteers with AEDs double survival in public locations, with zero inappropriate shocks — the definitive answer to safety and efficacy objections. The residential-complex null (2 survivors) sharpens the venue logic: PAD works where arrests are witnessed and dense — exactly the mass-gathering environment. Completes the resuscitation evidence arc from Wassertheil (staffed tiered response) and Valenzuela (security officers) to randomized proof.
Key findings
- 993 community units, >19,000 lay volunteers, RCT: CPR+AED vs CPR alone
- Survival to discharge doubled: RR 2.0 (1.07-3.77), P=0.03
- No inappropriate shocks - lay AED use safe
- Benefit concentrated in public locations; residential units saw almost none
- Randomized foundation for venue public-access defibrillation programs
Read the paper
- Publisher (DOI) ↗may be paywalled
- PubMed ↗abstract · free