• P Petit.
• L'Université Claude Bernard, Lyon 1.
• B Acad Nat Med Paris. 1999 Jan 1; 183 (8): 1581-91; discussion 1591-4.

AbstractIn 1991 the concept of chain of survival was widely accepted. In France, one of the main difficulties was to perform early defibrillation. Only physicians were authorized to use defibrillators and the survival rate was not better than 1 to 2%. In 1991, a prospective study was initiated by the SAMU in Lyon and extended in Paris and Lille to assess the improvement afforded by the use of automatic external defibrillators (AED) by firemen. In this study, time to defibrillation was divided by two (8 to 10 min). Over the six years period of the study, firemen applied AEDs on 877 patients suffering from non traumatic cardiac arrest, 36.1% of them were in ventricular fibrillation (VF) after the simultaneous intervention of firemen and medicalized Mobile Intensive Care Units. The global survival rate of all the patients improved from 2 to 6.2% and from 1.5% to 3.4% for patients without neurological impairment (p < 0.01). The survival rate of the 317 FV was 15.1% (9.5% without neurological impairment). This results are encouraging but not sufficient. Since 1998, AED can be legally used by non physicians professionals, but the others links of the chain have to be improved, particularly by educating the public.

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