Annals of emergency medicine
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Sudden cardiac death from ventricular arrhythmia kills about 350,000 people annually in the United States. This number has not improved since the widespread public availability of semi-automated external defibrillators (AEDs) and the teaching of nonbreathing cardiopulmonary resuscitation (CPR) procedures. When an out-of-hospital cardiac arrest occurs in a public space, lay witnesses do CPR in 40% of the cases and use AEDs on only 7.4% of the victims before emergency medical services (EMS) arrive. ⋯ Because arrest onset is often not observed, arrest onset to shock times maybe even longer. Survival from cardiac arrest decreases by approximately 7 to 10% per minute of ventricular arrhythmia. A prearrest protocol is proposed for the at-home use of fully automated external defibrillators in select cardiac patients, which should reduce the arrest-to-shock interval to under 1 minute and may eliminate the need for CPR in some cases.