First-aid defibrillator use increases rate of survival

Sudden Heart Death is the number one cause of death in the industrialised world. 1/3 of the patients die before being transported into hospital. 20 % to 30 % of these cardiac arrests happen in public areas.

Cardio Pulmonary Resucitation (CPR) was invented in the sixties and many people were trained in this technique as first-aiders. However, there was no significant raise in patients surviving cardiac arrest in the public due to CPR.

This is why Austrian Red Cross produced “all inclusive” survival-packages for companies, including automatic external defibrillators (AED), first aid and CPR-trainings for staff and emergency management, maintenance for the equipment and consulting (emergency maps, plans, …)

Together with the Austrian Broadcasting Corporation ORF and sponsors like the Business Chamber of Austria, Raiffeisenbank, and BP the Austrian Red Cross started a marketing campaign including radio and television-spots, magazine-advertisements and posters. A Website (defi.roteskreuz.at) supplemented online functionality to the campaign. As a measurement for quality management a scientific study was started to document and explore this program, which was the first in this scale in Europe.

In two years, there have been 1352 defibrillators being installed, most of them were financed by companies as “added value” for their customers. Governmental institutions like ministries, regional governments or towns installed defibrillators too. The campaign was recognized by 78% of Austrians aged 40 to 60 years. In the age-group 15+ there was a recognition of 68%. In urban regions recognition-rates were lower because of higher media-diversion. In Vienna for example, the campaign was only recognized by 51%. In the past two years, 37 uses of automatic external defibrillators out of this programme were documented. In 15 cases, there was a shockable cardiac rhythm; the defibrillator recommended to shock 14 times. All not-shockable rhythms were recognised correctly - in these cases no recommendation for a shock was given.

The average time between emergency call and first shock by AED was 5.54 +/- 2.77 minutes. The time until emergency medical service arrived was in average 10.88 minutes. The time without treatment therefore was decreased significantly (p=0.0039). Nine of the patients with shockable ECG-rhythm (60 %) left hospital without neurological deficits, one (6.6%) had a clear neurological deficit.

The experience of the Austrian Red Cross proved that “all-inclusive” packages – a combination of semiautomatic external defibrillator, training, consultancy and maintenance - found good acceptance in the public and showed clear life-saving results. The media-campaign worked extremely well to inform the public about defibrillators and to sensitize for the topic. The treatment-free interval can be significantly decreased by implementing first-aid defibrillators. The rate of survivors and their neurological status increase as a consequence of the implementation.