NCPA - National Center for Policy Analysis


August 13, 2004

Two recent studies published in the New England Journal of Medicine reveal that a program that trained bystanders to perform CPR and use automated external defibrillators (AEDs) saved as many cardiac arrest victims as highly trained paramedics.

Many Ontarians have been trained to perform CPR and use automated external defibrillators, which are being widely dispersed. The addition of emergency medical service (EMS) programs with trained paramedics, however, did not improve survival rates:

  • Because paramedics often arrive relatively late, the people they save are more likely to suffer brain damage.
  • Some 78 percent of those saved by bystanders without paramedics survived with excellent brain function vs. 68 percent of those treated by paramedics.

The survival rate of cardiac arrest victims jumped from 14 percent to 23 percent when bystanders use an AED to deliver a shock before paramedics arrived.

USA Today found in an investigation published last year that thousands of lives are lost because EMS is often fragmented, inconsistent, and slow. Paramedics simply can't reach victims fast enough.

The critical factor is time. When the two studies' findings are broken down, they show the chances of surviving a cardiac arrest:

  • Nearly quadruple if fast-acting laypeople perform CPR.
  • More than triple if a shock from a defibrillator is delivered within eight minutes.

Making AEDs more available worked in Washington, D.C., where survival rates shot up tenfold in two years. "These two studies will change the way we think of EMS," says Robert O'Connor of the American College of Emergency Physicians.

Source: Robert Davis, "CPR, Defibrillators as Good as Medics." USA Today, August 12, 2004; Public Access Defibrillation Trial Investigators, "Public-Access Defibrillation and Survival after Out-of-Hospital Cardiac Arrest," Vol. 351:637-646, No. 7, New England Journal of Medicine, August 12, 2004; and Ian G. Stiell et al., "Advanced Cardiac Life Support in Out-of-Hospital Cardiac Arrest," Vol. 351:647-656, No. 7, New England Journal of Medicine, August 12, 2004.

For USA Today text


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