Laiendefibrillation Ausserhalb des Spitals–Häufig Propagiert, Aber zu Selten Eingesetzt

Out-of-hospital cardiac arrests (OHCA) have a poor outcome. Firefighters, police or emergency medical services are generally unable to reach patients with an OHCA within the 5 minutes required for a successful defibrillation. Based on our experience and the existing literature, we demonstrate the advantage of early defibrillation by laypersons (public access defibrillation [PAD]). The rate of survival of 9% (4/43) at hospital discharge in patients treated by the emergency medical service of the Kantonsspital Baden lies within the worldwide average reported in the international literature. Totally 3 out of 12 defibrillated patients (25%) left the hospital alive. Only one of the surviving patients was, however, defibrillated by the emergency medical service. One patient survived an OHCA with only minimal neurological dysfunctions thanks to the use of an automated external defibrillator (AED) by a layperson. Several studies on PAD show a trend to reduce mortality in OHCA. AEDs can be used safely and cost-effectively by laypersons. Efforts of the Swiss Resuscitation Council (SRC) to promote AEDs in Switzerland in order to minimise the collapse to defibrillation time have not been successful so far. Presently there is no data in this country available about early defibrillation by laypersons to confirm the successful use of PAD. In order to improve the rate of survival after OHCA in Switzerland, sufficient funding and manpower to further promote the use of AEDs in public places with a high probabilty of OHCA is essential.