The Los Angeles public access defibrillator (PAD) program: ten years after.

Abstract

Public access automated external defibrillator (PAD) programs have been shown to be successful in several municipalities. This study sought to determine the usage of and survival rate from a large, urban PAD program in the first 10 years since its implementation. This was a prospective, longitudinal, observational study from January 2002-2012 conducted in Los Angeles, California, a city with a population of 3.8 million. An incremental rollout resulted in a current total of 1300 automated external defibrillators (AEDs) in place in city-owned buildings and other public places, including all 3 area airports, golf-courses, and public pools. All instances where an AED was applied were included in the study. There were 59 incidents of cardiac arrest with a public access AED applied, of which 42 (71%) occurred at an airport. 51 (86%) of the patients were male, with a median age of 64 years (interquartile range, 56.5 to 70 years). A shockable rhythm was detected and shocks were applied in 39 (66%) patients, with 30 (77%) of these patients achieving a return of spontaneous circulation (ROSC). Of those patients who received shock(s) by public access AED, 27 (69%) survived to hospital discharge. The youngest survivors were a 25 year old male and a 34 year old female. While the majority of PAD cases occurred at an airport, there were also survivors from other public locations. AEDs deployed as part of a large PAD program resulted in a very high survival rate for patients with cardiac arrest.