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Automated external defibrillation (AED) by EMS has considerably contributed to improving the outcome of out-of-hospital cardiac arrest and is now considered part of basic life support. Extending the use of AED to other potential rescuers as “first responders” has also been shown to be very effective under remote conditions like “in-flight” situations or in casinos when performed by trained safety personnel or police officers. Reports of AED use in hospitals are also encouraging. Finally “public access defibrillation”, i. e., the use of AED by lay people, seems to be possible and efficacious, if specific conditions such as the location of devices and the probability of events at a given location are taken into account. There are, however, several problems which still have to be solved in the near future. One concerns the best shock form and the other the optimal defibrillation energy. Both are unclear with the new biphasic defibrillators. The role of (mouth-to-mouth) ventilation in the initial phase of resuscitation has to be re-evaluated with regard to basic life support. Moreover, a recent report has also questioned the concept of attempting immediate defibrillation in the case of an arrest of longer duration before the arrival of rescuers.
Herzschrittmachertherapie + Elektrophysiologie – Springer Journals
Published: Jan 1, 2003
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