THEORETICAL CALCULATION OF MAXIMUM ATTAINABLE BENEFIT OF PUBLIC-ACCESS DEFIBRILLATION IN BELGIUM

Objective: Assuming that a lay person performing cardiopulmonary resus citation (CPR) will also use an automatic external defibrillator (AED) wherever available, we tried to estimate the maximal attainable benef it of public access defibrillation in some centres in Belgium. Methods : We analysed retrospectively the data from the Belgian Cardio Pulmona ry Cerebral Resuscitation Registry collected between 1991 and June 199 6. The majority of these emergency medical service (EMS) systems are t wo-tiered with an early defibrillation program for the first tier and a physician-staffed second tier. Results: The data show that, in 5543 registered cases: there were 1001 (18%) adults with non-traumatic vent ricular fibrillation/ventricular tachycardia (VF/VT) as the first moni tored rhythm. In this subgroup there were 419 (42%) cases who had lay CPR. The duration of lay CPR before the first defibrillation either by the first or the second tier is known in 357 cases. This duration was more than 5 min and 10 min, in 80% and 53% of the cases, respectively . The median (Q(1), Q(3)) lay CPR duration was 11 (7, 15) min. Surviva l to hospital discharge in this subgroup was achieved in 80/357 (22%) patients. Using Weaver's linear model for survival after witnessed VF/ VT, an estimated increase of more than 30% in survival rate was calcul ated. Conclusion: It is concluded that in our EMS system, laymen reach a substantial number of VF/VT victims many minutes before the arrival of the professional EMS teams. Therefore, a substantial increase in t he number of survivors could be expected if lay responders were prepar ed to use an AED. (C) 1998 Elsevier Science Ireland Ltd. All rights re served.