Sudden cardiac death and early defibrillation

Since most sudden cardiac death victims show neither symptoms before the ev ent nor other signs or risk factors that would have identified them as a hi gh risk population before their cardiac arrest, emergency out-of-hospital m edical services must be improved in order to obtain a higher survival in th ese patients. Early defibrillation is an essential part of the chain of sur vival that also includes the early identification of the victim, activation of the emergency medical system, immediate arrival of trained personnel wh o can perform basic cardiopulmonary resuscitation and early initiation of a dvanced cardiac life support that would raise the survival rate for sudden cardiac arrest victims. Many studies have demonstrated the enormous importance of early defibrillat ion in patients with a cardiac arrest due to ventricular fibrillation. The most important predictor of survival in these individuals is the time that elapses until electric defibrillation, the longer the time to defibrillatio n the lower the number of patients who are eventually discharged. Multiple studies have demonstrated that automatic external defibrillation will reduc e the time elapsed to defibrillation and thus improve survival. For these reason, public access defibrillation to allow the use of automati c external defibrillators by minimally trained members of the lay public, h as received increasing interest on the part of a growing number of companie s, cities or countries. The automatic external defibrillation, as performed by a lay person is being investigated. The liberalization of its applicati on, if is demonstrated to be effective, will need to be accompanied by lega l measures to endorse it and appropriate health education, probably during secondary education.