Limited response to cardiac arrest by police equipped with automated external defibrillators: Lack of survival benefit in suburban and rural Indiana - The police as responder automated defibrillation evaluation (PARADE)

William J. Groh, Mary M. Newman, Paul E. Beal, Naomi S. Fineberg, Douglas P. Zipes

Research output: Contribution to journalArticle

84 Scopus citations

Abstract

Objective: To assess the out-of-hospital cardiac arrest (OHCA) survival advantage after providing police with automated external defibrillators (AEDs) in rural and suburban Indiana. Methods: An observational evaluation was conducted in six Indiana counties (population: 464,741) before (retrospective) and after (prospective) training and equipping police with AEDs. The primary outcome evaluated was survival to hospital discharge for all cases of ventricular tachycardia/ventricular fibrillation (VT/VF) OHCA. Other factors evaluated include age, gender, race, arrest location, witnessed arrest, bystander cardiopulmonary resuscitation, response intervals, and survival to discharge for all OHCAs. Results are reported using chi-square, Student's t-test, and logistic regression. Results. Police were equipped with 112 AEDs, increasing total defibrillator capability by 43.2%. During the study period, AED-equipped police responded prior to emergency medical services (EMS) in 26 of 388 cases (6.7%). The time intervals from 911 call-to-scene and 911 call-to-shock were shortened by 1.6 minutes (95% confidence interval [95% CI] = 0.0 to 3.1, p = 0.05) and 4.8 minutes (95% CI = 1.3 to 8.3, p = 0.008), respectively, with police response as compared with EMS response. Survival to hospital discharge for VT/VF OHCA was 15.0% (3/20) in cases in which police responded first and 10.0% (16/160) in cases in which EMS responded first (relative risk [RR] 0.63, 95% CI = 0.17 to 2.39, p = 0.45). Survival to hospital discharge for VT/VF OHCA did not improve from the prestudy period (16/204, 7.8%) to after police AED availability (19/180, 10.6%) (RR 0.72, 95% CI = 0.36 to 1.45, p = 0.38). Conclusions: Out-of-hospital cardiac arrest survival in suburban and rural Indiana did not improve after police were equipped with AEDs, likely related to poor police response.

Original languageEnglish (US)
Pages (from-to)324-330
Number of pages7
JournalAcademic Emergency Medicine
Volume8
Issue number4
DOIs
StatePublished - Jan 1 2001

Keywords

  • Cardiopulmonary resuscitation
  • Defibrillation
  • Out-of hospital cardiac arrest
  • Outcomes
  • Survival

ASJC Scopus subject areas

  • Emergency Medicine

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