Public access defibrillation: emerging importance of automated external defibrillators as a diagnostic clinical tool

The use of public access automated external defibrillators (AEDs) has rapidly increased from 2003 to 2013 — with an 11-fold growth in Victoria — and has shown improvement in survival rates for out-of-hospital cardiac arrest.1 Prompt deployment relies on lay people to recognise a cardiac arrest, operate the device and manage basic life support.2 Lay people’s use of these devices located in public locations, as opposed to specialised health care settings, is unparalleled among medical devices. However, lay people are not involved in the clinical handover of the patient with the AED and it often remains with the private owner, who may not appreciate the importance of retrieving critical AED data. Lack of handover postresuscitation of initial rhythm and AED data has been shown to underdiagnose ventricular fibrillation (VF), as well as miss other significant rhythms such as complete heart block.3,4