EDITORIALS
Public access defibrillation: how to maximise the gain
1 London School of Hygiene and Tropical Medicine, London, UK
2 Camden Primary Care Trust
Correspondence to:
M McKee, European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK; martin.mckee@lshtm.ac.uk
| The first 150 words of the full text of this article appear below. |
The question of how to respond to out of hospital cardiac arrest (OHCA) encapsulates the tension between the individual and the population perspective on health. Faced with someone who has just collapsed with no pulse, the appropriate response is clear. Cardiopulmonary resuscitation (CPR) makes it possible to sustain some individuals until their cardiac rhythm can be diagnosed; those found to have ventricular fibrillation can often be shocked back into sinus rhythm and evacuated to hospital, from which they have an over 70% probability, in the best centres, of being discharged alive.1
The question of what to do, at a population level, to enhance the number of people who survive is more difficult. For almost two decades it has been argued that what is needed is a coordinated "chain of survival",2 which would include rapid access to skilled care, early CPR and defibrillation. What was initially less clear was how such
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