Effectiveness of Public Access Defibrillation with AEDs for Out-of-Hospital Cardiac Arrests in Japan.

In Japan, about 60,000 out-of-hospital cardiac arrests of cardiac etiology occur annually. Early initiation of cardiopulmonary resuscitation (CPR) and early defibrillation with public access automated external defibrillators (AEDs) by bystanders is the key to increasing survival after an out-of-hospital cardiac arrest (OHCA). Japanese data shows that nationwide dissemination of public access AEDs actually increases the rate of survival with a good neurological outcome after OHCA. Recently, the number of public access AEDs has been increasing rapidly, but implementation of AED use and CPR by public bystanders has not been sufficiently frequent, despite having become more common than before. To improve the rate of OHCA survival with a good neurological outcome by making effective use of AEDs, there need to be further spread of AEDs with specific installation criteria as well as infrastructure development for promoting AED use. In addition, educational activities and practical programs should be introduced in the community setting. Recently, many reports, including by the Utstein Osaka Project, have showed that chest compression-only CPR is as effective as conventional CPR with rescue breathing. To save more lives, we should encourage the widespread practice of CPR by widely diffusing AEDs and simplified chest compression-only CPR training.