Maisch S, Friederich P, Goetz A E
Klinik für Anästhesiologie, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg.
Anaesthesist. 2006 Dec;55(12):1281-90. doi: 10.1007/s00101-006-1098-0.
As ventricular fibrillation is the most frequent initial heart rhythm causing out-of-hospital sudden cardiac arrest, defibrillation is of essential significance. Automated external defibrillators (AEDs) have been available for some years and as a result defibrillation can be carried out by individuals other than physicians and healthcare providers such as trained first responders and untrained lay rescuers. This so-called public access defibrillation nourished hope of progress in the treatment of sudden cardiac arrest. However, several limitations exist, such as low frequency of sudden cardiac arrest in public, rare use of publicly placed AEDs, low cost effectiveness, legal requirements and insufficient public willingness to help. Due to these restrictions of public access defibrillation other measures are more promising than the attempt at general distribution of AEDs. These measures are primary or secondary prophylaxis of sudden cardiac arrest, general knowledge of adequate activation of emergency medical services, implementation of first responder teams equipped with AEDs and particularly a better education in and application of the well-established principles of cardiopulmonary resuscitation.
由于心室颤动是导致院外心脏骤停最常见的初始心律，除颤具有至关重要的意义。自动体外除颤器（AED）已经问世多年，因此除颤可以由非医生和医疗服务提供者的人员进行，如经过培训的急救人员和未经培训的普通救援者。这种所谓的公众可获取除颤为心脏骤停治疗的进展带来了希望。然而，存在一些限制，如公共场所心脏骤停发生率低、公共区域放置的AED使用稀少、成本效益低、法律要求以及公众施救意愿不足。由于公众可获取除颤存在这些限制，其他措施比广泛分发AED的尝试更具前景。这些措施包括心脏骤停的一级或二级预防、充分启动紧急医疗服务的常识、配备AED的急救团队的实施，特别是对成熟的心肺复苏原则进行更好的教育和应用。
