Out-of-hospital early defibrillation successfully challenges sudden cardiac arrest: the Piacenza Progetto Vita project.

ABSTRACT

BACKGROUND: Early defibrillation is the most important intervention influencing survival following sudden cardiac arrest (SCA). In order to improve public access to early defibrillation, in North America several experiences of out-of-hospital early defibrillation by non-medical volunteers have been successfully implemented and demonstrated to improve survival. METHODS: Since 1999, in Piacenza, we have established "Progetto Vita", the first experience of out-of-hospital early defibrillation by non-medical volunteers in a medium-size European city. Thirty-nine semiautomatic external defibrillators were placed in Piacenza, Italy (266,531 inhabitants) and distributed in 12 high-risk locations, 12 lay-staffed ambulances and 15 police-cars. A total of 1285 lay volunteers were trained by the emergency medical system to intervene in all cases of suspected SCA. RESULTS: During the first 15 months, 203 codes for suspected SCA were dispatched; 197 were confirmed SCA. The overall survival was 5.6% (11/197) survival improved from 2.9% (4/134) with emergency medical system intervention to 11.1% (7/63) when the "Progetto Vita" was activated (p < 0.05). The survival rate on "shockable" rhythm was 43.7% in the group of patients treated by volunteers vs 16.6% in those treated by emergency medical system aid (p = 0.05). CONCLUSIONS: The widespread use of semiautomatic external defibrillators allows early defibrillation by non-medical volunteers and more than triples the survival rate following out-of-hospital SCA.