Is the obligatory placement of automated external defibrillators (AEDs) in public areas likely to improve survival rates in patients with out-of-hospital cardiac arrest?
Bernd W. Böttiger: I am a little bit critical of installing AEDs everywhere because it can also be a danger if the lay persons are not well educated. For example, I remember a story when a very famous German singer, Udo Jürgens, collapsed in Switzerland, this was a witnessed arrest, and his driver did not start cardiopulmonary resuscitation (CPR), which would have been life-saving, but he started to run to the train station to get an AED and there he lost a lot of time.
For us the most important thing is to educate lay persons to start CPR. If you then have reached high levels of lay CPR rates in a country, you may think about installing AEDs at specific places. But this does not help if the lay persons are not educated and if they do not start CPR. I can tell you that in the city of Cologne, where I am from, our cardiologists together with a local bank installed more than 100 AEDs since 7, 8, or 9 years ago all over the city, and none of them have been used to save a life. Our focus is lay education in CPR. Thoracic compressions in adults without ventilation is the most important issue to save lives, so push hard and fast and do not think about AEDs at the beginning.