Cardiopulmonary Resuscitation in the Combat Hospital and Forward Operating Base: Use of Automated External Defibrillators

Objective time to defibrillation (t(defib)) directly correlates with survival from cardiac arrest. We investigated whether automated external defibrillators (AED) in a combat setting would improve this crucial variable. Methods: We performed a randomized simulation study to compare two systems of cardiac arrest response: public access AED vs. standard manual defibrillation. The study was conducted in two phases at two different settings: (1) in a contiguous United States (CONUS)-based training combat support hospital (CSH) and (2) at a deployed CSH within a combat forward operating base (FOB). The primary outcome was t(defib) and the secondary outcome was difficulty of use. Results: For the training CSH setting, t(defib), the AED model was significantly faster than the conventional model (1.3 vs. 2.0 minutes, p < 0.001, 95% Cl of the mean difference = 0.39-1.1). In the combat environment, t(defib) was between 2.2 and 8.4 minutes faster for the AED system. The AED system was found to be significantly easier to use than the standard model. Conclusion: In simulated cardiac arrest, the AED model demonstrated significantly improved t(defib) compared to the standard response for both training and combat settings.