Lifesaving AEDs are being increasingly mandated across states -- but bystanders aren't using them, study finds

Bystander use of AEDs for witnessed out-of-hospital cardiac arrests remains low despite legislative efforts to improve access to the devices, according to a new study.

Bystander use of automated external defibrillators, or AEDs, for witnessed out-of-hospital cardiac arrests remains low despite legislative efforts to improve access to these life-saving devices at recreational facilities across the United States, according to a study recently published in the Journal of the American Medical Association.

Researchers at the University of Texas Southwestern Medical Center and the University of Missouri-Kansas City reviewed how frequently bystanders used AEDs in 9,290 cases of witnessed cardiac arrest at recreational facilities, based on data from the Cardiac Arrest Registry to Enhance Survival (CARES). They further compared the frequency of AED use among states with and without enacted laws requiring the presence of AEDs on site at recreational facilities.

Although 46.8% of patients with out-of-hospital cardiac arrest had shockable heart rhythms, bystander use of AEDs remained low across the country, with only 19% of bystanders using AEDs in AED-enacted law states, and 18.2% of bystanders using AEDs in non-law states, the JAMA study, published Jan. 2, found.

Low rates of "bystander use of AEDs could be due to several reasons, including lack of AED availability on-site," "unawareness that an AED is available, or not knowing where it is located," wrote Dr. Ahmed Kolkailah, corresponding author of the study, from the division of cardiology at the University of Texas Southwestern Medical Center. "Even if an AED is available, bystanders may not know how to use it or may be afraid of causing harm."

Bystander cardiopulmonary resuscitation was only performed in 5,693 cases, or 61.3%, the study found. Additionally, rates for surviving an out-of-hospital cardiac arrest and making it to the hospital were similar for patients living in AED law states (44.5%) and non-law states (45.0%).