Chan adds that the use of AEDs in public settings, however, remains essential.
"Although our study found that an AED does not appear to be useful in the hospital setting, that does not mean that an AED is not useful outside the hospital, especially in public places," Chan said. "Because hospitals are equipped with staff that can perform CPR effectively, shock patients when needed, and give important cardiac arrest medications, the benefits of AEDs in a hospital may be harder to realize than outside the hospital."
The research concludes that hospitals relying on AEDs should reconsider treatment approaches.
"Our institutional CPR committee has struggled with what to tell the first person who responds to the bedside of a patient in cardiac arrest," says Steven Kronick, MD, assistant clinical professor of emergency medicine and director of advanced cardiac life support at the University of Michigan Health System, whose investigators helped research the study.
"This study supports that continuous chest compressions should be provided immediately and without interruption until the cardiac arrest rhythm can be determined. It also shows that in the hospital setting, rhythm identification should be done by the medical provider rather than by the AED, where delays in rhythm analysis can be significant," Kronick said.
More than 50,000 AEDs have been purchased by hospitals alone since 2005.
"Time to defibrillation is an important quality metric, but there has been no silver bullet to achieve shorter times to treatment to date," Chan says. "AEDs have been touted as a logical solution, and hospitals are buying these in increasing quantities. But, they do not appear to improve survival. In order to improve the quality of in-hospital resuscitation, we need to go back to the drawing board and do the hard work to identify innovative strategies to improve survival for cardiac arrest patients."