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In recent years, automatic external defibrillators have been popping up -- and saving lives -- in public spaces such as golf courses, airplanes, hotels, and shopping malls.

Mark Schonfeld, MD, associate clinical professor of cardiology at Yale University in New Haven, Conn., tells WebMD that what happens on the street can have a profound effect on what happens in the hospital and afterward.

"There's no doubt that the treatment modalities we have for patients who survive cardiac arrest are spectacular," he says. "But unless they make it to the hospital to begin with, their prognosis is ominous."

Above and beyond that, though, is the timely delivery of therapy out in the field, because if it's not done in the field then the outcome is also catastrophic.

"Unless they receive immediate medical care, patients who experience a sudden cardiac arrest away from medical attention may suffer severe brain damage from lack of oxygen in the brain," Schonfeld says.

In a study similar to the Miami studies, researchers from the Mayo Clinic in Rochester, Minn, the first U.S. city to equip and train police to use defibrillators, report that "long-term survival rate for sudden cardiac arrest can be very high when a community has a well-organized, prompt emergency defibrillation program."

Mayo Clinic internist T. Jared Bunch, MD, and colleagues looked at what happened to patients who received defibrillation in the field over a 10-year period, and found that of 118 patients who made it to the hospital alive, 52% survived to discharge. In comparison, in some cities only 1-2% of patients survive out-of-hospital sudden cardiac arrest, according to NASPE.

Schonfeld tells WebMD that in Seattle and Miami, two communities where aggressive, well-coordinated emergency cardiac care plans are in place, patient survival rates are significantly higher than in other U.S. cities.

"There is no doubt that these [automatic external defibrillators] have had a significant impact," he says. "They are ever-present in the community, and the ability to apply these will have a major impact in terms of survival for out-of-hospital cardiac arrest."

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