International Circulation: Could you give us a brief introduction of current application and achievement of automated external defibrillator (AED) in US?

　　《国际循环》:您能简要介绍一下美国AED的应用现状和已取得的成绩吗?

　　Richard Page: The modern AED has been around now for over a decade and is part of the American Heart Association’s Chain of Survival. At the Heart Rhythm Society we are strongly support AEDs being available in public places. My first work exposure to the AED was with American Airlines. We demonstrated， and published in the New England Journal of Medicine in the year 2000， that 40% of patients who had cardiac arrest due to ventricular fibrillation on an airplane actually survived to be discharged from the hospital. Even more impressive in terms of survival was the casino experience where almost 75% survived if they underwent resuscitation within 3 minutes. AEDs have been shown in the PAD trial to reduce mortality as well. In the United States AEDs are now required in many public places including airports and federal buildings. They are becoming more and more common. I think they should be as common as fire extinguishers.

　　International Circulation: Who can use an AED? Does it require special training or can everyone use it?

　　Richard Page: The AED is a very simple device. It has been shown that a 6th grader， someone who is about 12 years old， can figure out how work an AED within a minute and a half without any training. Likewise， a recent study showed that with minimal familiarity one could use an AED and apply it successfully. In some countries and in some states there is a sign which states “only for use by medical personnel.” I encourage everyone to learn CPR and to learn how to use an AED. If I were to have a cardiac arrest， I would much rather have someone take an AED and use it on me even without training， just following the simple instructions. The reason is two-fold. One is that the AED is simple to use. The other is that the chance of doing harm is very small. On American Airlines flights about half of the uses were for use as a monitor， not for use for loss of consciousness. Most cases were not ventricular fibrillation. The device correctly determined whether ventricular fibrillation was present and only advised a shock if it was appropriate. Even if someone doesn’t understand anything about AEDs， the device will not allow him or her to shock unless the rhythm would benefit from the shock. The bottom line is that anybody should be allowed to use an AED as they need rather than wait (if a trained person is not available) because the chance of survival is much less if one has to wait for an ambulance to arrive.

　　International Circulation: How many AEDs have been distributed in the Unites States?

　　Richard Page:  I don’t have the numbers but they are very common in some places. For example， you can see an AED every couple of minutes as you walk through an airport. In federal buildings they are universal. Unfortunately many places do not have an AED now and they are not as frequent as fire extinguishers， although I wish they were.

　　International Circulation: Is it a good practice to put AEDs in schools?

　　Richard Page:  The issue of AEDs in schools is somewhat debated although I personally think they should be present. The cost analysis is hard to interpret. But the tragedy of a young person dying suddenly when they might have had a benefit of an early shock and might have survived is such that I am a strong advocate for AEDs in schools. In addition the AED may save the life of a teacher， an administrator， a visitor to the school， or someone attending an athletic performance. So for thesee reason AEDs in schools should be universal. Currently many public schools already have AEDs. Some states require them now. In addition to that， many schools have independently made the decision that they want to provide them because of the tragedy when there is a cardiac arrest， that life could have been saved.

　　Richard Page教授: 现代体外自动除颤器AED已经应用了十年以上，并且已经成为美国心脏学会的Chain of Survival的一部分。在心律协会，我们非常支持体外自动除颤器应用于公共场所。我的第一项关于AED的研究是在美国航空公司进行，结果发表于2000年《新英格兰医学杂志》，证实在飞机上由于心室颤动引致心脏骤停的患者有40%能幸存下来并最终出院。印象更加深刻的是CASINO研究，结果显示如果在3分钟内及时进行复苏，其中75%的患者将会存活。PAD试验也证明AED可以减少死亡率。在美国，目前很多公共场所包括机场和联邦建筑都要求设置AED，AED正变得越来越平常。我认为AED应该象灭火器一样常见，但显然还没有达到这种程度。

　　尽管AED是否应该进入学校仍有争议，但是以我个人的意见，认为应该如此。很难进行成本分析，但是一个年轻人突然死亡，而如果及早电击本来有机会存活的这种悲剧促使我强烈建议AED进入学校。另外，AED也可以挽救教师、管理者、参观者或参加运动会的人员的生命。因此，AED应该在学校配置。目前，许多公立学校已经有了AED;一些州要求学校这样做。还有很多学校自主决定配备AED，因为他们想在突然发生心脏骤停时提供帮助以避免悲剧，使得生命可以被挽救。