CARDIOLOGY/BRIEF RESEARCH REPORT Automated External Defibrillator Availability and CPR Training Among State Police Agencies in the United States Lior M. Hirsch, BS, Sarah K. Wallace, AB, Marion Leary, BSN, RN, Kathryn D. Tucker, BA, Lance B. Becker, MD, Benjamin S. Abella, MD, MPhil From the Center for Resuscitation Science and Department of Emergency Medicine (Hirsch, Wallace, Leary, Tucker, Becker, Abella), the Doris Duke Clinical Research Fellowship Program (Wallace), and the HeartRescue Pennsylvania Project (Leary, Tucker, Becker, Abella), University of Pennsylvania, Philadelphia, PA. Study objective: Access to automated external defibrillators and cardiopulmonary resuscitation (CPR) training are key determinants of cardiac arrest survival. State police officers represent an important class of cardiac arrest first responders responsible for the large network of highways in the United States. We seek to determine accessibility of automated external defibrillators and CPR training among state police agencies. Methods: Contact was attempted with all 50 state police agencies by telephone and electronic mail. Officers at each agency were guided to complete a 15-question Internet-based survey. Descriptive statistics of the responses were performed. Results: Attempts were made to contact all 50 states, and 46 surveys were completed (92% response rate). Most surveys were filled out by police leadership or individuals responsible for medical programs. The median agency size was 725 (interquartile range 482 to 1,485) state police officers, with 695 (interquartile range 450 to 1,100) patrol vehicles (“squad cars”). Thirty-three percent of responding agencies (15/46) reported equipping police vehicles with automated external defibrillators. Of these, 53% (8/15) equipped less than half of their fleet with the devices. Regarding emergency medical training, 78% (35/45) of state police agencies reported training their officers in automated external defibrillator usage, and 98% (44/45) reported training them in CPR. Conclusion: One third of state police agencies surveyed equipped their vehicles with automated external defibrillators, and among those that did, most equipped only a minority of their fleet. Most state police agencies reported training their officers in automated external defibrillator usage and CPR. Increasing automated external defibrillator deployment among state police represents an important opportunity to improve first responder preparedness for cardiac arrest care. [Ann Emerg Med. 2012;60:57-62.] Please see page 58 for the Editor’s Capsule Summary of this article. A podcast for this article is available at www.annemergmed.com. 0196-0644/$-see front matter Copyright © 2012 by the American College of Emergency Physicians. doi:10.1016/j.annemergmed.2011.11.034 INTRODUCTION Background Approximately 300,000 people experience sudden cardiac arrest annually in the United States. 1 Access to both automated external defibrillators and first responder cardiopulmonary resuscitation (CPR) are key determinants of survival from cardiac arrest. State police represent a unique class of potential first responders to medical emergencies in that they patrol a large network of highways within the United States, as well as the numerous travel plazas and rest stops along the interstate highway system. According to a recent Centers for Disease Control and Prevention–sponsored analysis of a US cardiac arrest surveillance registry, an estimated 20% of out-of-hospital cardiac arrests occur in public locations; of these, approximately 25% happen on highways and streets. 2 Importance Previous investigations have shown that law enforcement officers can be trained to effectively operate automated external defibrillators and that police automated external defibrillator programs are cost-effective. 3,4 In addition, studies have demonstrated that automated external defibrillator– equipped law enforcement agencies within large metropolitan cities achieve a decrease of call-to-shock time provided by police and are associated with an increase in patient survival from out-of-hospital cardiac arrest. 5,6 Because an increase in survival from out-of-hospital cardiac arrest was observed from the availability of early defibrillation supplied by out-of-hospital providers in rural communities, the deployment of automated external defibrillators among state police patrolling the highway Volume , .  : July  Annals of Emergency Medicine 57