Why are firefighters not part of the team?

There is sufficient international evidence to demonstrate that first responders, including professional firefighters, improve patient outcomes, especially from out-of-hospital cardiac arrest (Ho et al, 1997; Hollenberg et al, 2009; Hoyer and Christensen 2009). With demonstrated improvement in cardiac arrest outcomes by using first responders, this has led to a move in recent years to have automatic external defibrillators (AEDs) placed in prominent locations where large numbers of people congregate so that the response time to defibrillation is as short as possible (public access defibrillation (PAD)). This policy has proved to be successful in decreasing the response time to the person and subsequent defibrillation, albeit with small numbers in the studies compared to other ‘first responder’ programmes (Colquhoun et al, 2008; Fleischhackl et al, 2008).