January 29, 1998 

Dennis Fotinos,

Chairperson,

Emergency and Protective Services Committee,

City of Toronto

Dear Chairperson Fotinos,

The use of defibrillators by emergency services has been extensively studied throughout the world and the overwhelming evidence of its efficacy for the treatment of cardiac arrest caused by ventricular fibrillation is well documented. Currently, defibrillation delivered by firefighters and paramedics in Toronto provides early access to this life saving measure for the community in the out-of-hospital setting. However, there is strong evidence that even earlier defibrillation can further improve the survival rate from cardiac arrest.

The technology to provide early defibrillation has now advanced sufficiently for consideration to be given to the wider use of this technology. Just as cardio-pulmonary resuscitation (CPR) was introduced into the community at large over the past decades with its concomitant impact on public awareness and improved survival from cardiac arrest, consideration is being given to introducing defibrillation to the public. The proposed inclusion of Toronto as one of the sites for the Public Access Defibrillation Trial (PAD)

will place our community in the forefront of out-of-hospital research. The potential to save more lives by even earlier rapid defibrillation delivered by members of the public followed by comprehensive out of hospital emergency care from firefighters and paramedics is an outstanding opportunity for our community.

Toronto Ambulance strongly endorses the proposal that Toronto become one of the sites for the Public Access Defibrillation Trial.

Yours truly,

Ron Kelusky,

Director, EMS Operations

pc. Barry Gutteridge