Historic breakthrough for public access defibrillation in Australia

Joshua G Kovoor, Gregory J Page and Pramesh Kovoor
Med J Aust 2023; 218 (5): 238-238. || doi: 10.5694/mja2.51855
Published online: 20 March 2023

To the Editor: Over 26 000 Australians experience out‐of‐hospital cardiac arrest (OHCA) each year, with almost nine in ten of these patients not surviving to hospital discharge or 30 days.1 Although it is known that swift defibrillation increases the possibility of patient survival in these situations, and that initial defibrillation by first responders (regardless of training) is associated with greater survival than initial defibrillation by emergency medical services,2 in Australia, less than 2% of OHCA cases receive defibrillation by a bystander.1 It is likely that this is driven by the limits to publicly accessible automated external defibrillators (AEDs) in Australian communities.3

On 30 November 2022, South Australia took a major step to deal with this problem and reduce death from OHCA. The SA Parliament passed the Automated External Defibrillators (Public Access) Bill 2022,4 making SA the first state or territory in Australia, and one of few in the world, to mandate the public provision of AEDs. The legislation, introduced by Member of the Legislative Council, the Hon Frank Pangallo of the SA‐BEST party, had bipartisan political support and backing from various organisations, and follows a recent public health campaign to install AEDs in Adelaide. The Bill will come into effect for government and public buildings in 2025 and a variety of private buildings in 2026, with awareness campaigns, grant programs, and communication with organisations being the focus of the interim period. The expected cost to the SA government of $7.2 million across four years is weighed against the $2 billion gross domestic product loss that Australia incurs annually as a result of sudden cardiac arrest.5

The health and economic benefits of public access defibrillation to Australian society are large. For the benefit of all Australians, other states and territories should follow the example set by SA and move to implement similar laws mandating the public availability of AEDs in their communities.

  • Joshua G Kovoor1
  • Gregory J Page2
  • Pramesh Kovoor3

  • 1 University of Adelaide, Adelaide, SA
  • 2 Heart of the Nation, Sydney, NSW
  • 3 Westmead Hospital, Sydney, NSW


The authors owe thanks to the Hon Frank Pangallo MLC and his Chief of Staff, Sean Whittington, for critical review of this manuscript.

Competing interests:

No relevant disclosures.

  • 1. Bray J, Howell S, Ball S, et al. The epidemiology of out‐of‐hospital cardiac arrest in Australia and New Zealand: A binational report from the Australasian Resuscitation Outcomes Consortium (Aus‐ROC). Resuscitation 2022; 172: 74‐83.
  • 2. Baekgaard JS, Viereck S, Moller TP, et al. The effects of public access defibrillation on survival after out‐of‐hospital cardiac arrest: a systematic review of observational studies. Circulation 2017; 136: 954‐965.
  • 3. Kovoor JG, Page GJ, Jui J, et al. Societal change is necessary to reduce sudden cardiac death. Heart Lung Circ 2022; 31: e159‐e160.
  • 4. Government of South Australia. Automated External Defibrillators (Public Access) Bill 2022. (viewed Nov 2022).
  • 5. Paratz ED, Smith K, Ball J, et al. The economic impact of sudden cardiac arrest. Resuscitation 2021; 163: 49‐56.


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