Letters Cardiopulmonary resuscitation

All UK trains should carry automated external defibrillators (AEDs)

BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e7611 (Published 13 November 2012) Cite this as: BMJ 2012;345:e7611
  1. Matthew D Hale, medical student1,
  2. Riituparna Banerjee, registrar anaesthetist2,
  3. Dudley Bush, consultant anaesthetist2
  1. 1Leeds University, Leeds, UK
  2. 2Department of Anaesthesia, Leeds General Infirmary, Leeds LS1 3EX
  1. um08mh{at}leeds.ac.uk

One of us (DB) was recently involved in a medical emergency on a mainline train and was surprised to find that no automated external defibrillator (AED) was carried.1 AEDs require minimal training to use, are designed for use by non-medical operators, and often include both audio and visual instructions to enable use by people who are visually or hearing impaired. For an immediate or life threatening emergency the target UK ambulance response time is eight minutes, and such a target may not be achievable if cardiac arrest occurs while the train is between stations.2

We subsequently contacted all major national and local UK train services (n=26) about whether they carried AEDs. A response was received from 18 companies, none of which carried AEDs on their trains.

AEDs have been shown to be effective in saving lives in aircraft and trains in the US.3 4 An AED may be purchased for as little as £771 (€967; $1233). For a train carrying 200 passengers the estimated cost of an AED per person for that single trip would be £3.86 per person. If that train were to carry 1000 passengers a day on average for a year then the cost of providing an AED on that service would be less than one penny per passenger.

It is the recommendation of this study that given the low cost of providing AEDs, their known benefit, and their ease of use, all UK trains should carry AEDs.


Cite this as: BMJ 2012;345:e7611


  • Competing interests: None declared.