Automated external defibrillators (AED) have been authorized for use by Emergency Medical Technicians (EMT) in Kentucky since March 1991. Emergency Medical Services (EMS) which use these devices are required to submit annual reports to the EMS Branch. During 1992, 17 services were approved to use AEDs. The device was used by 12 services on 93 victims of out-of-hospital cardiac arrest. Of the 93 victims, 27 were defibrillated, eight were resuscitated to hospital admission, and three survived to hospital discharge. The overall survival rate was 3/93 (3.2%). For patients receiving defibrillatory shocks, the survival rate was 3/27 (11%). This percentage is comparable with the survival rates reported from other predominately rural states where AEDs have been used by EMTs. Possible protocol violations and inadequate documentation were also identified from these reports. In summary, EMTs in predominately rural Kentucky can use AEDs to achieve survival rates for out-of-hospital cardiac arrest comparable with other rural states.