Sun
19
Apr
Practical Prevention – How defibrillators in public places can save lives
by Elizabeth Smoots, MD
What could be a more worthwhile form of prevention than saving someone's life? Sudden cardiac arrest victims feel fine one minute, then the next minute they are dead. But I've been hearing a lot about a new invention that could potentially change all that.
According to recent research, we might save many more lives by using these computerized gadgets called AEDs. These devices are effective, fairly simple to operate, and now readily available in many public places. The idea is to have them handy for trained members of the public to use immediately on cardiac arrest victims.
What could be a more worthwhile form of prevention than saving someone's life? Sudden cardiac arrest victims feel fine one minute, then the next minute they are dead. But I've been hearing a lot about a new invention that could potentially change all that.
According to recent research, we might save many more lives by using these computerized gadgets called AEDs. These devices are effective, fairly simple to operate, and now readily available in many public places. The idea is to have them handy for trained members of the public to use immediately on cardiac arrest victims.
Frequency of sudden heart death
Sudden heart death is a growing issue that's even beginning to affect teens and young adults in our country. According to a study publicized by the American Heart Association, deaths from cardiac arrest rose about 10% between 1989 and 1996 among young people ages 15 to 34. And though the rate of sudden heart death was twice as high in males as in females, the rate for females rose 30% over the study period compared with a 10% rise in males.
Researchers blame the trend on an increasing incidence of inactivity, obesity and other risk factors among our nation's youth. All told, heart disease is still the number one killer in the U.S. today, resulting in nearly one million deaths each year. Nearly half of these deaths occur suddenly and unexpectedly from cardiac arrest.
Researchers blame the trend on an increasing incidence of inactivity, obesity and other risk factors among our nation's youth. All told, heart disease is still the number one killer in the U.S. today, resulting in nearly one million deaths each year. Nearly half of these deaths occur suddenly and unexpectedly from cardiac arrest.
How rapid defibrillation helps
During cardiac arrest, the heart stops pumping and there is no effective heartbeat. The most common culprit is an irregular heart rhythm called ventricular fibrillation. The irregular rhythm causes the heart to fibrillate, or quiver uncontrollably, and renders the heart unable to pump blood around the body. This can lead to death in minutes.
According to recent studies, the single greatest factor in surviving cardiac arrest is early defibrillation. If ventricular fibrillation is stopped in one minute or less, survival rates can be as high as 90%. But when defibrillation is delayed, survival plunges to 50% at five minutes, 30% at seven minutes, 10% at 10 minutes, and less than 5% at 12 minutes. Automated external defibrillators have the potential to improve survival rates because they can be readily available outside of a medical setting and they are relatively easy to operate.
According to recent studies, the single greatest factor in surviving cardiac arrest is early defibrillation. If ventricular fibrillation is stopped in one minute or less, survival rates can be as high as 90%. But when defibrillation is delayed, survival plunges to 50% at five minutes, 30% at seven minutes, 10% at 10 minutes, and less than 5% at 12 minutes. Automated external defibrillators have the potential to improve survival rates because they can be readily available outside of a medical setting and they are relatively easy to operate.
Who should use an AED?
Increasingly, non-medical people are being trained to use defibrillators. The American Heart Association promotes the use of AEDs by police officers, firefighters, security guards, sports marshals, ski patrol members, ferryboat crews and airline flight attendants. Additional people who may benefit from AED training include family and friends of persons at high risk and even employees at worksites or public places where large numbers of people congregate.
The Centers for Disease Control and Prevention is conducting a two-year study to determine who should be trained in AED use and where the devices should be placed. AEDs are usually put in areas where they will most likely be needed, and where quick service by paramedics is not readily available. Common locations include airports, shopping malls, casinos, community centers and sports or medical facilities.
With more AEDs around, the key to safe and proper use is training. The American Heart Association and American Red Cross offer AED classes. When used by trained responders, the devices can be extraordinarily effective, with overall survival rates as high as 49%.
The Centers for Disease Control and Prevention is conducting a two-year study to determine who should be trained in AED use and where the devices should be placed. AEDs are usually put in areas where they will most likely be needed, and where quick service by paramedics is not readily available. Common locations include airports, shopping malls, casinos, community centers and sports or medical facilities.
With more AEDs around, the key to safe and proper use is training. The American Heart Association and American Red Cross offer AED classes. When used by trained responders, the devices can be extraordinarily effective, with overall survival rates as high as 49%.
How the devices work
In addition to being effective, recent advances in technology have made today's AEDs far safer and simpler to use. The lightweight portable devices have self-adhesive electrode pads that usually depict just where to stick them. Voice and text prompts guide the user through the few simple steps. The AED analyzes heart rhythm, automatically charges the machine when appropriate, and tells the user when to push the shock button. It then shocks the heart with a brief burst of electricity.
CPR is still important
For years people have been encouraged to learn cardiopulmonary resuscitation, or CPR. Learning to use an AED takes that lifesaving effort one step further. The American Heart Association says the four links in the chain of cardiac arrest survival are:
- Calling 911
- Early CPR
- Early defibrillation
- Early advanced medical care