The Results Were Shocking
November 15, 2016

The Results Were Shocking

If you’ve ever watched a hospital drama on TV, you’ve watched a scene like this. A doctor is overly attached to his dying patient. His attempts to revive the patient by shocking his heart are futile. When the heart doesn’t respond after multiple tries, the doctor shouts, “Again!” But the rest of the team has thrown in the towel.:. Someone gently removes the defibrillator paddles from the doctor’s desperate hands.

Those scenes are dramatic, but there is a defined protocol for using defibrillators in the hospital. It’s a part of Advanced Cardiac Life Support (ACLS). Anyone who uses defibrillators has been trained in that protocol. They know exactly what to do in a resuscitation situation. This includes what medications to administer when, how high to charge the paddles, and what heart rhythms they should shock and which ones they should definitely not shock.

But this is where it gets exciting (in real life, not on TV). Because the protocol is defined, a computer can administer it. It can stop a user from shocking too quickly after a previous shock. It can notice a heart rhythm that should not be shocked. And that’s exactly what Automatic External Defibrillators (AEDs) do.

These machines offer the benefits of defibrillation outside of the hospital. You might see them in shopping malls, airports, and other places where crowds of people congregate. If someone collapses in one of these places, bystanders can use an AED to attempt to revive the individual.

A recent study published in the New England Journal of Medicine found AEDs to be quite effective in saving lives of people who experience cardiac arrest outside the hospital.

The study was conducted in Japan, where they looked at outcomes for 43,762 patients with bystander-witnessed ventricular-fibrillation arrests of cardiac origin. The endpoint of the study was “survival at one month with favorable neurologic outcome.”

About ten percent of the patients received public-access defibrillation, and a month later, 38 percent of those had a favorable outcome. Of those who did not receive defibrillation, only 18 percent did as well. Neither sounds particularly appealing, but if you find me on the ground, go ahead and shock me.

Cardiovascular disease is still the world’s number one killer and bystander use of AEDs is one way to chip away at it. But we must increase their usage. In this study it was only employed in 10 percent of the cases it could have been. If it had been employed in every case, it would have translated to over 7,000 more good outcomes (i.e., lives saved).

So what’s the take-away here? First, if you see someone collapse, ask the facility if they have an AED (do it quickly!). Second, encourage places you do business with to keep AEDs on site. Third, ask your lawmakers to make this a public health priority. Odds are good that heart disease will affect someone you love. These steps can help keep them alive.

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