Use of portable
defibrillators by non-emergency responders on victims of cardiac
arrest doubled during a four-year period in Seattle and King
County, Washington. Survival rates were similar to or better
than those of people treated by emergency medical service
workers, researchers reported at the American Heart
Association’s Scientific Sessions 2003.
Public access
defibrillation (PAD) is when someone other than a traditional
emergency medical worker applies an automated external
defibrillator (AED) to treat out-of-hospital cardiac arrest.
Cardiac arrest occurs when the heart suddenly stops beating
normally and cannot pump blood to the rest of the body, causing
death within minutes, unless the patient gets cardiopulmonary
resuscitation (CPR). For many victims, an electrical shock to
the heart from an AED is their only chance for survival.
“PAD was used in
only a small proportion of all treated out-of-hospital arrests,
but the proportion increased over time,” said Thomas D. Rea,
M.D., M.P.H., an epidemiologist at the Division of Emergency
Medical Services, Public Health for Seattle and King County,
Wash.
Researchers
tracked out-of-hospital cardiac arrests treated by public access
defibrillation between January 1, 1999, and December 31, 2002,
in Seattle and King County. They wanted to determine how
frequently public defibrillators were used.
PAD accounted for
1.3 percent (50 people) of 3,754 cardiac arrests treated during
the study period, increasing from 0.82 percent in 1999 to 2.05
percent in 2002.
For those treated
with PAD, survival was 50 percent according to hospital
discharge data.
“This survival
rate is encouraging,” said Rea, although he added that the study
was not designed to determine whether PAD improves survival.
Businesses and
other entities in the community that bought their own AEDs and
trained responders registered with the Seattle area’s voluntary
Community Responder AED Program. In all, 457 AEDs were
registered, and more than 4,000 people were trained to use them.
“The primary aim
of the PAD program was to make sure that, in a cardiac arrest,
everything was in place so the victim would have the best chance
at survival,” Rea said.
About 250,000
U.S. residents die from sudden cardiac arrest each year,
according to the American Heart Association. This is about
half of all deaths from coronary heart disease.
Co-authors are
Linda Culley, B.A.; John A. Murray, M.D.; Barbara Welles, R.N.;
Carol E. Fahrenbruch, B.S., M.S.P.H.; Michele Olsufka, R.N.;
Mickey S. Eisenberg, M.D., Ph.D. and Michael K. Copass, M.D.