An Automated External Defibrillator can get a heart pumping again after a cardiac arrest or infarction. Yet few people have an AED themselves, while it increases the chance of survival.
Shocking intervention
17 percent survive
There is an AED in NS stations, supermarkets, airports, shopping centers, cafes and restaurants. Such an Automated External Defibrillator can restart the heart in the event of a cardiac arrest or infarction. Although such an incident usually occurs at home, few people own such a device.
The AEDs have experienced a stormy rise, says Jocelyn Berdowski, researcher at the Academic Medical Center (AMC) in Amsterdam. Around 2000, the defibrillator was removed from the hospital and installed on a trial basis on a number of police and fire engines, which often arrive faster than ambulances. The test showed that the faster the device was used in the event of an acutely disturbed heart rhythm, the greater the chance of survival. Berdowksi investigates how many AEDs are outside the
medical circuit.
Shocking intervention
An AED is a box that delivers an electric shock to a person whose heart is no longer pumping efficiently. There are two electrodes attached to the box that are glued to the chest. The AED uses these stickers to analyze whether the heart rhythm is disturbed to such an extent that a shock must be administered. The power surge also goes through those stickers.
There are two (frightening) situations in which an AED can be used. The first is if the patient has a sudden ‘cardiac arrest’ and suddenly collapses. The person is unconscious and not breathing normally; the heart rhythm is probably disturbed. The heart does not literally stand still, but ‘fibrillates’: the heart cells no longer contract neatly at the same time, but work past each other in a chaotic rhythm. A shock can restore that rhythm.
In the second case, the patient complains of ‘chest pain’, which is actually a heavy pressure in the chest, sometimes with radiation to other parts of the body. Then there may be a heart attack that can turn into a disturbed heart rhythm. Delivery of a shock can restore this.
When someone has acute heart problems, it is important that bystanders immediately call the emergency number 112 and report that there is probably a cardiac arrest. Then they have to plug in the AED, which hopefully is nearby, and listen to the commands. The device guides the user through CPR, announcing, for example, “Now you must press the Shock button” or “Now you must begin CPR.”
17 percent survive
Patients with an acutely disturbed heart rhythm who do not receive help die. If help is provided by AED, chest compressions and mouth-to-mouth resuscitation, on average 17 percent survive. If you only look at the group who initially used AED among trained laymen, that percentage is 25 percent. The faster the AED is used; the better it is. Within two minutes after 112 has been called, the chance of survival is 75 percent, but help can usually not be provided that quickly, at most if, for example, an ambulance is already ready for a major event. With the ticking of the clock, the odds drop pretty quickly; every minute counts. For example, the survival rate is 50 percent if a shock is delivered within six minutes, and 36 percent if it is delivered within ten minutes.
People who have been resuscitated in any way after a ‘cardiac arrest’, with massage, or with an AED, or by paramedics, and who have come out alive, have a good chance of recovering well. Nearly 90 percent function ‘neurologically well’ upon discharge from hospital: they are physically independent and can think well again. At most, they suffer from a minor disturbance in consciousness or general functioning. After six months, this group is usually back to normal. “Those who get through it well will improve over time,” says AMC researcher Berdowski. In about 10 percent, the neurological abnormalities are much more severe. “I sometimes wonder with some of them if it wouldn’t have been better for them if the CPR had not been attempted,” Berdowski said.
More information: www.6minutes.nl.
Do you have experience with CPR; as a patient, care provider or bystander? We will come back to the topic shortly. We’d love to hear your experiences! Write to the editors of Plus Magazine, PO Box 44, 3740 AA Baarn or to health@plusmagazine.nl.
Sources):
- Plus Magazine
