Friday, 14 May 2010

Automated external defibrillators - shockingly obvious!

Coronary heart disease kills more people world wide than any other disease put together. There is a sub-set within that generic that is probably the world's most prominent medical emergency; sudden cardiac arrest (SCA). Did you know that 400,000 people in the US, 700,000 people across Europe and an estimated 2 million people in China die from SCA every year? Truly a phenomenal amount of people. Sadly, the survival rate from SCA outside hospital is generally, at best, around 5%; look at it the other way around and that mean 95% of people suffering a SCA are dying. Even in hospital survival rate is no better than 15-20%.

The problem outside hospital in particular is due to the way we treat SCA. This is a life threatening condition for which the only effective therapy is defibrillation. However, traditionally the only place one would find a defibrillator is in the back of an ambulance. Now, given the fact that for every minute that passes without defibrillation survival falls by 7 to 10 percent one can clearly see that waiting ten minutes, at best, for an ambulance to arrive gives the SCA victim little chance of survival. Ambulance response times appear to be getting longer in some places due to a year-on-year increase in emergency calls coupled with less resources, traffic grid -lock in major cities contributing to their struggle to meet the needs of the population. Studies from around the globe have shown that by placing automated external defibrillators (AEDs) in public place can increase survival by over 70%. AEDs are easy to use, safe and effective devices that can be operated by non-medical persons with the minimum of training. By getting to the SCA victim and defibrillating them within 2 to 3 minutes can make a big difference to survival.

In 2004, the department of health in the UK, in conjunction with the British Heart Foundation, funded a defibrillation in public places programme, placing AEDs in railway stations, the London Underground system and the major airports in England. A study of the first 200-odd rescues showed an increase in survival from around 5% to 25% - a five-fold increase.

It is well accepted that AEDs are the way forward in saving lives from SCA, however the number of these devices is still small compared with the overall problem of SCA. By placing further AEDs in public places, workplaces, sports facilities and the like we can save more lives and increase survival considerably. Many individuals and organisations around the world are championing this cause, however unless the government of the day in these countries are prepared to stand behind this cause then the survival rate related to SCA will increase only slowly.

Many governments have implemented long term plans; healthy eating, stop smoking programmes or fitness regimes, these however are a slow drip, drip of preventative measures that will take several years to take effect. Saving lives should be the number one priority for any government and only by placing more AEDs will we be able to achieve both short term and long term survival for SCA victims.

Shockingly obvious wouldn't you agree?

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