Automated External Defibrillators, also called AED’s are rapidly becoming recognized as the standard of care in the management of victims of SCA (sudden cardiac arrest) outside of a hospital environment. Defibrillation; a long time effective tool for paramedics, emergency departments and hospital intensive care units, is now available to the general public by way of the AED.
The AED is a small computerized device that delivers an electrical shock to a victim that is in full cardiac arrest and presents with abnormal heart rhythms. The shock stops the heart for an instant and allows it to reset. When a person suffers a cardiac arrest, has no breathing and no pulse, this does not mean that the heart has completely stopped. In an arrest, it is very common that the heart continues to function, but abnormally. Consequently, because of abnormal rhythms the heart is unable to pump blood effectively. When the heart is unable to pump blood effectively, the body is unable to acquire the needed oxygen to sustain life.
The result of this inability to obtain the needed oxygen is death. In an unconscious person, the absence of breathing and a pulse is indication for using an AED immediately. When the electrode pads of an AED are applied, the device begins its analysis. If ventricular fibrillation or ventricular tachycardia is recognized, the device will advise that a shock is needed. It will then charge to the set energy range (usually 150 joules in adults) and prompt the rescuer to press the flashing shock button. Defibrillation is a way to reset the heart much like rebooting your computer. During a cardiac arrest, every minute that defibrillation is delayed reduces the victims chance of survival by about 10%. Recent studies have shown that if an AED is available to a victim of SCA within three to five minutes, it could increase the chance of survival by 40% or more.
AED’s are now available to the public and are now appearing anywhere from shopping malls and fitness centers to sports arenas and cruise ships. The cost for an AED is around $800.00 to $3500.00 per unit, depending on what model and how many you buy. I think that’s a relatively small price to pay when compare to life, especially when we live at a time where the cost of TV sets can be twice that. Late in 2004, the FDA approved the first over the counter AED for home use. This means that you do not need a prescription to purchase it. The only AED currently approved for home use is the Philips HeartStart Home Defibrillator. When turned on the AED offers step by step voice instructions to guide you through the process. It literally tells you what to do and eliminates much of the decisions making process for the operator.
Clinical trials are still underway studying the in home use of AED’s. The jury is still out and the results won’t be available for some time. There isn’t any specific criteria listing whether or not and AED is appropriate for your home. This should be considered on and individual basis and after consultation with a doctor. Because it is considered part of the standard of care for victims of SCA, and it is so effective, I would expect that companies and organizations will be taking a closer look at the AED in the near future. It is very simple to use and makes responding to victims of SCA so much easier and manageable, not to mention that it increases the victim’s chance of survival. Organizations need to explore all options available to them and consider whether or not they are providing the current industry standard of care for those who are injured or ill on the job and in the community. The current research and data is clear that AED’s save lives if applied in a timely manner and that they are extremely easy to use. It is also clear that having an AED accessible within a few minutes is more effective then only performing CPR until emergency crews arrive.
M. Morales
