The appropriate placement of automated external defibrillators (AEDs) is critical to optimize their use in public places, according to two studies published in Circulation: Journal of the American Heart Association.
Sudden cardiac arrest is the sudden, abrupt loss of heart function. Without immediate bystander cardiopulmonary resuscitation (CPR), brain death and permanent death start to occur in just four to six minutes after someone experiences cardiac arrest. Cardiac arrest can be reversed by immediate bystander CPR and treatment within a few minutes with an electric shock to allow the heart to restore a normal heartbeat. More than 92 percent of out-of-hospital cardiac arrest victims don’t survive to hospital discharge. In cities where bystander CPR and defibrillation is provided within 5 to 7 minutes, the survival rate from out-of-hospital sudden cardiac arrest is as high as 30 percent to 45 percent, according to the American Heart Association.
In one study, researchers found that school-based AED programs have a high rate of survival for students and others on school grounds.
Researchers found that 83 percent of 1,710 U.S. high schools with AED programs that they studied had an established emergency response plan for sudden cardiac arrest. However, only 40 percent practiced and reviewed their plans at least annually with potential school responders.
Of 36 cases of sudden cardiac arrests at the 1,710 schools:94 percent received bystander CPR,
Three factors — prompt recognition of sudden cardiac arrest, the presence of a trained rescuer to initiate CPR and access to early defibrillation through on-site AEDs — are critical to improving survival from sudden cardiac arrest in schools, said Jonathan A. Drezner, M.D., lead author of the study and associate professor and team physician in the Department of Family Medicine at the University of Washington-Seattle.
“It is not just about the AEDs — schools must have a comprehensive emergency response plan for sudden cardiac arrest that includes training anticipated responders in CPR and AED use, access to an AED, and practice and review of the response plan,” Drezner said.
“It is crucial to recognize that AEDs permit early defibrillation not only in young athletes but also in other individuals who may experience an unexpected sudden cardiac arrest. We found that more than half of sudden cardiac arrest events reported in schools occur in adults working at the school or attending a school event. Schools are a strategic location for AED programs to serve large concentrations of people at risk for sudden cardiac arrest.”
In a Danish study, researchers examined strategic placement of AEDs in public urban locations. A significant amount of interest and money is focused on AED deployment and public access defibrillation programs worldwide, but knowledge about where and how widespread AED deployment in the community should be is lacking, said Fredrik Folke, M.D., lead author of the study and a cardiology research fellow at Gentofte University Hospital, Hellerup, in Denmark.
To evaluate whether public AEDs were located where the majority of cardiac arrests occurred, Folke and colleagues digitally marked the exact locations of all arrests on a map and then analyzed the locations of 104 AEDs placed in municipal institutions in Copenhagen, Denmark, from 1994 through 2005. About 25 percent of out-of-hospital cardiac arrests occurred in public places.
According to the cardiac arrest analysis, carefully choosing AED coverage in 10 percent of the city area would provide coverage for about 67 percent of all cardiac arrests occurring in public. The highest rates of cardiac arrest in cities were in high-density public areas such as major train stations, large shopping centers, central bus terminals and sports centers.
“Our findings suggest that public access defibrillation programs should cover the greatest possible number of arrests in public, which is consistent with the recommendations from the American Heart Association,” Folke said. “But if AED deployment in the community is driven by local or political initiatives and not on strategic AED placement, there is a high risk of AEDs being placed primarily in low-incidence areas of cardiac arrest and hence low likelihood of the AEDs ever being used.”
Placing AEDs in about 10 percent of the city area cost an estimated $41,000 per extra year of a survivor’s life — deemed “acceptable” by the researchers. However, unguided AED placement trying to cover the entire city had an estimated cost of $108,700 per extra life year.
In an accompanying editorial, Dianne L. Atkins, M.D., a pediatric cardiologist at the University of Iowa, wrote that the two “informative” studies demonstrate that the mere presence of an AED in the general area of an arrest does not guarantee success. Successful AED programs require immediate bystander CPR and non-equipment components in addition to AED-availability, she said.“The need for ongoing CPR training, fully-developed and executed emergency plans and links to EMS are vital to the immediate and long-term outcomes of shock delivery,” Atkins wrote.
Co-authors, funding sources and author disclosures can be found on the respective manuscripts.
Statements and conclusions of study authors that are published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at www.americanheart.org/corporatefunding.
Gentle sensors for diagnosing brain disorders
29.09.2016 | King Abdullah University of Science and Technology
New imaging technique in Alzheimer’s disease - opens up possibilities for new drug development
28.09.2016 | Lund University
Researchers from the Institute for Quantum Computing (IQC) at the University of Waterloo led the development of a new extensible wiring technique capable of controlling superconducting quantum bits, representing a significant step towards to the realization of a scalable quantum computer.
"The quantum socket is a wiring method that uses three-dimensional wires based on spring-loaded pins to address individual qubits," said Jeremy Béjanin, a PhD...
In a paper in Scientific Reports, a research team at Worcester Polytechnic Institute describes a novel light-activated phenomenon that could become the basis for applications as diverse as microscopic robotic grippers and more efficient solar cells.
A research team at Worcester Polytechnic Institute (WPI) has developed a revolutionary, light-activated semiconductor nanocomposite material that can be used...
By forcefully embedding two silicon atoms in a diamond matrix, Sandia researchers have demonstrated for the first time on a single chip all the components needed to create a quantum bridge to link quantum computers together.
"People have already built small quantum computers," says Sandia researcher Ryan Camacho. "Maybe the first useful one won't be a single giant quantum computer...
COMPAMED has become the leading international marketplace for suppliers of medical manufacturing. The trade fair, which takes place every November and is co-located to MEDICA in Dusseldorf, has been steadily growing over the past years and shows that medical technology remains a rapidly growing market.
In 2016, the joint pavilion by the IVAM Microtechnology Network, the Product Market “High-tech for Medical Devices”, will be located in Hall 8a again and will...
'Ferroelectric' materials can switch between different states of electrical polarization in response to an external electric field. This flexibility means they show promise for many applications, for example in electronic devices and computer memory. Current ferroelectric materials are highly valued for their thermal and chemical stability and rapid electro-mechanical responses, but creating a material that is scalable down to the tiny sizes needed for technologies like silicon-based semiconductors (Si-based CMOS) has proven challenging.
Now, Hiroshi Funakubo and co-workers at the Tokyo Institute of Technology, in collaboration with researchers across Japan, have conducted experiments to...
14.10.2016 | Event News
14.10.2016 | Event News
12.10.2016 | Event News
21.10.2016 | Health and Medicine
21.10.2016 | Information Technology
21.10.2016 | Materials Sciences