Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Large-scale study proves volunteer operated defibrillators are life-savers

01.12.2005


The first large-scale study to see whether trained volunteers and lay people can use defibrillators to save the lives of cardiac arrest (CA) victims has concluded that their use by lay people is safe, and if the response time can be shortened to within eight minutes there is the potential to save the lives of 15 out of 100 people who collapse suddenly with CA.



Brescia in Italy – a large mixed rural and urban county with an area of more than 4,800 square kilometres and a population of well over a million – was the site for the Brescia Early Defibrillation Study (BEDS), the results of which are reported (Thursday 1 December) in the European Society of Cardiology’s journal European Heart Journal[1].

Dr Riccardo Cappato from Policlinico San Donato, University of Milan, and colleagues from the University of Brescia and the University of Washington in Seattle, USA, initiated BEDS after Italy passed a law allowing the use of automated external defibrillators (AEDs) by non-medical personnel.


A total of 2,186 volunteers and lay people received five hours of training involving theory and practical instruction, including training in basic life support, from 14 qualified instructors. One AED was supplied for every 22,700 of the population, in addition to the existing manually operated defibrillators used by the county’s 10 hospitals and in five medically equipped ambulances. The new volunteers were then organised into groups[2].

The study started in 2000, but for a two year period before that the team collected data to set the parameters for the study, including the numbers of CAs that happened outside of hospitals, the time it took for help to arrive and the number of patients who survived free of any neurological impairment one year after their heart attack. Further data were collected during a six-month pilot study. The historical cohort of 692 acted as comparisons for the prospective study, which involved 702 similar patients between 2000 and 2002.

Dr Cappato, who is Professor of Electrophysiology and Chief of the Arrhythmia and Electrophysiology Center in Milan, said: "Overall, we found that three out of a hundred patients in the prospective study survived to one year without any neurological problems, compared with under one out of a hundred of the earlier comparison group, even though the time from dispatching help to arriving with the patient was similar.

"There was an increase in survival for patients in both urban and rural areas, although it was significantly larger in the city than the countryside due to the shorter response time and larger number of defibrillators available. In the urban areas, survival rose from just under one and half persons per hundred in the earlier group to four per 100 in the study. In the rural areas it rose from one per two hundred in the earlier group to two and a half per hundred in the study. When you look at the relative gains though, as opposed to the absolute values, there was more benefit for the rural areas.

"However, there was a more than three times higher incidence of defibrillator teams being dispatched to CAs in urban areas (0.7 per 1,000 per year) than in the countryside (0.2 per 1,000 per year). This appears either to be mainly due to worse access in the country because of a higher incidence of CAs happening with no witnesses around, or a lower tendency for witnesses in rural areas to call out help."

For every quality adjusted life year (QALY)[3] saved during the study it cost less than 24,000 Euro (around 39,000 Euro during the start-up phase). The set-up costs were over one million Euro and the running costs once the system was established were around 681,000 Euro.

Dr Cappato said that the study had proved that defibrillators can easily and safely be exclusively operated by lay people. "This is an unprecedented finding and we hope that our study will serve as a benchmark for more systematic approaches in the future."

Operating the defibrillators did not require lots of training – only five hours, plus a three hour refresher course every six months. There were no problems or complications involving the operators in around 1,000 interventions.

It was though, he said, too early to expect national healthcare systems to be interested in supporting an ELPIS (Emergency Lay Person-Integrated Service).

"In our study, over three-quarters of the victims whose collapse was witnessed received defibrillation more than eight minutes after cardiac arrest. National standards require 90% of victims to be reached within eight minutes. Even so, it is worth noting that patients who received defibrillation later than the eight-minute threshold, accounted for a third of the those who survived at one year free of any neurological problems."

Dr Cappato said this finding outlined the need both for strenuous resuscitation efforts to be made with current technology even past the eight-minute point and for re-evaluation of early defibrillation programmes.

Dr Antonio Curnis, Chief of Electrophysiology at the Civil Hospital in Brescia and co-author of the study, said: "To make ELPIS widely feasible, we need to prove larger survival rates are achievable. I think it’s possible. The key lies in reducing the time between the person’s collapse and the arrival of the rescue team. If we can get that down to within eight minutes we could have 15% of CA patients surviving long-term, free of neurological damage. That is a huge number of lives given the incidence of CA in a population.

"It will need better organisation of the logistics and manpower, and co-operation among people with different professional specialties. It’s difficult, but it is possible."

Margaret Willson | EurekAlert!
Further information:
http://www.escardio.org/

More articles from Studies and Analyses:

nachricht Study relating to materials testing Detecting damages in non-magnetic steel through magnetism
23.07.2018 | Technische Universität Kaiserslautern

nachricht Innovative genetic tests for children with developmental disorders and epilepsy
11.07.2018 | Christian-Albrechts-Universität zu Kiel

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Unraveling the nature of 'whistlers' from space in the lab

A new study sheds light on how ultralow frequency radio waves and plasmas interact

Scientists at the University of California, Los Angeles present new research on a curious cosmic phenomenon known as "whistlers" -- very low frequency packets...

Im Focus: New interactive machine learning tool makes car designs more aerodynamic

Scientists develop first tool to use machine learning methods to compute flow around interactively designable 3D objects. Tool will be presented at this year’s prestigious SIGGRAPH conference.

When engineers or designers want to test the aerodynamic properties of the newly designed shape of a car, airplane, or other object, they would normally model...

Im Focus: Robots as 'pump attendants': TU Graz develops robot-controlled rapid charging system for e-vehicles

Researchers from TU Graz and their industry partners have unveiled a world first: the prototype of a robot-controlled, high-speed combined charging system (CCS) for electric vehicles that enables series charging of cars in various parking positions.

Global demand for electric vehicles is forecast to rise sharply: by 2025, the number of new vehicle registrations is expected to reach 25 million per year....

Im Focus: The “TRiC” to folding actin

Proteins must be folded correctly to fulfill their molecular functions in cells. Molecular assistants called chaperones help proteins exploit their inbuilt folding potential and reach the correct three-dimensional structure. Researchers at the Max Planck Institute of Biochemistry (MPIB) have demonstrated that actin, the most abundant protein in higher developed cells, does not have the inbuilt potential to fold and instead requires special assistance to fold into its active state. The chaperone TRiC uses a previously undescribed mechanism to perform actin folding. The study was recently published in the journal Cell.

Actin is the most abundant protein in highly developed cells and has diverse functions in processes like cell stabilization, cell division and muscle...

Im Focus: Lining up surprising behaviors of superconductor with one of the world's strongest magnets

Scientists have discovered that the electrical resistance of a copper-oxide compound depends on the magnetic field in a very unusual way -- a finding that could help direct the search for materials that can perfectly conduct electricity at room temperatur

What happens when really powerful magnets--capable of producing magnetic fields nearly two million times stronger than Earth's--are applied to materials that...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Within reach of the Universe

08.08.2018 | Event News

A journey through the history of microscopy – new exhibition opens at the MDC

27.07.2018 | Event News

2018 Work Research Conference

25.07.2018 | Event News

 
Latest News

Diving robots find Antarctic seas exhale surprising amounts of carbon dioxide in winter

16.08.2018 | Earth Sciences

Protein droplets keep neurons at the ready and immune system in balance

16.08.2018 | Life Sciences

3D inks that can be erased selectively

16.08.2018 | Materials Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>