Are you prepared to try and save a life if someone’s heart stops before your eyes?
Several recent studies underscore how important it is for bystanders to be prepared to use an external defibrillator and perform cardiopulmonary resuscitation, yet how few are ready and willing to act.
Dutch researchers reported interviews with more than 1,000 travelers from 38 nations as they passed through Amsterdam’s main rail station last year.
Less than half of those surveyed (47 percent) said they would be willing to use an automated external defibrillator stored in a public place to help someone who appeared to be in cardiac arrest. More than half (53 percent) did not recognize one of the devices. Only 28 percent correctly identified the AED, knew its purpose and expressed willingness to use it.
Just over a third were aware that anyone is allowed to use an AED — 49 percent said only trained personnel could use the devices. Most who said they wouldn’t use the machine in an emergency said it was because they didn’t know how it worked (69 percent) followed by fear of harming a victim (14 percent).”
“AEDs are increasingly available in public places, but it is only beneficial if a bystander is willing to use it,” said Dr. Patrick Schober, a researcher at University Medical Center in Amsterdam who led the study published online by the Annals of Emergency Medicine.
Cardiac arrest is a leading cause of death in the United States and Europe. The American Heart Association says there are at least 300,000 episodes of cardiac arrest outside of hospitals in the U.S. each year, yet only 30 percent receive any type of CPR and even fewer, perhaps 10 percent, are treated with an AED.
The portable medical devices are easy to use, come with simple instructions and include diagnostic software that automatically assesses whether a patient is suffering from a heart rhythm abnormality that can benefit from a shock before prompting the operator to deliver current.
Significantly, another study published last month by researchers at the National Institutes of Health found that the types of cardiac arrest that can be treated by electric stimulation occur with greater frequency in public places than they do at home. The study reviewed more than 14,000 instances of cardiac arrest, including more than 2,000 that occurred in a public place. Of those occurring in public places, 79 percent were so-called “shockable” events, compared to about a third of the events that took place in a home.
The difference likely reflects to some extent differences in the age and underlying medical problems of people who go into cardiac arrest at home rather than out in public, the researchers said, but also noted that differences in how quickly someone starts treatment in a public place versus at home probably plays some role.
More than a third of the patients who experienced cardiac arrest in a public place and were treated with an AED survived. Survival among those treated with an AED after a cardiac arrest at home was 12 percent.
“AED use in the home will benefit some patients, but not nearly as consistently as in public places,” said Dr. Myron Weisfeldt, a cardiologist at Johns Hopkins University in Baltimore and lead author of the study. “At home, it is even more important to call 911 to get the emergency medical services activated and to perform CPR.”
The American Heart Association agrees. In January, it issued a science advisory calling on state legislatures to mandate that CPR and AED training be made a requirement for high school graduation.
“Bystander CPR can double or triple survival from cardiac arrest,” said Mary Fran Hazinski, a professor of nursing at Vanderbilt University and co-author of the advisory statement.
Having more people trained in CPR and the workings of AEDs would make the first link in a “chain of survival” from sudden cardiac arrest stronger by putting more bystanders on the streets able to recognize and take the first responses necessary, Hazinski said.
According to the American Heart Association, during the 2009-10 school year, 36 states had a law or curriculum standard that encourages CPR training. But the association said that a mandate, along with funding to ensure that the teaching is done, is needed to have the greatest impact.
— Reach Lee Bowman at [email protected]