Public Defibrillators: High-tech Life-savers or Expensive Gimmicks?
Public Defibrillators: High-tech Life-savers or Expensive Gimmicks?
Public defibrillators are not necessarily the best way to reduce rates of sudden death, say several U.S. experts in this month’s issue of British Medical Journal USA.
Their comments follow two recently published studies examining the benefits of placing automated external defibrillators (AEDs) in airports, stadiums and other public locations.
In the first study, use of defibrillators by police and fire fighters did not significantly increase survival, while the second study found that public place defibrillators were not good value for money.
AEDs are best seen as a component of CPR, suggest Dr. Paul Pepe and Sherry Caffrey-Villari. They refer to several studies showing better survival and recovery if basic CPR is given for a few minutes prior to the first shock.
Timing is everything, according to Dr. Myron Weisfeldt, Physician-in-Chief at Johns Hopkins University, as studies have shown that defibrillation within four minutes resulted in a high survival rate.
The challenge for the future is to bring its benefits to more individuals, he writes. This could include bringing defibrillation into the home, where 70% of cardiac arrests take place, and combining defibrillation with other interventions that will lead to better long term survival.
Finally, researchers at the Mayo Clinic College of Medicine point out that, even giving AEDs to all heart attack survivors would, at most, reduce rates of sudden death by 5%. In contrast, primary care physicians can reduce sudden death by 30% or more by simply advising patients to quit smoking, exercise regularly, and eat more oily fish.
