Defibrillators - Good or Bad

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A new study suggests having defibrillators installed in public places slightly increases the likelihood that victims of cardiac arrest will survive.

The study surveyed 19,000 volunteer respondents who had access to automated external defibrillators (AEDs) in places like malls and apartment complexes. Having immediate access to an AED in addition to using CPR yielded 30 survivors in 128 cardiac arrests, compared to 15 survivors in 107 cardiac arrests where only CPR was available.

The authors of the study concluded that "trained laypersons can use AEDs safely and effectively in a variety of public locations."

Volunteers were trained to use AEDs on airplanes, ferries, ski hills and "other locations where volunteer AED response provides the only hope of survival."

Studies show that 20 per cent of all cardiac arrests -- defined as attacks where the heart stops beating -- happen in public. Cardiac arrest is not the same as a heart attack. A heart attack happens when an artery is blocked. During a heart attack, the person is conscious, has a pulse and is breathing.

Conducted by researchers at St. Paul's Hospital in Vancouver, the study's participants came from across North America.

One of the cardiac arrest victims who survived thanks to an AED is Tom Dallas. He went unconscious at his fitness centre in Whitby, Ontario.

"The last thingI remember is feeling quite dizzy. Then three minutes later I remember a paramedic smiling at me," Dallas said.

A woman who was at the scene when the cardiac arrest happened said one of the fitness centre staff ran and grabbed the AED.

"They hooked it up to him and they had to give him a shock to get his heart back in rhythm," the woman said.

The AED had only been installed in the fitness centre two weeks earlier, and staff were only recently trained. Dallas is relieved all of the precautions were in place.

"If it weren't for the defibrillator, I wouldn't be here," he said.

"AEDs can double the rate of survival in areas with ambulance response, such as those included in this study," said its author, Dr. Jim Christenson, director of research in the Emergency Department of St. Paul's.

A second study published in the New England Journal of Medicine has revealed that it's not always the advanced techniques and medications administered by paramedics that save lives.

"The more rapid a defibrillation you can get, the more likely you are to be saved," said Dr. Ian Stiell of the Ottawa Health Research Institute.

In Vancouver, more than 1,000 volunteers were trained and AEDs were put in 60 community locations, including shopping malls, office towers, golf courses, casinos and major hotels.

The study trained about 20,000 volunteer rescuers in 24 cities in the U.S. and Canada.

Fortunately, newer machines have made operating a defibrillator surprisingly simple. But because the majority of cardiac arrests happen at home -- where there are no defibrillators -- some say the focus should be on CPR. Unfortunately, only 15 per cent of Canadians know how to perform it.

"Paramedics need you to buy time, to perform CPR until we get there," said Gary Wright of Toronto Emergency Medical Services. "It's simple and it's easy to use."

The new research shows that public defibrillators, coupled with more training in CPR, could save more than 2,000 lives a year across Canada.

Researchers say it costs about $100 Cdn to train an individual in both CPR and how to operate an AED. The defibrillator units cost about $3500 Cdn.

The information appears in the New England Journal of Medicine