Automated External Defibrilator (AED)

Student: AB

Health Communication

Automated External Defibrillator

Sudden cardiac arrest (SCA) is a leading cause of death in the United States and Canada.¹ There is a difference between cardiac arrest and a heart attack in that a heart attack involves a blockage in a portion of the heart, while cardiac arrest stems from the insufficient function or stopped function of the heart.⁴ Problems associated with the heart can occur anywhere and at any time.  Trained medical personnel will not always be near individuals experiencing heart trouble, so it is imperative that a standard is set in place to reduce the death, hospitalization, and long-terms effects associated with experiencing any cardiac problem.

The American Heart Association estimates that over 300,000 individuals suffer the effects of SCA every year in the United States alone.  Roughly half of those incidences take place outside of a medical facility.  This fact necessitates the need for an automated external defibrillator (AED) to be place in more public areas.  It may take more than just supplying places with an AED, but rather equipping the public of knowledge of what an AED is, and how it can be used to help an individual experiencing a SCA.

An AED can be used to save lives if the machine is readily accessible.² Sherry L. Caffery et al. conducted a survey in Chicago at the O’Hare Airport demonstrating that when an AED was nearby and used within the first five minutes of the cardiac arrest, the survival rate of the individual increased.  A majority of the individuals who operated the AED were bystanders acting in good faith.  Approximately half of the bystanders had no medical degrees, no training, or no experience with using an AED.  If these bystanders could operate an AED without training or experience, it goes to show that almost anybody can operate an AED.

A study conducted by John W. Gundry et al. showed that naïve sixth graders, without prior experience of operating an AED, could operate an AED only moderately slower than trained professionals.³ The findings of this study compounded with the findings from Caffery’s airport study, shows that adults and children alike can operate an AED with or without training or previous experience. The location of an AED should then be placed in reasonable distances for both children and adults to access in case of an emergency.

A trained professional knows that an AED can deliver an electric shock to an individual experiencing SCA to help restore the function of the heart.  The National Heart Lung and Blood Institute define an AED as “a portable device that checks the heart rhythm and can send an electric shock to the heart to try to restore a normal rhythm”.  Some trained professionals such as EMS workers can be equipped to use multiple methods to stabilize an individual.

Since it is known that an AED can deliver a shock to an individual in order to help restore a normal rhythm, a cross comparison should be analyzed between the cost of an AED to traditional, historical EMS methods. A study by G. Nichol concluded that, “Where cardiac arrest is frequent and response time intervals are short, rapid defibrillation by targeted nontraditional responders may be a good value for the money compared with standard EMS.” The findings of this study are evaluated from a median quality-adjusted years using interquartile ranges. AEDs were found to be cost effective for a public institution if the treatment time was short and/or the probability or cardiac arrest is on the upper, or high rate.⁶

There are grants available to not only help individuals supply a public place with an AED, but to also train employees of a public institution where an AED shall be housed on the proper protocols and operating procedures. Funding can be found online at www.aedgrant.com/aed-grant-news.htm. This site offers trainings in AED and CPR, a method for comparing AEDs to see which would suit your institution the best, and an option to donate to the cause amongst other links. Some community organizations may already have initiatives in place to help supply various public institutions with an AED.

 One should always be familiar with the various laws associated with the use of an AED. The Sudden Cardiac Arrest foundation has provided links to laws with explanations on their website, www.sca-aware.org/aed-laws . There are federal and state laws for AED use, so one should govern their use accordingly. Many states now allow The Good Samaritan Law to give critical protection to an individual seeking to own an in-home AED.⁷

A key thing to note and remember is that an AED will not be a means to treat every heart problem, nor should it be considered an be-all and end-all. AEDs are used to restore a normal heart rhythm. In the case of a blockage or other nonrhythmic problem, an AED shock would be just as viable as cardiopulmonary resuscitation (CRP).⁵ If the use of an AED is required by a bystander, medical attention by certified medical professionals such as those at the nearest hospital should be alerted. With multiple programs already established to equip public places with AEDs such as Public Access Defibrillaton (PAD), it is a goal to reduce the rate or individuals succumbing to the ill effects of SCA.

 References:

1. Abella, Benjamin A. et al (2008). “Reducing Barriers for Implementation of Bystander-Initiated Cardiopulmonary Resuscitation: A Scientific Statement from the American Heart Association for Healthcare Providers, Policymakers, and Community Leaders Regarding the Effectiveness of Cardiopulmonary Resuscitation”. Circulation Journal of the American Heart Association. 117:704-709

2. Caffery, Sherry L. et al (2002). “Public use of Automated External defibrillators”  The New England Journal of Medicine. 347:1242-1247

3. Gundry, John W. et al.(1999) “Comparison of Naïve Sixth-Grade Children with Trained Professionals in the use of an Automated External Defibrillator” Circulation Journal of the American Heart Association. 100:1703-1707

4. Mayo Clinic Staff (2010). “ Sudden Cardiac Arrest Defintion” retrieved on 9/23/11 at www.mayoclinic.com/health/sudden-cardiac-arrest/DS00764

5. Mayo Clinic Staff (2011). “Automated External defibrillators: Do you need an AED?” Heart arrhythmias. Retrieved on 9/23/11 at www.mayoclinic.com/health/automated-external-defibrillators/HB00053

6. Nichol, G. et al (2003). “Cost Effectiveness of Defibrillation by Targeted Responders in Public Settings” Circulation Journal of the American Heart. 108:697-703

7. “The Good Samaritan Law for AED users”  The Good Samaritan Law. Retrieved on 9/24/11 at chfs.ky.gov/NR/rdonlyres/B954EF52-7BE0-440A-84B6-3C2C8B8709E4/0/KentuckyGoodSamLaw.pdf