X-Message-Number: 22089
Date: Fri, 27 Jun 2003 14:26:47 -0400
From: "Raphael T. Haftka" <>
Subject: Defibrillators

Put your money where your mouth is?


Thanks for all who replied to may query about the cost effectiveness of 
defibrillators. In particular, Catherine Gaspar was as usual a good source of 
information. Some advised me to spend my money to keep my weight down, take care
of my cholesterol, get married, etc. I probably should have said in my original
message that I had already done all of these things. However, even though my 
heart is in good shape mechanically and the pipes are not clogged, I have 
arythmia, which increases my chances for a heart attack. After checking on the 
subject, I am leaning  to the view that de-fibrillators are a good investment. 
The following article that I got from pub-med was particularly interesting.

Public use of automated external defibrillators.

Caffrey SL, Willoughby PJ, Pepe PE, Becker LB.


City of Chicago Department of Aviation, O'Hare International Airport, Chicago, 
IL 60666, USA. 


BACKGROUND: Automated external defibrillators save lives when they are used by 
designated personnel in certain public settings. We performed a two-year 
prospective study at three Chicago airports to assess whether random bystanders 
witnessing out-of-hospital cardiac arrests would retrieve and successfully use 
automated external defibrillators. METHODS: Defibrillators were installed a 
brisk 60-to-90-second walk apart throughout passenger terminals at O'Hare, 
Midway, and Meigs Field airports, which together serve more than 100 million 
passengers per year. The use of defibrillators was promoted by public-service 
videos in waiting areas, pamphlets, and reports in the media. We assessed the 
time from notification of the dispatchers to defibrillation, survival rate at 72
hours and at one year among persons with cardiac arrest, their neurologic 
status, and the characteristics of rescuers. RESULTS: Over a two-year period, 21
persons had nontraumatic cardiac arrest, 18 of whom had ventricular 
fibrillation. With two exceptions, defibrillator operators were good Samaritans,
acting voluntarily. In the case of four patients with ventricular fibrillation,
defibrillators were neither nearby nor used within five minutes, and none of 
these patients survived. Three others remained in fibrillation and eventually 
died, despite the rapid use of a defibrillator (within five minutes). Eleven 
patients with ventricular fibrillation were successfully resuscitated, including
eight who regained consciousness before hospital admission. No shock was 
delivered in four cases of suspected cardiac arrest, and the device correctly 
indicated that the problem was not due to ventricular fibrillation. The rescuers
of 6 of the 11 successfully resuscitated patients had no training or experience
in the use of automated defibrillators, although 3 had medical degrees. Ten of 
the 18 patients with ventricular fibrillation were alive and neurologically 
intact at one year. CONCLUSIONS: Automated external defibrillators deployed in 
readily accessible, well-marked public areas in Chicago airports were used 
effectively to assist patients with cardiac arrest. In the cases of survivors, 
most of the users had no duty to act and no prior training in the use of these 
devices. Copyright 2002 Massachusetts Medical Society

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