A Shocking Way to Save Lives
May 18, 2000 (Washington) -- We've all seen the dramatic scenario re-enacted
on television shows or films many times. A machine called a defibrillator
delivers a life-saving burst of electricity and restores a stricken heart
patient to a normal heart rhythm.
The reality, though, is that such heroics don't happen nearly often enough,
according to researchers meeting here at a medical conference here. New studies
show that the use of portable defibrillators could substantially reduce the
toll from sudden death in the U.S., which now stands at about 350,000
"Early defibrillation [or shocking the heart] is the key to
survival," says Robert Myerburg, MD, director of the division of cardiology
at the University of Miami School of Medicine. He says it's reasonable to think
we could cut the sudden death rate caused by heart problems by 10% yearly,
sparing about 35,000 lives.
However, it's estimated that less than 10% of patients survive this
scenario, which often produces the deadly rapid heartbeat known as ventricular
fibrillation. While CPR can sustain someone, only an electrical shock can
convert the heart to its proper pace.
On the flip side, if a person is fortunate enough to get defibrillated
within two-minutes of an attack, the survival rate is about 50%. Waiting for an
emergency rescue team takes precious minutes and decreases the survival rate
From police cars to playgrounds to airplanes, these defibrillators appear to
be making a difference. Perhaps, the most ambitious experiment with the laptop
computer-sized devices is under way in Miami. Starting last year, all 1,900
police cars in the city and county area were equipped with defibrillators at a
cost of $5 million.
It's still early in the experiment, but investigator Myerburg says this
first-of-its-kind effort has already cut response time and saved lives.
"Police on the road in a large city can save anywhere from four to five
minutes," Myerburg says. A defibrillator has two pads that stick to a
patient's chest, and a verbal and visual display prompts the operator what to
do. The device has been called "idiot proof" by some and can be
operated by someone with virtually no medical training.
He also says the officer's reluctance to use defibrillators was overcome, at
least in part, by allowing police personnel rather than doctors to do the
training. Simplicity of operation is a key issue in a device that can make a
life or death difference, and another study of defibrillators aboard airliners
shows they can be used successfully by trained flight attendants.
Over a two-year period, defibrillators were used on more than 200 passengers
aboard American Airlines flights. According to researchers, the defibrillators
got a perfect score for determining if a shock were necessary. Nine of the 21
patients who actually got treated on the plane were later released from the
hospital. Interestingly, a physician happened to be on the aircraft almost 70%
of the time to help out.