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A Shocking Way to Save Lives

WebMD Health News

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 annually.

"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 dramatically.

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.

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