Nov. 12, 2003 (ORLANDO, Fla.) — Ordinary people saving lives could be the answer to keeping more people alive after cardiac arrest a new study shows.
Researchers say that training volunteers to use defibrillators distributed in shopping malls, sports venues, and other public places can double the odds that cardiac arrest victims will survive.
Each year, nearly 460,000 Americans die after a cardiac arrest, most of which strike without warning. The heart suddenly stops beating, blood does not circulate, and victims immediately fall into unconsciousness. More than nine in 10 die before ever reaching the hospital.
Paramedics and firefighters are trained to use defibrillators to shock victims’ hearts back to normal — if they arrive in time. With only a five- to 10-minute window of opportunity, most do not.
Enter the new study, designed to see if placing defibrillators in public places for use by trained volunteers can improve the odds.
The study was presented here at a meeting of the American Heart Association.
For the study, defibrillators were placed in key locales at nearly 1,000 shopping centers, recreation centers, apartment complexes, entertainment complexes, and community centers in 24 cities across the U.S. and Canada.
The researchers then enlisted about 20,000 volunteers. All were taught to do CPR; half were also taught how to use the defibrillators.
During the next year and a half, the volunteers attempted to resuscitate nearly 300 cardiac arrest victims. Forty-four survived, 29 of whom were aided by volunteers using defibrillators in addition to CPR and 15 of whom were treated by those who performed CPR alone.
“Having trained teams with the ability and capability to use defibrillators early roughly doubles survival,” says Joseph Ornato, MD, chairman of the PAD Steering committee and professor and chairman of the department of emergency medicine at the Virginia Commonwealth University Medical Center in Richmond.
The trial also showed that the strategy is extremely safe, with no cases in which a person was inappropriately shocked or failed to be shocked when he should have been, Ornato says.
Cardiologists at the meeting were extremely enthused about the results.
Raymond J. Gibbons, MD, chairman of the AHA committee on Scientific Sessions program and Arthur and Gladys D. Gray, professors of medicine at Mayo Medical School in Rochester, Minn., say the trial is extremely important from a public health viewpoint, “clearly demonstrating the value of training people to use defibrillators in the kinds of public places that were described.” He says he expects the AHA to help spearhead efforts to get more defibrillators in public spaces and train additional volunteers.
Training is simple, Gibbons says, with studies showing that even eighth graders can be taught to use the device correctly.
Jerry Potts, PhD, director of science for ECC programs at the AHA’s national office in Dallas, says the defibrillator’s “perfect safety record” in the public setting of the trial also “gives us a lot of confidence that safety is high when used by trained lay people.”
The National Heart, Lung, and Blood Institute, which funded the trial, has embarked on a companion study to find out if placing defibrillators in the homes of people at high risk of cardiac arrest and training family members to use them will save even more lives.
Noting that 80% of the cardiac arrests that occur outside the hospital each year in the U.S. occur in the home, Ornato says, “That’s the ultimate test. Placing defibrillators in public places is a bridge, a next step, while we await those results.”