Originally Published MDDI January 2003

NEWSTRENDS

Gregg Nighswonger

It has been more than two years since legislation was passed to require increased public access to automated external defibrillators (AEDs). More than 40,000 AEDs have been deployed in public places, such as police cars, hotels, sports arenas, high schools, and manufacturing plants. In fact, the Federal Aviation Administration has ruled that U.S. airlines must carry AEDs. Last November, 62-year-old Michael Tighe became the first airline passenger on a domestic flight to have his life saved by an onboard AED.

Use of such devices is widely viewed as being critical to increasing survival rates. The American Heart Association, for example, suggests that as many as 50,000 lives could be saved each year if communities could achieve a 20% cardiac arrest survival rate.

Now, the lifesaving devices are being made available to those who want the ability to respond to incidents of cardiac arrest within the home, where some studies have shown 70% or more of cardiac arrests happen.

In November, FDA cleared the HeartStart Home Defibrillator, manufactured by Royal Philips Electronics (Best, Netherlands). According to Philips, the device is "the first of a new generation of defibrillators designed specifically for the home." According to Deborah DiSanzo, vice president and general manager for cardiac resuscitation at Philips Medical Systems, "The HeartStart Home Defibrillator was carefully designed to help people of various ages and abilities use the technology successfully when faced with an emergency situation. We believe that the HeartStart Home Defibrillator allows Philips to extend the ability to help save a life to this newest group of responders."

Jeoffrey K. Stross, MD, professor of internal medicine at the University of Michigan Medical Center (Ann Arbor, MI), says "Defibrillator technology has evolved significantly during the last several decades, resulting in automated devices that are intuitive, simple to operate, portable, easy to maintain, and relatively inexpensive." He adds that technology improvements have allowed defibrillators to be distributed through public access defibrillation (PAD) programs. Such programs, says Stross, "make the devices available to trained and targeted responders such as firefighters, police officers, flight attendants, corporate emergency response teams, and even the general public. Because most cardiac arrests occur in the home, defibrillators designed for home use have the potential to complement and extend the progress of PAD programs in improving SCA survival outcomes."

Stross cites studies that have demonstrated the ease of use of these new-generation defibrillators. "During mock cardiac arrests," says Stross, "sixth-grade children delivered shock therapy with an AED with only modestly slower rates than emergency medical technicians and paramedics (90 seconds vs. 67 seconds)." He explains that none of the children touched the pads or the mannequins during shock delivery, demonstrating that the devices were easy to use. Stross adds that additional data suggest that "laypersons aged 60 and older can successfully operate an AED after watching a short instructional video."

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