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Currents Winter 2002-2002Currents
Recent Studies
What About Private Access Defibrillation?
Public access defibrillation has had gratifying success, and new PAD programs continue to be implemented. But the stark fact remains that the majority of sudden cardiac arrests take place in the home. Will the near future find AEDs hanging on dining-room walls? The Department of Health Services of the University of Washington in Seattle and the King County EMS Division recently published reports on three aspects of that possible future.
Will Doctors Prescribe Them?
Cardiologists in Washington State were surveyed. Of the 144 in the sample, 85% believed that AEDs could be effective – but only 7% had ever prescribed one. Those who were reluctant gave as their reasons that (1) AEDs are not yet considered the standard of care (71%), (2) AEDs are not covered by insurance (67%), and (3) the cardiologists had concerns about adequate training for the lay operator (58%).
Sandison T, Meischke H, Schaeffer SM,
Eisenberg MS. Barriers and facilitators to
the prescriptions of automated external
defibrillators for home use in patients
with heart disease: a survey of cardiolo-gists.
Heart & Lung. 2001;30:210-215.
How Can Family Members Best Be Trained to Use Them?
Face-to-face instruction was compared with video-based instruction for effectiveness in AED use on a manikin. No clinically meaningful distinctions were found between the two instruction methods in AED performance of seniors at the initial assessment. At the 3-month follow-up, however, almost 25% of the trainees were not able to deliver a shock and almost 50% were not able to correctly place the pads on the manikin. Retention remains the hallenge.
Meischke H, Rea T, Eisenberg MS,
Schaeffer SM, Kudenchuck P. Training
seniors in the operation of an automated
external defibrillator: a randomized trial
comparing two training methods. Ann
Emerg Med. 2001;38:216-222.
Could Dispatcher Assistance Make a Difference?
Participants in this study were 150 senior citizens (ages 58 to 84 years) in King County, Washington, who had received AED training approximately 6 months previously. Those assisted by dispatchers were more likely to correctly deliver a shock with the AED during
the simulated VF cardiac arrest (91% versus 68%, P=0.001). Those successfully administering the shock with the help of the dispatcher took an average of 45 seconds longer to do so than those who successfully administered shocks without the assistance. Dispatcher
assistance showed an approximate 10% relative overall survival advantage despite the slightly longer time to shock.
Ecker R, Rea TD, Meischke H, Schaeffer
SM, Kudenchuck P, Eisenberg MS.
Dispatcher assistance and automated
external defibrillator performance among
elders. Acad Emerg Med. 2001;8:968-973.
For more information about these studies,
contact Hendrika Meischke at 206-296-4693
or email hendrika@u.washington.edu.
10 Winter 2001-2002©2001 American Heart Association
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