The Importance of AED’s

The importance of AED’s (Automated External Defibrillator’s)

According to the WHO (World Health Organization), coronary heart disease is the leading cause of death worldwide, claiming the lives of more than 7 million sufferers every year. Similarly, the American Heart Association says that up to 475,000 Americans die of cardiac arrests in any given year. Out of that 475,000, more than 350,000 of these incidents are outside of hospital cardiac arrests (OHCA’s), with 90% of these reported to be fatal.

 

These alarming statistics have urged the state and federal governments to require public establishments such as workplaces, shopping centers, and other places with high traffic to have access to AED’s. The National Safety Council surmises that up to 40,000 deaths due to cardiac arrests can be prevented if this medical equipment were more accessible to the public.

 

There’s no doubt that AED’s can save lives. With that being said, what is an AED and what does it do?

 

What does an AED do? 

 

You might have seen this medical equipment in public places; an encased tool located conspicuously and in plain sight. Unlike a first aid kit, an automated external defibrillator is what you need in tackling a more serious health emergency like sudden cardiac arrest (SCA).

 

This serious health problem is often confused with a heart attack. For those who are unaware, a heart attack is caused by a blockage in the heart’s blood vessels, preventing proper blood flow and causing the heart to stop. A sudden cardiac arrest, on the other hand, is an electrical malfunction, causing an erratic blood pumping action. An abnormal heart function can trigger loss of consciousness and breathing difficulties.

 

SCA can affect anyone regardless of age, and there are rarely any warning signs. Fortunately, an AED device can be used to check a person’s heart rate and provide an electric shock to correct the malfunction, if necessary. This medical device can save lives by detecting two abnormal heart rhythm functions: Ventricular Fibrillation and Ventricular Tachycardia. Once it detects abnormal heart rate, it notifies the user to send an electric shock to restore its normal rhythm.

 

This medical device may look complicated, but it’s relatively easy to use. Apart from monitoring heart rates and delivering an electric shock, it also provides rescuers with instructions on how to perform Cardiopulmonary Resuscitation (CPR) properly.

 

CPR is defined as a lifesaving first aid procedure applied to a person whose heartbeat has stopped. It can also be performed in people who have stopped breathing, for instance, those who have been saved from drowning. The procedure aims to restore the flow of oxygen towards the brain and the body’s other vital organs.

 

Part 2 coming soon: The Importance of Access to AED’s

 

Network of Automated External Defibrillators in Poland before the SARS-CoV-2 Pandemic: An In-Depth Analysis

Introduction: Sudden cardiac arrest (SCA), which causes more than half of all cardiovascular related deaths, can be regarded as a common massive global public health problem. Analyzing out-of-hospital cardiac arrest (OHCA) cases, one of the key components is automatic external defibrillators (AEDs). Aim: The aim of this study was to analyze the use and distribution of AEDs in Polish public places.

Materials and methods: The data were analyzed by using the Excel and R calculation programs. Results: The data represents 120 uses of automatic external defibrillators used in Polish public space in the period 2008–2018. The analysis describes 1165 locations of AEDs in Poland. It was noted that the number of uses in the period 2010–2016 fluctuated at a constant value, with a significant rise in 2017. When analyzing the time of interventions in detail the following was noted: the highest percentage of interventions was observed in April, and the lowest in November; the highest number of interventions was observed on a Friday, while the least number of interventions was observed on a Sunday; most occurred between 12:00 to 16:00, and least between 20:00 to 8:00.

Conclusions: The observed growth in the number of cases of AED use in public places is associated with the approach to training, the emphasis on public access to defibrillation, and, therefore, the growth of social awareness.

This study will be continued. The next analysis would include 2020–2022 and would be a comparative analysis with the current research.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9331639/

Location of out-of-hospital cardiac arrests and automated external defibrillators in relation to schools in an English ambulance service region

Introduction: This study sought to identify the availability of automated external defibrillators (AEDs) in schools in the region served by West Midlands Ambulance Service University NHS Trust (WMAS), United Kingdom, and the number of out-of-hospital cardiac arrests (OHCA) that occurred at or near to schools. A secondary aim was to explore the cost effectiveness of school-based defibrillators.

Methods: This observational study used data from the national registry for OHCA (University of Warwick) to identify cases occurring at or near schools between January 2014 and December 2016 in WMAS region (n = 11,399). A school survey (n = 2,453) was carried out in September 2017 to determine the presence of AEDs and their registration status with WMAS. Geographical Information System mapping software identified OHCAs occurring within a 300-metre radius of a school. An economic analysis calculated the cost effectiveness of school-based AEDs.

Results: A total of 39 (0.34%) of all OHCAs occurred in schools, although 4,250 (37.3%) of OHCAs in the region were estimated to have occurred within 300 metres of a school. Of 323 school survey responses, 184 (57%) had an AED present, of which 24 (13.0%) were available 24 h/day. Economic modelling of a school-based AED programme showed additional quality-adjusted life years (QALY) of 0.26 over the lifetime of cardiac arrest survivors compared with no AED programme. The incremental cost-effectiveness ratio (ICER) was £8,916 per QALY gained.

 

Conclusion: Cardiac arrests in schools are rare. Registering AEDs with local Emergency Medical Services and improving their accessibility within their local community would increase their utility.

https://pubmed.ncbi.nlm.nih.gov/35911779/

Defibrillators added to FDA’s list of device shortages

The Food and Drug Administration added automated external defibrillators (AED) to its list of medical devices in short supply. The AED supply disruption reflects both surging demand and problems sourcing a component, part or accessory. For wearable and non-wearable AEDs, the supply disruption is expected to last for the duration of 2022, the FDA said. In a footnote, the FDA added there is a global shortage of semiconductor chips that are essential to some medical devices. The regulator linked to the footnote in its description of the problems with a component, part or accessory that are affecting AEDs. Six entries — two AEDs and four ventilators — are linked to the chip shortage.

https://www.medtechdive.com/news/defibrillators-chest-drains-device-shortages/627665/

Facility-Level Factors and Racial Disparities in Cardiopulmonary Resuscitation within US Dialysis Clinics

  • Clinics caring for Black versus White cardiac arrest patients have significant differences in quality, resources, and patient case mix.
  • Accounting for differences in clinic characteristics between Black versus White cardiac arrest patients did not reduce race disparities in cardiopulmonary resuscitation.
  • Relative to younger patients, older Black patients were less likely to receive cardiopulmonary resuscitation (including AED use) in dialysis clinics compared with older White patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9255868/

The Impact of Medical Students Teaching Basic Life Support to Laypersons

Basic life support (BLS) courses for laypersons, including cardiopulmonary resuscitation (CPR) training, is known to improve outcomes of out-of-hospital cardiac events. We asked medical students to provide BLS training for laypersons as a part of their emergency medicine education and evaluated the effects of training on the BLS skills of laypersons. We also used a questionnaire to determine whether the medical students who provided the BLS training were themselves more confident and motivated to perform BLS compared to students who did not provide BLS training. The proportions of laypersons who reported confidence in checking for a response, performing chest compressions, and automated external defibrillator (AED) use were significantly increased after the BLS training. The proportions of medical students who reported increased confidence/motivation in terms of understanding BLS, checking for a response, chest compression, use of AED, and willingness to perform BLS were significantly greater among medical students who provided BLS instructions compared to those who did not. BLS instruction by medical students was associated with an improvement in laypersons’ CPR accuracy and confidence in responding to cardiac arrest. The results indicate that medical students could gain understanding, confidence, and motivation in regard to their BLS skills by teaching BLS to laypersons.

https://pubmed.ncbi.nlm.nih.gov/35790356/

Importance of proper management of automated external defibrillators

To increase the functionality of AED, strict and reasonable guidelines may be helpful. The article outlines the guidelines for managing registered AED in South Korea.

In South Korea, a law regulating AED was established in 2007, which stipulates AED installation in specific places which provides guidelines for public access defibrillation placement and management since 2010. According to the guidelines, installation and usage of AED should be reported to a public health centre by the chief manager of each installed AED.  The government provides budgetary support for the installation and management of AEDs by covering the costs for the replacement of pads and batteries. Such a guideline with national policy support including funding could contribute to the spread of AED usage and increase the survival rate of patients with out-of-hospital cardiac arrest.

https://www.resuscitationjournal.com/article/S0300-9572(22)00591-3/fulltext

Trends in maintenance status and usability of public automated external defibrillators during a 5-year on-site inspection

This study aimed to assess the trend of the maintenance status and usability of public automated external defibrillators (AEDs). Public AEDs installed in Seoul from 2013 to 2017 were included. An inspector checked the maintenance status and usability of the AEDs annually using a checklist.

During the study period, 23,619 AEDs were inspected. Access to the AEDs was improved, including the absence of obstacles near the AEDs (from 90.2% in 2013 to 99.1% in 2017, p < 0.0001) and increased AED signs (from 34.3% in 2013 to 91.3% in 2017, p < 0.0001). The rate of AEDs in normal operation (from 94.0% in 2013 to 97.6% in 2017, p < 0.0001), good battery status (from 95.6% in 2013 to 96.8% in 2017, p = 0.0016), and electrode availability increased (from 97.1% in 2013 to 99.0% in 2017, p < 0.0001); the rate of electrode validity decreased (from 90.0% in 2013 to 87.2% in 2017, p < 0.0001).

The overall rate of the non-ready-to-use AEDs and AEDs with less than 24-h usability accounted for 15.4% and 44.1% of the total number of AEDs, respectively. Although most AEDs had a relatively good maintenance status, a significant proportion of public AEDs were not available for 24-h use.

Invalid electrodes and less than 24-h accessibility were the main reasons that limited the 24-h usability of public AEDs.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9232625/

Sudden death in young athletes: Is it preventable?

Sudden death in young athletes is a rare but always dramatic condition. Unlike all other rare diseases, the estimate of its real incidence is made complex not only because of the uncertain number of correctly identified cases (numerator) but also because of the uncertain estimation of the real number of the reference population, the athletes (denominator). New elements of complexity are also emerging with regard to prevention.

The current two pillars of prevention are pre-participation screening (proactive strategy) and promoting use / access to the automated external defibrillator (reactive strategy). The standardization of procedures implemented over the past two decades for pre-participation screening can now allow us to assess the impact of this approach. The result is complex to evaluate. While screening may allow the identification of conditions potentially associated with SDA, and therefore the adoption of specific treatments, in about 0.4% of screened subjects, a single study investigated the yield in terms of mortality showing a positive predictive value of 4.7% with 25% sensitivity.

Conversely, the reactive strategy appears considerably effective, due to the widespread use of the automated external defibrillators in sports facilities, calling for a homogeneous implementation worldwide. On a broader perspective, the vast attention devoted to SDA prevention in the world of sports represents a major driver for transfer of a reactive prevention strategy to the general population.

https://pubmed.ncbi.nlm.nih.gov/35718646/