About a decade ago, American Airlines and other decided to equip their airplanes with Automated External Defibrillators (AEDs). Since that time, casinos, airports, shopping centers, schools, churches, sports venues and just about every airline in the world have followed and in public places, you're likely to see AEDs widely distributed.
AEDs are computerized devices designed to be simple to use and provide defibrillation (an electrical shock) only when appropriate. They can be used by non-medical personnel because you don't need to know how to read an EKG to use the device safely.
By 2003, AEDs had been proven to decrease the risk of death from sudden cardiac arrest (usually due to heart attack) in airplanes and casinos.
In late 2003, the Public Access to Defibrillation (PAD) trial was presented at the American Heart Association annual meeting. Almost 20,000 non-medical volunteers had been randomly assigned to one of two groups. Volunteers in the first group were trained to call 911 and begin CPR. In the second group, training included 911, CPR and AED use. Both public places and private residences were included in the study, though the majority of events occurred in the former. Over 21 months, survival to hospital discharge was 54% higher with responders in the AED-trained group.
In 2007, the Resuscitation Outcomes Trial (ROC) demonstrated a 2-fold increase in survival with AED vs. EMS based defibrillation.
More recently, the Home AED Trial (HAT) showed a 33% decrease in mortality from sudden cardiac events with home AEDs. The result was not statistically significant, probably because the overall number of events was very small (likely a testament to the preventive benefit of aspirin and medications to treat elevated blood pressure and cholesterol).
The bottom line is that you cannot get on a major commercial airliner, visit a Vegas casino, or attend a high school football game without an AED being nearby. For patients at high risk (those who have known or suspected coronary disease or risk factors for coronary disease) or for whom the cost of the device (about $1,500 each - and not covered by insurance) is not prohibitive, an AED at home and work may be reasonable. There are several brands, and multiple models of AEDs. We prefer (and keep in our office) the Phillips HeartStart professional model. We can provide these to patients who wish to purchase them. Linda in our office is American Red Cross certified to teach both CPR and AED use and will teach you, your family or your office staff how to use the device. Let Sherri know if you'd like more specific information about the device or training.
Written / Posted by: Scott W. Yates, MD, MBA, MS, FACP
