Public Access Defibrillation Underutilized in Cardiac Arrest

(HealthDay News) — In out-of-hospital (OOH) cardiac arrest, public access defibrillation (PAD) prior to ambulance arrival may be only rarely used, according to a study published online February 19 in Heart.

Charles D. Deakin, MD, from South Central Ambulance Service in Otterbourne, U.K., and colleagues ascertained the availability and effective use of PAD in all OOH cardiac arrests in Hampshire over a 12-month period. To establish the known presence of PAD, emergency calls were reviewed; in addition, a review of all known PAD locations in Hampshire was undertaken.

The researchers found that 673 known PADs were located in 278 Hampshire locations during the study period. Of the 1,035 calls confirmed as cardiac arrest, access to an automated external defibrillator was reported in 4.25% of calls (44 occasions). The automated external defibrillator was successfully retrieved and used before ambulance arrival in 1.74% of cases (18 occasions).

“This study highlights the need for both improved PAD availability and the need to improve bystander confidence in the use of these devices,” the authors write. “With survival from OOH cardiac arrest doubling in cases where PAD is used, there is a need to improve PAD availability, publicize locations and support bystanders in deploying the device.”

One author disclosed financial ties to South Central Ambulance Service and Prometheus Medical.

Cardiac Arrest Survival 2012

Here we have a story from a lady who had a Cardiac Arrest in 2012. This story just shows why Defibrillators should become a necessity just like fire extinguishers are in shops and it also shows what an important role First Responders have in the chain of survival

This lady’s name is Sue and she has given us permission to show you her story. Sue lives in the local area of Staffordshire.

I suffered a cardiac arrest and survived

Wednesday 25 January 2012 was just like any other ordinary day, I got up and went to work. I can’t remember what the weather was like that day or what I was wearing, come to think of it I can’t really remember much about the few days previously. I do remember gradually waking up in Stafford hospital
about 6 or 7 or so days later to the beeping of machines. I remember feeling terrified and trying to express the fear with my eyes, as I could not talk because I had a tracheotomy. As I woke my family were there and doctors and nurses and the story of what had happened to me began to unfold. I had been sitting on the wall outside of work talking to my daughter Hayley who had come to meet me at lunch time to tell me how her first day on a university course had gone. None of this I really remember but I am told I had a sudden cardiac arrest.

Clair my other daughter said she had thought I had been looking rather grey and tired of late and with hind sight I remember having some hot flushes and palpitations’ and feeling very tiered, which I dismissed as being a part of my age and thought “oh just get on with it Susan”. I am told that my collapse was sudden and as my daughter and I sat chatting on the wall outside my work I said that I felt dizzy and was going to pass out. With a massive thud I hit the ground, despite Hayley trying to break my fall I hit my head and chest on the hard cobbles, cracking a cheek bone and putting my teeth through my lip. Hayley ran into my work and asked them to phone for an ambulance and then returned where a passerby helped to put me in the recovery position as at this time they thought that I had a pulse. As my daughter bent over to see if I was breathing, the first responders arrived, just as my breathing had stopped. They were there in less than three minutes. By this time my heart had stopped. I was dead! I was incredibly lucky that the first responders and paramedics were at my side within less than three minutes; They cleared my airway of blood, and gave me the all important defibrillation and then put a tube into my airway and began CPR, this continued in the short ambulance ride to the A&E department. I received a total of 40 to 45 minutes’ CPR.

Doctors and nurses believed that there was nothing further they could do and my family were told that I had passed away.My family were beginning to ring relatives and friends to inform them I had died, when a doctor returned some 20 or 30 minutes later to say miraculously they had found a pulse! However they were not very optimistic and warned that they could not be sure how long my brain had been starved of oxygen and that even if I did live I might have irreparable brain damage. My family then had to call
people back with the news that I was alive but critically ill and that there was only a small chance that I would survive and if I did I would most probably be brain damaged.

But I did survive and gradually and very gently nurses and doctors on Stafford Critical Care Unit began they to wake me up and six days later on my eldest daughter’s birthday I opened my eyes. As I woke up in the critical care unit my family told me of the amazing care I had received, I could not speak as I had to have a tracheotomy, for anyone who knows me you will understand how frustrated I became, this was possibly the worst part as I could not tell anyone how I felt. As I became more awake I was told that I had two broken ribs from the CPR, which had nicked a blood vessel and caused my chest cavity to fill with blood collapsing my lung. While I was asleep I had an emergency procedure to insert a chest drain, and again there were serious concerns as they tried to get the bleeding under control. My family told me of the skill and expert care that I had received and even going for tests was organised with almost military precision by several doctors and nurses. As the blood vessels would not stop bleeding I was given blood transfusions and heavily sedated and given drugs to paralyse me in order to try and stop the bleeding. Doctors also put me in an induced hypothermic state to try and reduce the brain damage that I might suffer The care I received in Stafford Critical care unit was nothing short of amazing I had a senior nurse by my side 24 hours a day, not only did they care for me but they looked after my family when I couldn’t, my family were with me around the clock and were emotionally and physically exhausted.

The nurses supported them with compassion and extreme care which helped them to stay positive when the doctors were not holding out much hope. The weeks passed and I became stronger and after about four weeks I was ready to get out of bed for the first time. I remember clearly how wonderful it was when I first stood up, feeling the air all around me, but my legs didn’t feel my own, they were like jelly, but I had to learn to walk again. At first it didn’t seem possible, but there was so much encouragement from the physio team and nurses even when they were short staffed they made time for me as they knew how important this was to me. It kept me going even in the tough times when I was so weak I thought that I would never walk again properly but I did at first with the aid of a Zimmer frame, then with sticks, it was hard work but I was determined to get on my feet again. One nurse even washed my hair while I lay in bed as she knew that this was something important to me, I remember we laughed a lot and she got very wet feet. I had my first shower after four weeks it was amazing, I began to feel almost human again.

After a month I was well enough to leave critical care and onto the cardiology ward. While there I was put on a monitor which showed that not only had I had a cardiac arrest but that I was having 6 to 8 second pauses where my heart would stop, but these only happened at night. I had an angiogram which came back normal so no furred up arteries my echocardiogram was normal all good news but still no reason for why I had a cardiac arrest. Doctors were reluctant to speculate but said it could have been something as simple as an infection that caused it. I spent 7 weeks in hospital and now I have an ICD fitted that will pace my heart should it need it and administer a shock if it ever goes into ventricular fibrillation again. Now I can get on with my life and feel confident as I have my own internal cardiac defibrillator. During that time I was in hospital I was on three different wards and I can honestly say the care on all of the wards was excellent compassionate and I was treated with dignity and busy nurses went the extra mile, I had visits from outreach nurses from CCU which gave me the emotional support I needed and they even took me to the shop and to sit outside, which was something I longed for.