“I have reviewed the scientific literature on automated defibrillators
used by trained and untrained members of the public. The results are
impressive. Basically the provision of such units doubles the chance of
survival and eventual release from hospital. The most important issue is the
time it takes to achieve successful defibrillation (of ventricular fibrillation - chaotic electric heart rhythm,
associated with no effective circulation of blood). The paramedics take too
long - they have to battle through traffic. The results show that few members
of the general public are happy to perform the procedure. Those with CPR
training are the ones most likely to do it, so CPR training is an essential
preliminary stage for this.
The big question is where to put such units given their expense and
maintenance costs. Obviously a considerable footfall is required to make them
cost-effective (lives saved versus expense) (although politically, businesses
might want them in order to show that they care). For this reason public
funding has been drawn to large shopping malls, airports etc. Clearly there are
places of high risk - those employing older people and where their is a risk of
electrocution (factories); drowning, poisoning, accidents of all sorts. It
would be difficult to justify them in small shop units or offices. There they
would qualify as an extreme luxury, not a necessity. I understand, however, how
they might be persuaded to introduce them.” 5/1/2011
Dr David H Dighton MB BS MRCP(UK) London Hospital Medical College, London University thecardiaccentreuk.co.uk