New Guidelines Suggest Wide Use of Defibrillators

Aug. 17, 2000
Companies, communities and major public venues should consider\r\npurchasing automated external defibrillators (AEDs), suggests new\r\ninternational guidelines on the treatment of cardiac arrest.

Companies, communities and major public venues should consider purchasing automated external defibrillators (AEDs), suggests new international guidelines on the treatment of cardiac arrest.

The survival rate for cardiac arrest -- currently only 5 percent -- could increase 10-fold if defibrillators were widely available and used accurately and quickly, said Dr. Graham Nichol, a spokesman for the Heart and Stroke Foundation of Canada (HSFC) and one of the drafters of the guidelines.

"They''re simple enough that a Grade 6 student can figure out how to use it," said Nichol.

Many employers are investing in the life-saving machines, which cost about $3,000 to $4,000C.

For instance, Air Canada announced last month that it was putting defibrillators on all its jets.

The guidelines, published Tuesday, were drawn up by the American Heart Association in partnership with HSFC and other international resuscitation councils.

They say that arrested hearts should be shocked back into action within five minutes to minimize the risk of brain damage and maximize the chance of survival.

Every year, 35,000 to 40,000 Canadians die of sudden cardiac arrest, according to HSFC.

Studies show that in large urban areas, it takes about nine minutes for a defibrillator to arrive on the scene after a 911 call.

That''s too long, the guidelines say. The possibility of successful resuscitation declines at a rate of between 7 to 10 percent with each minute that passes without defibrillation.

The guidelines suggest that if there is a reasonable chance that one person will suffer from a cardiac arrest over a period of five years, then a site or venue ought to consider purchasing one of the devices.

What constitutes a reasonable chance? The guidelines recommend a formula that works like this: If 1,000 people were to spend a year in one place, statistics project that at least one would have a heart attack. Applying the five-year criteria means that out of a population of 200, one person would have a cardiac arrest.

The guidelines also contain a simplified protocol for cardio-pulmonary resuscitation.

People helping someone in cardiac arrest shouldn''t bother to check for a pulse -- too many people get it wrong.

Instead, they should check for signs of circulation such as whether the person is breathing, moving or responding to a stimulus such as a gentle shaking.

Another change involves the treatment of people who have lost consciousness as a consequence of choking.

The new guidelines recommend that people skip the Heimlich maneuver -- used to dislodge an object from the respiratory passages -- and go directly to chest compressions.

For more information go to the HSFC Web site at www.hsf.ca or the American Heart Associations'' homepage at www.americanheart.org.

by Virginia Sutcliffe

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