Sandy Says: Heartstopping

March 1, 2011
A new study out of the Netherlands reports that less than half of people in a public place with access to an automatic external defibrillator (AED) would be willing to use it.

My first job out of college was at a local weekly newspaper chain. Every reporter took turns going to Valley View, as we called the corporate offices, to oversee the production of our newspaper pages.

We examined the pages before they went to print and asked the production employees to correct mistakes. One production guy — his name was Bill — really imparted the feeling that I was raining on his parade when I pointed out mistakes.

Bill was a grumpy, chain-smoking curmudgeon at the age of 35. One day, having just corrected one of my pages (rolling his eyes while he did it), he dropped dead. Literally.

Bill had suffered a myocardial infarction (a heart attack) in the workplace, and back then, automated external defibrillators (AEDs) were not available. The day that Bill died is a blur, but I doubt anyone even tried cardiopulmonary resuscitation on him.

I'd like to think that times have changed and someone like Bill could be saved by the use of an AED in the workplace, but I'm not so sure.


Sudden cardiac arrest is a leading cause of mortality in North America. Odds of survival decline by as much as 10 percent per minute of delay in defibrillation. AED application by bystanders saves only 1.4 lives per 1 million people in North America. Partially, that's because most bystanders to sudden cardiac arrest do not have access to an AED. But sadly, that's not always the case.

A recent Dutch study discovered that only 47 percent of people in a public place with access to an AED would use it. (“Public Access Defibrillation: Time to Access the Public,” Annals of Emergency Medicine.)

As the study's lead author, Patrick Schober, M.D., Ph.D., of V.U. University Medical Center in Amsterdam, The Netherlands, points out: “An AED is only beneficial if a bystander is willing to use it when someone is in cardiac arrest.”

Despite valiant efforts by AED manufacturers to reassure people that anyone can use one without any previous training (I can attest to this, having tested just about every brand of AED on the market), nearly half the people surveyed (49 percent) believed only trained personnel could use it. The most frequently mentioned reason given for not using an AED was not knowing how it works (69 percent), followed by fear of harming the victim (14 percent). Only 6 percent of study participants spontaneously mentioned AEDs in response to a question about what should be done as quickly as possible for someone suspected of being in cardiac arrest.

“AEDs are actually very easy to use, but it is obvious that the public has not gotten that message,” said Schober. “Only a minority of individuals demonstrated both knowledge and willingness to operate an AED. Wide-scale public information campaigns are an important next step to exploit the lifesavings potential of public AEDs.”

Workplace campaigns are another important step to promote the lifesaving potential of AEDs. Any employer concerned about skyrocketing healthcare costs should consider investing in AEDs and training sessions for all employees.

A new research study, led by Stephen S. Johnston, M.A., of Thomson Reuters, found that acute coronary syndrome (ACS) is more costly to employers than other conditions such as high blood pressure common in working-age adults. While the researchers were examining the high cost of ACS to employers in hard (medical) and soft (loss of production, retraining) costs, my takeaway — perhaps because of my experience with Bill — was this: Half the people suffering heart attacks are workers and there's a decent chance they're suffering those heart attacks in the workplace.

If the cost of saving a life is the purchase price of an AED and some training for employees, wouldn't you do it in a heartbeat?

Send an e-mail with your thoughts to [email protected].

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