See on Scoop.it – Defibrillation

A defibrillator is a life saving device that issues a electrical shock to the heart in some cases of cardiac arrest. This process is called defibrillation and can help save lives. Cardiac arrest happens when the heart stops pumping bloody around the body. At this time it is critical that defibrillation happens as soon as possible.

This electrical shock depolarizes a critical mass of the heart muscle, terminates the arrhythmia, and allows the natural rhythm  of the heart to be re-established by the body’s organic pacemaker, in the sinoatrial node of the heart.

According to the British heart foundation for every minute that a patient is not giving defibrillation their chances of survival decrease by 14 per cent. In fact research also show that’s providing a shock within five minutes of the patient collapsing provide the best chance of survival.

Defibrillators can come in many forms and sizes. These can be external, transvenous, or implanted. This will all depend on the device used. The most common devices are called automated external defibrillators (AEDs) and because they automate the defibrillation process, by automation of the treatable rhythms, meaning that bystanders or people with very little or no training at all can use them.

Because of the importance of the defibrillators and the low numbers available, it is vital that these devices are strategically placed within an area. These are often placed where an ambulance would find it difficult to get to –  i.e.,  placed with traffic congestion, poor infrastructure, or where large crowds gather.

Defibrillation was first successfully performed in 1899 by two physiologists in Switzerland. It was found that small electrical shocks could induce ventricular fibrillation in dogs. However, it wasn’t until 1933 that a serious alternative to injecting powerful drugs straight to the heart. Dr Albert Hyman came up with the invention of a hollow needle, an insulated wire to the heart to deliver the electrical shocks.

These days Defibrillators have come a long way from the Hyman days. In order to use the AED, the machine is turned on and then a voice prompt will instruct the rescuer on what to do. The voice prompts the rescuer to place the pads into position on the chest and these then detect if a shock is needed by reading activity in the heart.

Defibrillation should never be seen as an alternative to to CPR, which can help buy time before defibrillation is needed. The British Heart Foundation state that if more GP surgeries were equipped with defibrillators that survival could be increased by up to 60 per cent if the patient is treated immediately after entering cardiac arrest.

AED’s are often placed in highly visible areas and it is not recommended that these should be placed in locked or code restricted cabinets as this makes them inaccessible in time of emergency where the time taken is of essence. AED’s are often brightly coloured, and are often encased in protective cases. When these protective cases are opened nearby staff are alerted by a buzzer.

 
See on www.blog4safety.com

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See on Scoop.it – Defibrillation

Dr Aseem Malhotra, from Manchester, a cardiology specialist registrar at the Royal Free Hospital in London, says the machines could save thousands of lives.

Former footballer Fabrice Muamba’s life was saved as medics used a defibrillator when he suffered a heart attack on the pitch

A cardiologist has called for defibrillators to be placed in all public buildings in a bid to improve the  low survival rates for cardiac arrest victims.

About 60,000 cardiac arrests happen outside of hospitals in Britain each year – but the survival rate is between just two per cent and 12pc.

Dr Aseem Malhotra, from Manchester , a cardiology specialist registrar at the Royal Free Hospital in London, says the machines could save thousands of lives.

The former Manchester Grammar pupil said: “There should be defibrillators in all public buildings. They should be there like you have fire extinguishers.

“We know that, with defibrillation, the chances of survival increase to 75 pc. They are simple, computerised, tell you what to do, and it analyses the heart rhythm for you, shocking patients out of the abnormal rhythm.”

Dr Aseem and colleague Roby Rakhit, consultant cardiologist and clinical director at the hospital, have written an article in the British Medical Journal which says scientific evidence to support early defibrillation is overwhelming.

Dr Aseem Malhotra

They say lessons can also be learned from Seattle in the US, which has the world’s highest rate of survival for cardiac arrests. Children in Seattle are taught CPR in schools.

They say there should be more CPR training in Britain and steps should also be taken to ensure that patients are sent to the right hospitals where they can be treated by specialist cardiologists.

The call for more machines also comes after the Bolton Wanderers footballer Fabrice Muamba nearly died during a match but was saved thanks to prompt treatment and the use of a defibrillator.

Surveys have revealed that only one in 13 people in Britain feel confident enough to carry out emergency first aid.

Campaigners including leading doctors, health experts and MPs have written to the prime minister asking him to consider changing the law to make the life-saving machines compulsory in every community.
See on www.manchestereveningnews.co.uk

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See on Scoop.it – Defibrillation

Google Glass has made its way into healthcare.  Its use in the operating room and in medical education has been profiled here.  Yet the magic of Glass will be found in the applications that can make this “technology” into real-world solutions for health and medicine.  It’s a bit like the smart phone and how its realization is a function of the countless apps that bring the device to life.

Inside The Operating Room

Christian Assad, MD has taken the next step with Glass and developing a practical app that can turn Glass into a real life-saver. He recently profiles this application on his blog and I believe it’s an important turn of events that showcase just how technology can be applied to medicine and public health issues.  Here’s how it presents the concept in his blog–Google Glass and augmented CPR:

THE CPRGLASS SCENARIO

1)   Person walking, witnesses someone passing out (syncope)

2)   Individual says “OK GLASS, CPRGLASS”
A) Instructions appear ABC (Assess Airway, Breathing and Circulation)
B) “OK GLASS, No Pulse!”      (An algorithm developed by Hao-Yu Wu et al at MIT demonstrate how a normal camera can detect a pulse in a person with strong accuracy.) We are looking incorporate such algorithm aka (which will be open source) ”Eulerian video magnification” to CPRGLASS for 2 reasons;
1) Will help as an innovative method to assess if the compressions are adequate
2) Will be able to tell us if patient has regained pulse if we stop compressions, possibly, instead of even having to look for a pulse

3)   This triggers the following algorithm
A) Staying Alive Music starts which will guide you to do the compressions at a rate of 100/min.
B) Gyroscope tells you if compressions are adequate enough by moving
C) Tracks TIME of CPR initiation and number of compressions given
D) Calls 911 with your GPS based location
E) Via GPS will try to find nearest AED which information is being obtained by crowdsourcing. Ex AED4US
F) Sends Txt Msg to nearest hospital with information regarding ungoing CPR for them to get prepared

Dr. Assad combines science, technology and popular culture to create a platform that is as simple as it is important.  From the scientific underpinning to the driving musical beat, he’s part of a generation of clinicians ushering in digital health and the interesting and evolving role of Google Glass.
See on www.forbes.com

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See on Scoop.it – Defibrillation

People who suffer a cardiac arrest in Denmark today are three times more likely to survive than a decade ago, thanks largely to a national effort to teach people CPR, a new study says.

Denmark launched a national effort in 2005 to teach its residents to perform CPR, or cardiopulmonary resuscitation, in order to save people who suffer a cardiac arrest outside a hospital. The country gave out 150,000 instructional kits; kids began learning CPR as early as elementary school. Teens were required to learn CPR in order to get a driver’s license.

The results have been dramatic, say authors of a study in today’s Journal of the American Medical Association, or JAMA. About 300,000 people in North America each year suffer a cardiac arrest, when the heart stops beating, outside of a hospital.

In Denmark, the number of cardiac arrest victims who received “bystander” CPR — from someone other than a health professional — more than doubled, from 22% in 2001 to 45% in 2010.

In the same time period, the percentage of cardiac arrest victims who arrived at a hospital alive increased from 8% to 22%.

The percentage of patients alive after 30 days tripled, growing from 3.5% to 11%. The percentage of patients alive after one year also more than tripled, from 3% in 2001 to 10% in 2010.

Those findings are impressive, says Michael Sayre, a professor of emergency medicine at the University of Washington and a spokesman for the American Heart Association.

Although other studies have looked at smaller, community efforts to promote CPR, Sayre says the new study is striking because it involved an entire country.

Thanks to efforts by the heart association, Washington and a handful of other states now require students to take a CPR class before graduating from high school, Sayre says.

Still, study authors say that Denmark’s CPR initiative can’t take all of the credit for improving survival.

That’s because Denmark also made other important changes aimed at increasing survival after a heart attack, such as improving the care provided both by hospitals and emergency medical services.

“Teaching bystanders the importance of CPR can make a difference,” says Suzanne Steinbaum, director of the program on women and heart disease Lenox Hill Hospital’s Heart and Vascular Institute, in New York.

Performing CPR is actually easier than ever, Steinbaum says. That’s because the heart association now recommends a “hands-only” CPR procedure, in which bystanders concentrate on performing chest compressions, instead of alternating compressions with mouth-to-mouth breathing.

“Those who witness a cardiac arrest and start CPR can actually change the outcome of what happens to the victim,” she says.

 
See on cpr-professionals.com

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