Category Archives: Defibrillation

Practices lack vital lifesaving kits | Dentistry.co.uk

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Health industry’s defibrillators would go ignored in a genuine emergency, survey finds

A new survey reveals that many dental practices are without key lifesaving equipment.

More than half of the staff polled were unaware if their practices were kitted out with a defibrillator.

Dentistry figured among the health industry survey which also highlights a need for more education to rid misplaced fears about misuse.
 
The survey shows that 54% of staff in workplaces such as dental surgeries and GP practices stated that their premises either do not have, or that they are not aware that they have, a defibrillator.

Of those questioned that do have defibrillators, 36% do not know how or would not be confident enough to use it.
 
This raises fears that this emergency heart equipment may not be used in the places where it is most needed.
 
Vincent Mathieu, managing director of DOC UK calls for more education for health service providers: “With 124,000 heart attacks a year in the UK touching people of all ages and physical conditions, defibrillators are essential equipment – and you expect the health industry to set the gold standard. However, defibrillators do no good if they are not used. It’s vital that companies within the health industry sector have an on-site defibrillator that their staff will be confident to use in case of an emergency.”
 
The survey indicated that the general apprehension about using emergency equipment is based on risks that do not exist. For instance, a defibrillator will only work on someone who is having a genuine cardiac arrest. 48% per cent of respondents were concerned about injuring the casualty or being held liable if something went wrong. This is alarming as the equipment will only function on people who are having a cardiac arrest, and there have been no cases of people being sued for using a defibrillator.
 
Dr Stephan Van Wyk, a dentist at The Bridge Dental Centre, East Twickenham, highlights the importance of defibrillators in dental practices which are high stress environments.

He said: ‘Although we are not required to have a defibrillator at the practice, it is a recommendation for dentists and regarded as best practice. We hope that we never have to use it, but we see having the defibrillator as an extension of our customer service, it’s an added extra to help make our customers feel comfortable and reassured.’
 
DOC’s defibrillators work by connecting the user to a call centre staffed with medically trained personnel who guide the user through the defibrillation process, removing the need for training, and removing the fear factor should an emergency occur.

See on www.dentistry.co.uk

Villagers turn old phone box into mini A&E with life-saving machine

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A DEFIBRILLATOR has been installed in a rural red call box after locals bought the kiosk from BT for a pound.

AN old phone box has been transformed into a potential lifesaver after being purchased by villagers for £1.

A defibrillator, which gives the heart an electric shock in some cases of cardiac arrest, has been installed in the red call box.

And as the nearest accident and emergency department is 20 minutes’ drive away, the machine could mean the difference between life and death.

The call box in Arnprior, Stirlingshire, was bought by the community from British Telecom under the company’s Adopt a Kiosk scheme.

Funding for the defibrillator came from various organisations, including Stirling Council and the Sandpiper Trust, who aim to provide Scotland’s rural doctors and nurses with emergency medical equipment.

A BT spokesman said: “We’re very pleased to hear that the villagers of Arnprior have found a new lease of life for one of our old, rarely used boxes.

“Over the years, many people have described their local phone box as a lifeline. Now that everyone has a phone at home or a mobile, that’s no longer true.

“But kiosks fitted with defibrillator machines could be real life savers for the community in the future.”

The Scottish Ambulance Service and the Community Heartbeat Trust, a charity dedicated to the provision of defibrillation services to local communities, gave their help to the project.

Backing also came from the community council and Stirling Council’s Community Pride fund. Villagers were given advice and training on how to use the defribillator.

And children from the local primary school will be on hand to help open the lifesaving installation on Monday.

A spokesman for the Sandpiper Trust said they were delighted to have been involved in the Arnprior project.

He said: “It has become increasingly clear over the past decade since the trust was set up that working together with all these organisations is what saves lives.

“We are also pleased that the children of Arnprior School have been involved in this project.”

More than 100 traditional red kiosks in Scotland have been adopted by their local communities for £1.

Arnprior is the second community in Scotland to have a defibrillator fitted in their call box.

Glendaruel Village, Argyll, was the first in 2011.
See on www.dailyrecord.co.uk

How a health club’s AEDs saved 100 lives

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David Lloyd Leisure’s health clubs do business throughout Europe; the company has 80 sites in the UK alone. With more than 440,000 members the company gets 25 million club visits a year. Since 1998, the David Lloyd Leisure staff has used AEDs to save the lives of more than 100 people.

There’s no legal requirement in the UK for fitness clubs to have automated external defibrillators (AEDs) on the premises. But the health and safety experts at David Lloyd Leisure insist on having AEDs readily accessible at every one of their busy clubs. This policy, along with staff training in AED use, has made a world of difference. Since 1999, David Lloyd Leisure has saved more than 100 lives.

“Our feeling is every fitness facility should have an AED, even if there’s no legal requirement,” says Caleb Brown, of the health and safety office at David Lloyd Leisure. “AEDs have become so affordable, and the response element is something which is really easy for a health club to do — they’ve already got team members available.”

One of Europe’s largest health and fitness businesses, David Lloyd Leisure started its AED program in 1998. At first, this simply meant ensuring that the reception desk at every facility had a defibrillator at hand.

A staff member from David Lloyd Leisure Brooklands with their Powerheart AED. Staff at the club used the AED to revive a member in 2010.

The return on investment in terms of lives saved was immediate, and the company nurtured the AED program. Brown, who joined the company in 2000, has been involved in the development of the company’s AED training program as part of overall safety training. Today, an AED is brought immediately to the scene of any health incident at one of the clubs.

While the survival rate for people who suffer outside-of-hospital sudden cardiac arrest in the United Kingdom is less than 20 percent, the survival rate for someone who suffers cardiac arrest or another serious health incident at one of the David Lloyd Leisure clubs reached 88 percent in 2012.

How They Chose Powerheart AEDs

All David Lloyd Leisure clubs are equipped with at least one AED, and one large, six-story site has two defibrillators on the premises. All the AEDs — with the exception of devices at clubs recently acquired from other companies — are Cardiac Science Powerheart AED G3s. The Powerheart AEDs were chosen because they’re highly portable and easy to use, with long-lasting medical-grade batteries and Rescue-Ready technology that conducts an automatic self-check of the main components (battery, hardware, software, and pads) every day. When it’s nearing time to replace a battery, a Rescue Ready indicator on the AED turns red and sounds an alert.

“The Powerhearts are so easy to look after, and the maintenance system is brilliant,” Brown says.

In the aftermath of any incident in which an AED was required, the club replaces the used pads with a set of spares. Brown, or one of his health and safety team colleagues, then visits the club to download data from the AED for hospital use, write up an incident report, and supply a new set of spare pads.

Training: Key to a Successful AED Program

Brown, who took on a leadership role in the AED program in 2006, has designed training for club employees that enables them to respond with maximum speed and efficiency when a cardiac incident occurs.

“Because of the voice prompts, even an untrained bystander can use an AED,” Brown points out. “With a training program, you give people the ability to react faster in an event, which is going to increase chances of survival.”

Ambulance response time in urban areas in the UK is usually under 8 minutes, Brown noted, but for a sudden cardiac arrest victim that is often too late. Brown’s goal has been to train David Lloyd Leisure staff to get the AED to the victim, and the defibrillator pads on the victim’s chest, within 1 minute.

Once the pads are attached, the AED can diagnose the heart rhythm, and, if appropriate, administer a shock. The AED’s voice prompts coach the team through every step of the process, including administering CPR. The AEDs are programmed in accordance with the latest resuscitation guidelines, and David Lloyd Leisure bases its training on those same guidelines.

“I believe that some businesses overestimate the amount of training that is required for a successful AED program,” Brown says. “Our training is only two hours for an employee, once a year. With just that basic training, in the vast majority of incidents requiring an AED, we are able to get the pads onto the chest in less than a minute.”

In 2012, the company’s survival rate for incidents in which an AED was deployed reached 88 percent.

Case Study: Saving a Life at the Health Club

“I would not be alive now had it not been for the quick intervention of Paul, Laura,and others and their ability to resuscitate me,” a 45-year-old businessman wrote in a letter to David Lloyd Leisure. “I have been advised by doctors that if I had been anywhere else, in particularly where there was no defibrillator, I would not have survived.”

The man had collapsed while using a rowing machine at the North London club. Bystanders alerted the club’s team straightaway, and one of the team immediately started CPR. The AED was brought to the area and the pads put on immediately. The AED diagnosed a shockable heart rhythm and it administered one shock.

“By the time the ambulance crew arrived, the man was breathing and talking,” Caleb Brown, part of the company’s health and safety team, said. “He went on to make a complete recovery, went back to work, and he’s back at the club.”

Two members of the David Lloyd Leisure staff were directly involved in the rescue. One delivered CPR and the other used the AED. A half dozen others assisted, clearing members from the area and making sure there was access for the ambulance crew.

“The training I received in using the AED enabled me to use the AED with confidence and the clear voice prompts helped to keep me calm,” one of the rescuers reported after the incident. “It’s an amazing feeling to know that the actions I took resulted in a life being saved.”
See on www.cardiacscience.com

Doctor’s plea for defibrillators to be in all public buildings

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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

‘OK Glass, Save A Life.’ The Application Of Google Glass In Sudden Cardiac Death

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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

Heathrow is the safest place in London to have a cardiac arrest

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The London Ambulance Service has declared Heathrow Airport as having the highest cardiac arrest survival rate in London, outside of hospital.

The airport has 180 heart-starting defibrillators, over 100 first aid-trained front line staff and a specialist team of 15 bicycle-riding London Ambulance Service paramedics.

Recent statistics show that the Heathrow Cycle Response Unit reached 93.6% of the most serious and life-threatening emergencies at the airport within eight minutes – far exceeding the national target of 75% within that time frame.  The overall cardiac arrest survival rate in London in 2011/12 was 10.9% and in Heathrow was 74%.

The bicycling paramedics treated almost 900 passengers out of the 6.5m that travelled in June – with more than a fifth being treated for life-threatening conditions.  It is reported that passengers are never more than two minutes away from a defibrillator.

London Ambulance Service Community Resuscitation Training Officer Martin Bullock said:  “We’ve been working with Heathrow Airport for over ten years and thanks to the defibrillators, its first aid-trained staff and our cycle responders, it has one of the highest cardiac arrest survival rates in the world.  The survival rate witnessed for cardiac arrests at the airport is six times as high as in London overall.”

If a passenger is believed to be in a life-threatening condition, the onsite ambulance is called at the same time to ensure additional helps arrives as soon as possible.  In less serious cases, the bicycle paramedic or emergency medical technician is sent initially on their own and can then request further assistance if required.

Heathrow also encourages its staff to participate in company-wide first aid courses.
See on www.airport-world.com

Even lifesaving defibrillators need regular maintenance

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Portable, heart-shocking defibrillators are not fail-safe.

Like any machine, automated external defibrillators, or AEDs, need to be maintained. Batteries run down and need to be replaced.

Electrode pads that attach to a patient’s chest also deteriorate and have to be replaced every year or so. Circuitry can fail. And maintenance can be spotty.

The U.S. Food and Drug Administration has received more than 45,000 reports of “adverse events” associated with failure of AEDs between 2005 and 2012, although only some of the events involved the fully automated devices put in public areas. The others were defibrillators limited to medical use. Manufacturers also conducted more than 80 recalls during the seven-year period.

The number of AEDs sold in the U.S. has been rising steadily, from around 100,000 a year in 2010 to between 500,000 and 1 million this year, according to the Sudden Cardiac Arrest Foundation and industry officials. There are about 2.5 million deployed.

“Survival from cardiac arrest depends on the reliable operation of AEDs,’’ said Dr. Lawrence DeLuca, a professor of emergency medicine at the University of Arizona in Tucson.

He led a 2011 review of more than 40,000 AED malfunctions reported to the FDA between 1993 and 2008. The analysis found that 1,150 deaths occurred during those failures.

No one knows exactly how often someone attempts to use an AED, but with an average survival rate of 2 percent to 4 percent from sudden cardiac arrest outside a hospital, according to studies, the devices help save roughly 3,500 to 7,000 lives each year, although not all of the rescues are performed by untrained bystanders. If AEDs were more widely available, the number of saved lives could triple or more, experts say.

“AEDs can truly be lifesavers, but only if they are in good working order and people are willing to use them,’’ said DeLuca, who had a personal experience with batteries failing on a device when he was trying to revive a fellow guest at a resort in 2008.

It took nine minutes to retrieve a second AED, which did work. The patient was not revived.

Problems with pads, cables and batteries accounted for nearly half the failures — mistakes that could have been due to poor maintenance. Forty-five percent of failures linked to fatalities occurred when the device was attempting to charge (power up) and deliver a recommended shock to someone in cardiac arrest, DeLuca said.

But there also were incidents reported to the FDA when the devices shut down without analyzing a patient’s heart rhythm.

Regulators and watchdogs believe some victims were not revived when the machines failed, but it’s difficult to say whether any particular patient would have had heartbeat restored.

The FDA said the most common malfunction reports involved design flaws and manufacturing of the devices using poor-quality parts such as capacitors and software.

AED failures have raised enough concern that the FDA is ending the medium-risk status that AEDs have had since they first became widespread more than 20 years ago.

Now, they’ll be classified high-risk equipment that reflects their use to support and sustain human life — and their greatly increased sophistication over the years. Manufacturers will have to provide more safety evidence and FDA inspectors will be allowed to inspect plants where parts are made.

The tighter rules don’t mean the public should lack confidence in the lifesaving devices. Dr. William Meisel, the FDA’s chief scientist for devices, stressed the essential role AEDs play when he announced the new rules in March.

“These devices are critically important and serve a very important public-health need,” Meisel said, noting that none were being taken out of service beyond the recalls manufacturers have already issued. “Patients and the public should have confidence in these devices and we encourage people to use them under the appropriate circumstances.”
See on www.courierpress.com

Denmark setting the bar for CPR! | CPR Professionals Blog

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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

AEDs can save lives, but units, knowledge to use them, scarce

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Sudden cardiac arrest — when, without warning, the heart instantly stops beating — kills 350,000 Americans of various ages and occupations a year, according to the American Heart Association.

Yet now, with high school sports teams beginning their fall seasons, now is when we are most aware of these fatalities because of a tragic drama: A young football player in peak condition, who has never flunked a physical or shown the faintest symptom of cardiac problems, suddenly collapses.

Death is usually all but instantaneous — but it is not necessarily inevitable, not if a device called an Automated External Defibrillator, or AED, and someone willing to use it are close at hand.

Sudden cardiac arrest is not the same as a heart attack, which usually is caused by blocked arteries and often gives some advance warning. Sudden cardiac arrest occurs when the electrical impulses that control the heart suddenly misfire.

The mild electric shock from an AED “resets” the heart and allows it to resume normal function. Bystanders revive several thousand people this way each year. More widespread use of the devices could save at least 20,000 more, according to the American Red Cross.

Since their introduction in the 1950s, AEDs have become smaller, simpler and basically foolproof; in one study, sixth-graders mastered them quickly and easily. There are about 2.5 million AEDs in the country, far short of the 30 million experts say are needed just to cover metropolitan areas and far short of the Red Cross goal of having every person in America within four minutes of an AED.

There are no good reasons why AEDs are not now widely and readily available. They should be and the solution may require a certain amount of public outcry and political attention.

Uniform national standards need to replace the often complex and inconsistent state and local rules on where and how AEDs are placed — ordering that they be placed prominently, like fire extinguishers, and regularly maintained.

The AEDs should clearly display the good Samaritan legal exception — all states have them — that protects from liability for injury or wrongful death people who voluntarily and in good faith try to save a life.

Says one manufacturer of AEDs, “It’s kind of blunt, but the bottom line is that when you’re in cardiac arrest, you’re dead before you hit the ground. There’s no way you can cause that victim any more harm using that device. You’re trying to bring them back.”

Unlike TV hospital dramas, AEDs do not have paddles that administer massive jolts. Two adhesive leads attach to the chest and the shock, if the machine’s diagnostics say one is needed, scarcely causes the patient’s chest muscles to twitch — and the newer devices will talk the user through the process.

An American public that had no problem mastering smartphones should have even less difficulty with AEDs once they are highly visible and readily accessible.Click here to edit the title
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