Home defibrillators do or do not increase survival? What?

[spenac]

Heres two conflicting article titles based on same study.

http://www.reuters.com/article/newsOne/idUSN0130534320080401[web:449989666c]http://www.reuters.com/article/newsOne/idUSN0130534320080401[/web:449989666c]

http://ap.google.com/article/ALeqM5iLo64f8...He7VqwD8VP9UEG2[web:449989666c]http://ap.google.com/article/ALeqM5iLo64f8npoY9pqDkUDLACnHe7VqwD8VP9UEG2[/web:449989666c]

[Richard B the EMT]

Consistent with the old adage of there being "Lies", "Damned Lies", and "Statistics", follow the money: Who paid for either of those studies?

I duly note that both articles are datelined for Chicago.

[irme]

Without being able to see the study I wonder the kinds of people that were used live with massive co-morbidities; how else would the study presume that these people were likely to arrest?

The study shows that the most success was for others not involved in the study (neighbours etc.) with a much higher conversion rate. AED's are clearly invaluable but those living with associated cardiac arrest causes are always less likely to live through cardiac arrest than someone who is having their first MI..

Interesting to read the failure rate and the teaching process; we all know that defibrillating a hypoxic heart is often futile; so I wonder if the delay in getting the machine on the pt and lack of prior 2 minutes of CPR meant the pt's heart became too hypoxic?

[ERDoc]

I don't think the articles are conflicting. The sensationalized titles conflict, but if you pull apart the articles, they say the same thing. AEDs can work, but good CPR and EMS activation is just as good and costs less.

[Richard B the EMT]

Following up on my "Follow the money" comment, I get, every now and then, an e-mail from persons unknown to me, mentioning a particular "plug in air freshener" brand, and calling it a fire hazard that has caused several home fires.

I spoke to several fire marshals and fire investigators from the FDNY (my employer, as most of you already know), who, while not denying the possibility, also state that the e-mails might have been started by folks who might benefit by sales of competing brands of plug in air fresheners over the one mentioned in the e-mails. Kind of, if you can't beat them, beat them down!

[kristo]

Well, of course AEDs at every house would increase survival. Early defibrillation is proven to increase survival, so better accessibility obviously would.

Another thing we could do would be to implant defibrillators into everyone. That would probably decrease mortality from AMIs significantly.

So, who's going to pay?

A sidenote: My dad actually has one of those implanted defibrillators. Amazing thing. He goes to his cardiologist every three months for a checkup. The cardiologist checks his bloodwork and actually downloads data from the device, looking over the last 3 months of cardiac activity. Really cool.

[prettyone]

I read the posted article out of the Chicago source. I am upset by the Chicago opinion stated. I am surprised me myself being from Chicago....that my home town would say that CPR...worked just as well...cause of people not knowing or using the AED's.

I actually have a friend who was saved last year by an AED...in Chicago. And as far as the article stating about the AED's being very expensive over $1000.00. Of course they are expensive. That's what if someone has it available flex-spending if for ( FSA )aka...Flex Spending Account. Now obviously not everyone in America, has this available to them. I firmly believe that AED's do and will work when used properly. I also think our AMERICAN GOVERNMENT should provide some type of reduce payment even more so than FSA...as I stated..above. But, hey I know that will not happen in my generation. A girl can dream though can't she....lol...

[firedoc5]

The only reason someone would require a home defibrillator is if they have had a hx of full arrest or a dysrhythmia. But now a days, if someone requires one they can have one implanted more readily.

But I can't see just having one around for a "just in case" kind of thinking.

[AZCEP]

Right on firedoc5.

Many times the patient with the history that would warrant having a home AED will get the ICD prior to discharge. Home AED's should be considered if there is a waiting period between discharge and having the ICD placed. They can also be used if the possibility of pulseless arrest is there, but the utility of an ICD would be questionable.

They are not the answer that everyone wants them to be, but they might buy some more time when they are needed.

[Richard B the EMT]

The only reason someone would require a home defibrillator is if they have had a hx of full arrest or a dysrhythmia. But now a days, if someone requires one they can have one implanted more readily.

But I can't see just having one around for a "just in case" kind of thinking.

My sister is a smart woman, but about a decade ago, when the so called "home defibrillators" first hit the market, she was pumping me for information on getting one, "just in case!" I talked her out of it, and now, everywhere she goes, she has her laptop computer, instead!