Defibrillation

Defibrillation

Defibrillation is a process in which an electronic device, called an automated external defibrillator (AED), helps reestablish normal contraction rhythms in a heart that's not beating properly. It does this by delivering an electric shock to the heart. All emergency personnel should be trained and allowed to use a properly maintained defibrillator if their job requires them to respond to people having cardiac arrest. This includes all first-responding emergency personnel, both hospital and non-hospital.

It's essential to integrate early defibrillation into an effective emergency cardiac care system. This means employing the "chain of survival" concept. The components of this concept are:

• Early access to the emergency medical services system (call 9-1-1 immediately)
• Early CPR (cardiopulmonary resuscitation) when needed
• Early defibrillation when indicated
• Early advanced cardiac care

To make early defibrillation possible, it's essential that a defibrillator be immediately available to emergency personnel responding to a cardiac arrest. Thus, all emergency ambulances and other emergency vehicles that respond to or transport heart patients should be equipped with a defibrillator.

What can I do to help improve access to AEDs in my community?

• Find out if the first-responder vehicles (ambulances, police cars and fire department vehicles) in your community are equipped with AEDs. If they are not, ask why.
• Speak to members of city councils, county boards and state legislatures. Advocate starting an early defibrillation program in your community, including equipping all first responders with AEDs.
• Support allocating funds to establish an early defibrillation program and to equip all first responders with AEDs in your community.
• Advocate and support regulatory changes in your state that expand the use of AEDs by a broader range of first responders.

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Response to Food and Drug Administration clearance of automated external defibrillator for home use

Response to Food and Drug Administration clearance of automated external defibrillator for home use: "Response to Food and Drug Administration clearance of automated external defibrillator for home use

November 13, 2002

The Food and Drug Administration recently gave clearance for an automated external defibrillator (AED) designed for use in the home. AEDs are portable medical devices that provide the most effective treatment for sudden cardiac arrest victims who have a deadly abnormal heart rhythm known as ventricular fibrillation.

Sudden cardiac arrest is responsible for approximately 340,000 adult deaths per year in the U.S. Approximately 95 percent of those who suffer sudden cardiac arrest outside a hospital die. For many people, sudden cardiac arrest is the first sign of cardiovascular disease.

More than 70 percent of all out-of-hospital sudden cardiac arrests occur in the home. Therefore, it has been suggested that family members of individuals at risk of sudden cardiac arrest should be trained and equipped to provide CPR and attempt defibrillation. The American Heart Association recommends early defibrillation as a potentially life-saving treatment and recognizes there are different approaches to making early defibrillation possible. Data from lay rescuer defibrillation programs in public locations have shown that the highest survival from sudden cardiac arrest occurs when the arrest is witnessed an and when bystanders provide immediate CPR and defibrillation within three to five minutes of the arrest.

Prior to making a formal recommendation about home defibrillation, the American Heart Association needs more data on the overall effectiveness of this approach. Data is limited on the number of times a cardiac arrest in the home is witnessed and who is most at risk. Questions also exist about the level of training necessary to make successful resuscitation likely. The American Heart Association looks forward to reviewing the results of an ongoing scientific trial, funded by the National Heart, Lung, and Blood Institute, which will provide valuable data about the home use of AEDs in a few years.

At this time, in the absence of scientific evidence of effectiveness, the American Heart Association can not recommend broad adoption of the home use of AEDs. The association does encourage anyone with questions about their risk factors for heart disease to discuss their treatment options with their physicians. Families of those at risk should learn to identify the signs of sudden cardiac arrest and call 9-1-1 immediately if any of the signs occur. In addition, the American Heart Association recommends that family members learn CPR so they’re prepared to help a loved one survive sudden cardiac arrest.

The American Heart Association is working to improve survival from sudden cardiac arrest by strengthening the chain of survival in every community. The chain of survival includes rapid recognition of a cardiac emergency, early access to emergency medical services (EMS) system by calling 9-1-1, effective bystander CPR, early defibrillation and early access to advanced care.

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