Defibrillation often used late in U.S.

High voltage shocks to restart the beating of the heart after it has stopped have been used to save many lives. But a recent study has shown that almost one third of the patients don’t get the treatment in time, resulting in fatal damages.

It is well known that if a patient does not get an appropriate and timely defibrillation, chances of his survival are very few. The delay is caused as there are no clear standards and the decision to give the shock depends on the expert opinion only. The study also recommended that defibrillation should be done within two minutes of the cardiac failure.

"We still have a lot to learn as to how to deliver treatment in an effective way," said lead author, Dr. Paul S. Chan of St. Luke's Mid America Heart Institute in Kansas City, Mo.

The research is based on the data collected at 369 hospitals which participated in the National Registry of Cardiopulmonary Resuscitation. It included 6,789 cases of cardiac arrest caused by an abnormal heart rhythm, the kind most responsive to getting shocked back to a normal heartbeat.

To get appropriate results, only the cases which occurred in intensive-care units or regular units were included, not those in the emergency room or during surgery. Thirty-four percent of those studied lived to be discharged from the hospital.

"It is probably fair to say that most patients assume — unfortunately, incorrectly — that a hospital would be the best place to survive a cardiac arrest," Dr. Leslie A. Saxon, a cardiologist at the University of Southern California.

The main cause of this delay is that in hospitals patients are not continuously monitored especially the patients admitted with diagnoses other than heart disease and also during the off hours like weekends and night time.

The study also found that in Blacks, the risk of having a delay increased by 23 percent. Although the reasons to this are not yet known, it is assumed that such variations are due to geographical differences in access to hospitals with more resources, such as monitored beds. It is also being suggested that this data might reflect actual differences in patterns according to race.

One solution to this problem is to put Automated External Defibrillators at public places, which will provide a ready set up for defibrillation and the patient might get the necessary dosage at that place only, without any delay.

We might make external defibrillators available to more units," Chan said. "That is one potential solution that might have a significant impact over time. And hospitals might set up emergency teams to intervene when there is a cardiac arrest code."

It is surprising that survival rate is disappointingly less than the 50 percent rate amongst the people who collapse in an airport, casino or some other location where automated external defibrillators (AEDs) are readily available for emergency use.

This shows more effective measures are the need of the hour. Estimates show that almost 750,000 patients experience cardiac arrest in U.S. hospitals each year.