Do Automated External Defibrillators (AEDs) have an impact on outcomes in health-care settings?
This question was submitted by a practising dentist: AEDs have become somewhat of a comfort object in a number of our offices emergency kit. Recently, a physician colleague commented on the generally unfavourable morbidity/mortality outcomes despite the use of AEDs to re-establish cardiac activity. Is this true??
Dr. Alan Lane, anaesthesiologist at the Ottawa General Hospital provided this initial response:
I would say the literature supports that view. Reports indicate that the rate of successful hospital discharge for out-of-hospital cardiac arrests (OOHCA) is around 5%.
Sudden OOHCA survival depends on adequate bystander CPR, on successful early defibrillation of a shockable rhythm, and on appropriate definitive care via the EMS. It’s then easy to see why survival rates are so low.
An interesting review on OOHCA in Ontario health clinics by Brooks et al (Canadian Family Practice Vol 56 June 2010) showed, among others things, that the rate of AED use was between 5 to 10% in OOHCA in public places and health care clinics. Between 25 and 50% of patients in these 2 settings did not receive CPR, so it appears there are many variables that can influence the survival outcome of which AED is just one element.
Dr. Alan Lane is a specialist anaesthesiologist at the Ottawa General Hospital.
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