Automated External Defibrillators

April 19, 2016 | Aging Services Risk, Quality, & Safety Guidance

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A CCRMmember asked us about healthcare facilities' policies on resuscitation. See our response.

Cardiac arrest, or the sudden and abrupt loss of heart function, is a leading cause of death in the United States. According to the AHA, about 326,200 out-of-hospital cases of sudden cardiac arrests occur annually in the United States; fewer than 10% of those victims survive (Mozaffarian et al.). In one study of over 31,689 instances of out-of-hospital cardiac arrest that took place between October 2005 and December 2010, the U.S. Centers for Disease Control and Prevention found that 13.5% occurred at a nursing home or assisted-living facility (McNally et al.).

In about 40% of individuals suffering cardiac arrest, the heart goes into an uncontrolled quivering pattern (i.e., fibrillation) that stops it from pumping (AHA "Lay Rescuer"). Because death can occur quickly, AHA recommends that defibrillation in these cases begin within three to five minutes in order to jolt the victim's heart with an electric shock and restore a normal heartbeat. For every minute that passes before regular heart rhythm is restored, the patient's survival chances are reduced—by 7% to 10% if no CPR is available and by 3% to 4% if bystander CPR is available. (AHA "Implementing an AED Program"; Morrison et al.)

AHA's combined 2010 and 2015 guidelines on emergency CPR stress the importance of using AEDs as a way to facilitate early defibrillation. In fact, AHA states that, in instances of witnessed cardiac arrest in which an AED is immediately available, defibrillation should be administered as soon as possible, as opposed to administering chest compressions first. (AHA "2015 Guidelines") Studies suggest that delays continue to occur in responding to cardiac arrest; the interval between activating the EMS system and EMS arrival is seven to eight minutes or longer on average. In an effort to speed responses to cardiac arrests, AHA recommends the deployment of public access defibrillation (PAD) programs enabling lay rescuers to perform CPR and use AEDs to deliver the necessary shock to perform defibrillations on cardiac arrest victims. (AHA "2015 Guidelines")

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