Portable defibrillators: A life-saving new option

Ease of use, low cost make these units attractive

For years, defibrillators — those marvelous machines that electronically "zap" new life into hearts that have stopped beating — have been the exclusive purview of emergency department physicians, nurses, and trained technicians.

However, within the last 18 months, several manufacturers have made available new, portable defibrillators that are so simple to operate that well-trained safety managers or wellness professionals can feel comfortable using them in an emergency situation.

Called automated external defibrillators (AEDs), these small light units analyze a patient’s heart rhythm and inform the operator whether a shock is needed. They also indicate the appropriate charge for each shock.

"They are specifically designed to treat only those people in cardiac arrest," explains Paula Lank, RN, program director for AED product development at Redmond, WA-based Physio-Control Corporation, which manufactures the LIFEPAK 500 AED. (The other major AED manufacturers are SurVivalink in St. Paul, MN; Laerda in Stavanger, Norway; and Heartstream, based in Seattle.)

Lank sees growing demand for AEDs, noting that close to 100 companies have ordered the $3,000 LIFEPAK 500 unit.

"We have a company that is very committed to wellness and prevention, and we want to be prepared to handle any emergent condition that we can," explains Brenda Daniel, RN, COHNS, Occupational Health Nurse at Lillian Vernon Corporation, a Virginia Beach, VA-based mail-order distribution firm. "For cardiac arrest, the ultimate treatment is defibrillation. You can perform effective CPR, but by having your own defibrillator on site, you can correct a person who goes into lethal arrhythmia."

Lank says it just makes sense for companies to have on-site defibrillators, noting that she has read estimates of between 250,000 and 450,000 instances of cardiac arrest in the United States a year — or about 1,000 a day. "Since 70% to 80% occur in the home, as much as 20% could be at the work site," she says.

CPR training a must

Although the units are very user-friendly, says Lank, they are not for novices. "You need to know CPR," she asserts. "You also need to have taken a course equivalent to the American Heart Association’s AED Course, and, of course, be trained in the use of this specific equipment."

Why is a CPR background so important? "Not everyone who is pulseless, not breathing, and with no blood pressure will need a shock," she explains. "About 60% to 85% will be in cardiac arrest. For the others, CPR will be the preferred protocol."

Is there any danger in having non-medical personnel operate the device? "The likelihood [of harming the patient] is extremely remote," insists Lank. "Although someone could be harmed if they were hit over the head with it. If it is placed on a patient inappropriately — for example, if they were moving and breathing — it wouldn’t even analyze their heart rate."

Of course, a portable defibrillator is something you hope you never have to use, says Daniels, "But we’re glad we have it if we do need it."

As a matter of fact, while she has not yet had the need to treat an employee for cardiac arrest, the company’s defibrillator was put into action just a couple of months ago. "We had an employee in his late 30s with severe chest pains, who was brought into our health office and put on a monitor," Daniels recalls. "We were able to monitor him and determine he had no life-threatening disrhythmia." Ultimately, she says, he underwent angioplasty. "It definitely gave us the security of knowing we were equipped to treat him on site if needed," she says.

[Editor’s note: For more information on AED’s, contact: Paula Lank, RN, Physio-Controls Corporation, 11811 Willows Road Northeast, P.O. Box 97006, Redmond, WA 98073-9706. Telephone: (206) 867-4644. Fax: (206) 867-4616. E-mail: macmail!Paula_Lank@physio-control.com.]