Survival, yes, but what about quality of life?
Survival, yes, but what about quality of life?
Resuscitated patients fare well
There is a definitive and proven therapy for ventricular fibrillation defibrillation, which eliminates the fibrils and allows a coordinated electrical rhythm and pumping action to resume. Survival rates are high if the therapy is administered quickly. (See cardiac arrest survival curve, below.)
The automated external defibrillator (AED) offers the potential to decrease time to initial defibrillation. Delivering an electric current to the heart within the first three minutes after cardiac arrest can raise survival rates to 30% six times the current national survival rate of 5%.1
In cities where defibrillation is delivered quickly, survival rates increase to greater than 30%, and if a 30% rate could be achieved nationally, it would result in more than 100,000 lives saved annually.2 In New York City, for example, it takes an average of more than 12 minutes for emergency vehicles to arrive at the scene of a sudden cardiac arrest. The survival rate there is less than 2%. In Seattle, the average time to defibrillation is less than seven minutes, resulting in a survival rate of almost 30%.
At the spring AHA conference on public access to defibrillation in Arlington, VA, Myron L. Weisfeldt, MD, of Columbia Presbyterian Medical Center in New York City said, "Studies have shown that our current strategy to save people from sudden cardiac death works poorly." The AHA supports making AEDs more accessible to individuals who respond first to cardiac emergencies, both health care personnel and lay people. Public access defibrillation would make the procedure available to firefighters, police, security personnel, and individuals at home.
More useful than fire extinguishers’
Jim Christopher, coordinator of emergency medical services at St. Francis Hospital and Health Centers in Beech Grove, IN, says, "These devices may become more useful than fire extinguishers in public buildings in the near future. You don’t see as many fires as you used to, but people do get ventricular fibrillation, and quick electricity is the only way out of that."
At the conference, investigators from Johannes Gutenberg-University in Mainz, Germany, presented their findings on the quality of life in patients resuscitated following cardiac arrest. Their conclusion was that, concerning various psychic factors, survivors showed little deviation from the average population and therefore their quality of life is comparable.
The research team looked at data from patients who had been successfully resuscitated.3 Questionnaires assessed general well-being, depression, and anxiety, and results were compared to scores of an average population. One-third of patients were more depressed than the average population, and one-fifth were less depressed. Anxiety was higher in 20% and lower in 27%. One-third felt better and 7%, worse.
Reference
1. American Heart Association. When Every Second Counts. Dallas; 1996.
2. Roth R, Stewart RD, Rogers K, et al. Out-of-hospital cardiac arrest: Factors associated with survival. Ann Emerg Med 1984; 13:237-243.
3. Schneider TH, Elich D, Jantzen JAH, et al. Quality of life after clinical death. Presented at the Public Access to Defibrillation II conference. Arlington, VA; April 1997.
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