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In increasing numbers, community collaboratives are forming to help combat SCA. These collaboratives can include the federal and municipal governments, not-for-profit agencies, corporations, defibrillator manufacturers, and local EMS services. The result of this teamwork and commitment are early defibrillation programs that work and save lives.
Within Local Communities
Rochester, Minnesota has achieved response times that average 6 minutes, with 45% of VF victims surviving. A study in that city showed that 21 of 44 persons with out-of-hospital cardiac arrest were long-time survivors. Of these 44 victims, 14 had initial defibrillation by the police force. Ten of the 14 survived and were discharged. The overall survival rate of 21 of 44 victims can be compared with the survival rate in New York, where 26 of 2,329 victims survived.
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In Airports
Due to the crowds of people who pass through them daily, airports are a vital place for defibrillators. In June of 1999, defibrillators were mounted throughout Chicago's O'Hare and Midway airports. In the first ten months, 14 cardiac arrests occurred, with 12 of the 14 victims in ventricular fibrillation. Nine of the 14 victims (64%) were revived with a defibrillator.
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On Airlines
American Airlines and Delta Airlines were the first domestic carriers to install defibrillators in their aircraft and to train flight personnel to use them.
A study from the New England Journal of Medicine analyzed defibrillator usage on American Airlines from 1997 to 1999. This study found that of the passengers who were defibrillated, the rate of survival to hospital discharge after a defibrillator shock was 40 percent.
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Airlines will be required to carry AEDs as part of their emergency medical kits as of May 2004.
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In Places of Work
Many companies that have large campuses or that are located in high-rise buildings keep defibrillators for use by trained responders. Some examples include Banker"s Trust, Boeing, Dow Chemical Company, General Mills, General Motors, Gillette, Goldman Sachs & Co., Home Depot, Honda of America, IBM, Lucent Technologies, R.J. Reynolds, Smith Barney and The New York Times Company.
Companies that adopt defibrillator programs can save lives, improve morale, and avoid potentially costly lawsuits and jury awards. In addition, these companies demonstrate to their workers and clients that they care about their health and well-being, becoming models for other companies in the community.
Wherever People Gather
Managers of public areas such as resorts, recreational facilities, and hotels are actively making defibrillators accessible at their facilities. Medical facilities, such as hospitals, doctor's offices, and clinics, are also adding defibrillators to increase their emergency care preparedness.
Casinos serve as another example of a gathering place where people can benefit from defibrillation programs. Some casinos are training security officers to use defibrillators, and placing the units strategically for a response time of three minutes or less from collapse to first defibrillation.
In a study in the New England Journal of Medicine, of the 105 patients whose initial cardiac rhythm was ventricular fibrillation, 56 of the patients (53%) survived to discharge from the hospital. The survival rate was 74% for those who received their first defibrillation no later than three minutes after a witnessed collapse, and 49% for those who received their first defibrillation after more than 3 minutes.
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The trend to equip large gathering places has extended to malls as well. Recently, Urban Retail Properties Co. announced plans to place defibrillators in its malls across the U.S. Some malls will have wall-mounted units that can be readily accessed by trained responders. When the rescuer opens the cabinet to remove the defibrillator, an alarm immediately alerts mall security personnel who are trained to use defibrillators. In other malls, defibrillators will be available in the security offices and in mall patrol vehicles.
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