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In the 1960's, Irish cardiologist J. Frank Pantridge discovered that 60% of the young and middle-age males that died from acute myocardial infarctions (heart attack) did so within one hour of the onset of symptoms. In addition, more than 90% of the early deaths resulted from ventricular fibrillation, a condition that could only be corrected by defibrillation. From these facts, Dr. Pantridge concluded that treatment must commence even before the patient reaches the hospital.
Pantridge converted an ambulance into a mobile coronary care unit, and equipped the unit with hospital personnel and a portable defibrillator. Within the first 15 months, Pantridge recorded ten pre-hospital resuscitations with a 50% long-term survival rate.5
The first out-of-hospital defibrillation device weighed over 100 pounds, was manual, and needed trained personnel to operate it. These operators read the electrocardiograms (ECGs) to interpret the victim's heart rhythm; from this, they determined whether to deliver an electrical shock from the defibrillator.
In 1979, the first automated external defibrillators (AEDs) became available, further extending the concept of pre-hospital care. Today, emergency medical personnel use lightweight and portable AEDs to defibrillate victims of SCA, increasing their survival rates from 5% to up to 49%. These sophisticated devices contain microcomputers that accurately identify a victim's heart rhythm. If VF is occurring, the AED automatically decides that a shock is advised.
These technological advances mean that almost anybody can learn to use an AED. Due to their ease of use and affordability, AEDs now appear in many public places, such as offices, airports, fitness centers, and golf courses. In the future, AEDs may become almost as common as a fire extinguisher--omnipresent and ready in case of emergency.
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