Approximately 80 percent of cardiac arrests occur in the home, and the majority of those are witnessed. Defibrillators in private residences may reduce the time it takes to provide potentially lifesaving defibrillation therapy to victims, impacting sudden cardiac arrest survival.

HeartStart…Don’t Stay Home Without It

Phil Philcox

HeartStartDon't Stay Home Without It
by Phil Philcox

Approximately 80 percent of cardiac arrests occur in the home, and the majority of those are witnessed. Defibrillators in private residences may reduce the time it takes to provide potentially lifesaving defibrillation therapy to victims, impacting sudden cardiac arrest survival.


It's amazing how many things can go wrong with the human body. We're familiar with most of them and hopefully smart enough to seek out help. However, somewhere on that list is sudden cardiac arrest or SCA. It usually strikes without warning and occurs when the normal rhythm of the heart is disrupted so it doesn't pump blood properly. Unfortunately for some of us, many attacks occur in the home, far away from professional care, so quick action is called for.

In all medical emergencies, you should call 911 first. When medical personnel arrive and recognize the symptoms, they use a defibrillator to get the heart back in synch. Defibrillation is a process in which an electronic device gives an electric shock to the heart. This helps reestablish normal contraction rhythms in a heart having dangerous arrhythmia or in cardiac arrest. You've seen the process on TV: the doctor uses two paddles, warns everybody around the victim to step back and sends an electric current to the patient's heart. This and CPR are the standard treatment for cardiac arrest incidents.

Up until recently, a doctor's prescription was required to purchase a defibrillator for home use. Philips (www.HeartStartHome.com, 1-866-333-4246) has introduced a home version called HeartStart Home. For the past several years, Philips defibrillators have been used on commercial aircraft, in schools, the workplace, nursing homes, ambulances, and anywhere people congregate. There are no age restrictions on SCA, so young or old, everyone is a potential victim but there's help out there for all ages.

"It's important to recognize that for a substantial percentage of SCA victims, cardiac arrest is the first sign of heart disease," said Dr. Jeremy Ruskin, Director of Cardiac Arrhythmia Service at Massachusetts General Hospital. "We know that access to early defibrillation helps save lives. Removal of the prescription requirement for the HeartStart Home Defibrillator gives people freedom of choice to be better prepared for unexpected cardiac arrest - a rate but life threatening emergency."

Although the process sounds complex, the home version of HeartStart is simple in operation. After you call 911, you turn the unit on (it measures 8" by 9", weighs about 3.5 pounds) and it actually starts talking to you, explaining every step along the way. It tells you to attach the two pads to the person's bare skin according to the pictures on the pads. When you attach the pads, it immediately begins to analyze the person's heart rhythm using an algorithm called SMART analysis. If a shock is needed, the unit instructs you to push the flashing orange button. If is shock is not needed, it tells you so and instructs you to attend to the person and begin cardiopulmonary resuscitation or CPR if needed. The blue "I" button tells you that even more information in available. Push it and it will tell you step-by-step how to perform CPR.

Being prepared for any medical emergency in the home is something we should all consider. Medical help might be available at the other end of the 911 line, but being able to do something while help is on the way could mean the difference between life and death.

SIDEBAR:

What is sudden cardiac arrest?

Sudden cardiac arrest (SCA) is one of the leading causes of death in the United States. SCA is an electrical malfunction of the heart typically associated with an abnormal heart rhythm known as ventricular fibrillation. It is a condition in which the heart's electrical impulses suddenly become chaotic, causing an abrupt cessation of the heart's pumping action. Victims collapse and quickly lose consciousness, often without warning. Unless a normal heart rhythm is restored, death follows within a matter of minutes. The current national survival rate is less than five percent. This can strike anyone, at any time, anywhere. Many victims have no history of heart disease, or if heart disease is present, it has not functionally impaired them. Most victims of SCA have no prior symptoms.

There are four critical steps - called the "Chain of Survival" for the treatment of sudden cardiac arrest. Step One: early access to care (i.e., calling 911 or another emergency number); Step Two: early cardiopulmonary resuscitation (CPR); Step Three: early defibrillation; and Step Four: early institution of advanced cardiac life support as needed. A break in any of the four links in the chain can compromise the patient's chance for survival; however, early defibrillation is recognized as the most critical step in restoring a normal cardiac rhythm and resuscitating an SCA victim.

Defibrillation is the treatment of irregular heart rhythms by delivering an electrical current to the heart. It is recognized as the definitive treatment for ventricular fibrillation. Defibrillation administered within the first few minutes after collapse is most successful. The likelihood of successful resuscitation decreases drastically with every minute that passes. After 10 minutes, very few resuscitation attempts are successful. Thus, the most important element in the treatment of SCA is providing rapid defibrillation therapy.

Only one out of every 20 SCA victims survives-though many of these lives could potentially be saved through timely defibrillation. With a brief window of opportunity for effective intervention, it is vital that a victim be defibrillated within 10 minutes of arresting.

In a typical community, it takes an average of nine minutes for an ambulance to reach a victim. Outside influences such as street congestion, high-rise buildings and remote or rural locations further prolong response times. For example, studies of persons experiencing SCA in New York City and Chicago, where emergency medical system (EMS) response times are prolonged by heavy traffic and tall buildings, show survival rates of two percent or less. The American Heart Association estimates 40,000 more lives could be saved annually in the U.S. alone if defibrillators were more widely available and could reach victims quickly.

SCA is more common among men than women, and the risk begins to rise in general once men reach age 45. Some people are at an increased risk for developing heart disease due to family history or lifestyle. However, SCA is largely unpredictable. It can strike anyone, anywhere, at anytime-often without warning. Many victims have no prior history or symptoms of heart disease. In fact, 50 percent of the sudden deaths in men and 63 percent of those in women occur in persons with no prior symptoms of coronary artery disease. Other factors besides heart disease and heart attack can cause SCA, including respiratory arrest, electrocution, drowning, choking or trauma.

What steps are being taken to improve survival rates?

In the mid-1990s, the American Heart Association issued a "call to action," encouraging the broad deployment of defibrillators in public places where large groups of people gather. Advances in technology delivered a new generation of devices called automated external defibrillators. Automated external defibrillators are small, portable, very easy-to-use, inexpensive devices that, for the first time, made it possible to train and equip a broad new group of emergency "first responders" in their use. The technological advances that led to automated external defibrillators helped migrate their use from highly skilled operators in emergency rooms and ambulances to minimally trained firefighters, EMTs and police officers. As understanding of the life-saving potential of defibrillators increased, airlines, airports, convention centers, health clubs, cruise ships, corporations and industrial parks implemented programs.

Automated external defibrillators continue to be deployed in new locations including shopping malls, sports arenas and even across entire communities. In fact, all 50 states have enacted defibrillator laws or adopted regulations protecting trained citizens who use the device in an attempt to save a life. Published studies demonstrate dramatic increases in survival as a result of the broad deployment of defibrillators.

Approximately 80 percent of cardiac arrests occur in the home, and the majority of those are witnessed. Defibrillators in private residences may reduce the time it takes to provide potentially lifesaving defibrillation therapy to victims, impacting sudden cardiac arrest survival.

How can consumers buy a defibrillator for home use?

Consumers can purchase a defibrillator for the home, without a prescription, at www.HeartStartHome.com

What is the cost of a home defibrillator?

The Philips HeartStart Home Defibrillator has a manufacturer's suggested retail price of $1,495.

Phil Philcox is the Editor/Director of The Press Association and a contributor to hundreds of magazines and newspapers. He's the author of fifty non-fiction books on various subjects, many listed on amazon.com under this name. He can be reached at px@knology.net.


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