Hospitals Delay Using Defibrillators to Restart Heart

A new study published in the New England Journal of Medicine suggests that hospitals in the US are often slow on getting hearts that have stopped following cardiac arrest restarted. This lethargy by the hospitals is leading to several hundred deaths each year.

Every near, nearly half a million patients in the US suffer cardiac arrest while under going treatment inside a hospital. Less than one third of these patients survive the attack. In most cases, the heart can be restarted by delivering an electrical shock to the organ through a device called a defibrillator. However, this is effective only if the shock is delivered within minutes of the cardiac arrest.

Since 1991, the American Heart Association has recommended hospitals to be ready to restart a heart with electrical shock within two minutes following a heart attack. However, the new study by researchers from the University of Michigan has found that in 30% of cardiac-arrest cases, hospitals wait for more than the recommended two minutes, most often leading to death.

Led by Dr. Paul Chan, the researchers analysed data gathered from 369 hospitals participating in a voluntary program to track defibrillator usage organized by the Heart Association. The analysis revealed that only 70% of the patients who suffered a heart attack inside a hospital between 2000 and 2005 received shock treatment within two minutes.

The chances of these patients surviving the cardiac arrest were found to be 39%. For the 17% of patients who received a shock between three to five minutes of the arrest, the chances of survival were found to be 28%. This rate dropped to just 15% if the shock delivery took more than five minutes.

Differences were also seen between bigger and smaller hospitals with facilities having less than 250 beds faring worse than their bigger counterparts. Black patients were found to be 23% less likely to receive a shock than whites in the participating hospitals. According to the researchers, this did not necessarily indicate a bias on the part of the hospital staff.

“It may very well be the case that black patients are more likely to go to smaller community hospitals that have no academic affiliation,” Dr. Chan said. He expressed the hope that their findings will lead to a discussion about the best ways to improve these statistics.

In his opinion, allowing nurses to administer shocks with manual defibrillators, installation of automatic defibrillators, and expanding use of automated monitoring systems for detection of cardiac arrest could form part of such measures. At the same time, he expressed the need for further studies for determining the most cost-effective steps.

Related Discussions Do you actually think about your heart? Working of the heart Computer and heart

Related Articles FDA Warning about Malfunction of Certain Guidant Implantable Defibrillators Cardiac Revascularization - Can Specialty and Non-specialty Hospitals Compare in this Respect?