Saturday, January 5, 2008

DELAYS IN DEFIBRILLATION DURINGCARDIAC ARREST

DEFIBRILLATION IN CARDIAC ARREST  NEJM DEC 2007

Kansas city researcher Dr. Chan has stirred up a hornet's nest with his study on cardiac arrests in hospitals and shocking the heart back to beating (defibrillation).    It seems the doctors have 2 minutes after the heart stops for good success.  A delay to about six minutes lower the survival rate to about 7%. Most big hospitals responded in 1 minute, but one third of them took longer than the critical 2 minutes.

            Around 500,000 patients have cardiac arrests in the hospital.  Only about 30% of the patients survive long enough to make it home.  Small hospitals  (250 beds) had most of the delays, along with arrests occurring on weekends or after hours (when the regular staff is off), and for some reason black patients have a high rate of delays.

Many public places have defibrillators on their premises.   Who will respond in 2 minutes and who is qualified or has the guts to put the paddles on the patients?  And lastly, will the legal community rationalize that such a delay is possibly malpractice?

What do you think?

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