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- Article #2-

Public Access Defibrillation - A Better Way

NOTE:
Numbers in article are LINKS to footnotes

Over the past few years the slogan "CPR + AED + 911 = SAVE, has become common knowledge in public access defibrillation. Granted there have been saves. But, the question is whether there could have been more saves or better outcomes (see case study).

It is our opinion that the slogan overlooks several major problems in attending to victims possibly in sudden cardiac arrest, they are:

the victim may not be in ventricular fibrillation, e.g. the victim is breathing although not perceived by the rescuer, in which case the defibrillator is of no value. More than likely the responder won't know until the AED advises whether or not a shock is indicated shock. That process may take several minutes during which the victim is without a supplemental oxygen source.


• the victim may be hypoxic (oxygen deprivation) and not respond to defibrillation.
  
  
• the victim may revert back to ventricular fibrillation because of an inadequate oxygen supply, post defibrillation. 1
  
  
• defibrillation with CPR has been touted as equivalent to oxygen assisted defibrillation. No distinction has been made. 2

The Old Way
The first sequence of photos is taken from a brochure illustrating one of the defibrillation processes.

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a The victim is without a supplemental oxygen source during a substantial part of the defibrillation process, particularly if multiple shocks are required.

b CPR cannot be given while the defibrillator is analyzing the victim's cardiac rhythm.

c It is difficult to perform mouth to mask CPR while someone else is prepping the victim for the AED.

The second set of photos shows the defibrillation process using the
TXO2® AUTOMATED First Aid Oxygen unit.

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Footnotes:

1.) "Proper patient management requires integration of cardiac care with adequate oxygenation and ventilation. Maximizing ventilation and oxygenation (to return the patient's' physiology to the best possible condition) is essential. This can make the difference between successful resuscitation, without sequelae, and a poor outcome." Patient Ventilation and Oxygenation, 42, January 2003, EMS. Back to Article

2.) Check the manufacturer's literature regarding AED's. Generally, there is a reference to an EMS unit or police officer using an AED. The orange bag often seen with the police officers, fire fighters, etc. contains oxygen. However, few manufacturers mention the oxygen, or if mentioned is a footnote or side note. Back to Article