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Friday, 6 September, 2002, 06:59 GMT 07:59 UK
Public heart aids 'not worth it'
Defibrillator
A defibrillator is used to shock the heart back to normal
The government's policy of putting machines to treat heart attack patients in public places is unlikely to save many lives research suggests.

The Department of Health is committed to providing 700 public access defibrillators in 72 sites across England and Wales, including airports and shopping centres.

But a study carried out by doctors at Glasgow University suggests that the policy is unlikely to have much effect.


The essential question in a system with limited resources is whether the money can be better spent in a different way to save more lives

Professor Stuart Cobbe
The researchers used records of 15,189 heart attacks that took place outside a hospital between 1991 and 1998 to estimate how many lives public access defibrillators would have saved.

Nearly eight out of ten (79%) of the heart attacks took place at sites - such as in the home - where people would not have been able to access a defibrillator.

Just 18% occurred in suitable sites, such as shops, places of business or sport centres, while another 3% occurred in possibly suitable sites, such as buses and multi-storey car parks.

The authors predict that locating public access defibrillators only in suitable sites would increase the survival rate from 5.0% to 6.3%.

If defibrillators were located in suitable and possibly suitable sites, the survival rate would increase only slightly further to 6.5%.

Better alternatives

The researchers say that more lives would potentially be saved by giving other emergency services, such as the police, assess to defibrillators, and training the public in basic life-saving skills.

Lead researcher Professor Stuart Cobbe said: "Introduction of public access defibrillators will save a small number of lives according to our analysis.

"While every life saved is to be welcomed, the essential question in a system with limited resources is whether the money can be better spent in a different way to save more lives."

Katharine Peel, head of emergency life support at the British Heart Foundation, echoed Professor Cobbe's views.

She said: "Because 70% of cardiac arrests occur outside hospital and 70% of those occur at home, widespread training is needed to increase the likelihood of CPR (cardiopulmonary resuscitation) or early defibrillation being performed before the arrival of the emergency services."

Early initiation of CPR, including 'mouth to mouth' and chest compressions, doubles the chance of survival.

Ambulance view

Jonathan Fox, of the Association of Professional Ambulance Personnel, agreed that educating the public to provide CPR would save many lives.

He said: "Without a radical sea-change in culture amongst the public towards learning this life-saving skill, it will be impossible for the National Service Framework for coronary heart disease, with its aim to save 3,000 additional lives annually from cardiac arrest, to be realised regardless of the skilled intervention of paramedics or first responders attending."

A spokeswoman for the Department of Health said government figures for survival rates after a cardiac arrest differed greatly from those in the study.

She said: "Where defibrillators in public places have been used so far under the department's initiative they have increased survival rates after cardiac arrest from 1-2% to 13% - we do not consider this a marginal improvement.

"What this study does confirm is that 20% of cardiac arrests occur in public places where survival without early defibrillation is very poor. This is the very reason the initiative was set up in 2000."

A defibrillator is an electrical device with two paddles that are placed on the chest. It discharges electricity through the heart when a lethal rhythm is present. The goal is to shock the heart back to normal.

The research is published in the British Medical Journal.

 WATCH/LISTEN
 ON THIS STORY
Two sides of the defibrillator debate
Jill Pell, Glasgow University, and Tony Wales, NHS Lanarkshire
See also:

16 Apr 00 | Health
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