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Public-access defibrillators double chance of survival
ORLANDO, Fla. -- The first major test of public-access defibrillators found that placing the devices in office buildings and shopping malls and training ordinary people to use them can double the chances of surviving cardiac arrest.
Defibrillators have already become standard equipment, like fire extinguishers, in many airports, convention centers and health clubs. And while earlier studies suggest they are safe, there has been no clear proof until now they actually increase survival.
Each year, about 250,000 Americans die from cardiac arrest, which can result from heart attacks, underlying heart disease or accidents, among other causes. While most such deaths happen in the home, roughly 20 percent occur in public places, and 95 percent of victims die even before reaching the hospital.
Paramedics can shock victims' hearts back to a normal beat with defibrillators, but they rarely arrive in time. In fact, every minute spent waiting for a paramedic lowers the chance of survival by 10 percent.
The latest study was intended to see if putting automated defibrillators about the size of laptop computers into the hands of ordinary volunteers increases the chances of saving these people while the ambulance is on the way.
About 1,500 defibrillators were distributed to 993 sports facilities, shopping centers, entertainment venues, community centers, office buildings, factories, apartment buildings, transit centers and schools in 24 cities. About 20,000 volunteers who worked there took part. Half were taught to do CPR only. The rest were also shown how to work defibrillators.
After almost two years, there were 292 attempted resuscitations and 44 survivors -- 29 among the volunteers with defibrillators, and 15 among those who did CPR alone.
Dr. Joseph Ornato of Virginia Commonwealth University in Richmond presented the results Tuesday at a meeting of the American Heart Association in Orlando.
"The bottom line is we believe defibrillators in public facilities will double survival, if there are trained teams to use them," he said.
They also turned out to be extremely safe when used this way. The devices can detect whether someone truly is in cardiac arrest. In the study, they did not deliver any unnecessary shocks.
Dr. Raymond Gibbons of the Mayo Clinic said he hopes the results will persuade more businesses to install defibrillators.
"It potentially will have an enormous impact," he said of the study. "Hopefully over time this will save lives."
Epidemiologist Clay Mann of the University of Utah, who headed the project in his state, said the devices seem to be most useful in shopping centers, fitness clubs and other recreation areas where elderly people often congregate.
In one case at a fitness center, a 41-year-old man walked on a treadmill while his wife swam in the pool nearby. Suddenly he collapsed with cardiac arrest, and two women working the front desk had him hooked to the defibrillator within a minute.
"He was shocked twice and woke up before his wife arrived from the pool," Mann said. "He's doing just wonderfully."
Most victims in the study were in their 60s and 70s. One disappointment was that while 15 percent of the defibrillators were placed in central locations in apartment buildings and gated communities, they were used in just one save.
A new federally funded study involving 7,000 people is testing whether providing the devices to families of heart attack patients will improve the chances of surviving cardiac arrest in the home.
The study was conducted in Birmingham, Ala.; Chicago; Cincinnati; Indianapolis; Milwaukee; Minneapolis; Mission Viejo, Calif.; New York City; Newark, Del.; Phoenix; Pittsburgh; Portland, Ore.; Richmond, Va.; Seattle; Palm Springs, Calif.; Stony Brook, N.Y.; Syracuse, N.Y.; Virginia Beach, Va.; Washington, D.C.; Salt Lake City; Detroit; Calgary, Alberta; Vancouver, British Columbia; and Edmonton, Alberta.
It was sponsored by the National Heart, Lung and Blood Institute with contributions from the heart association and three defibrillator makers.
EDITOR'S NOTE: Medical Editor Daniel Q. Haney is a special correspondent for The Associated Press.
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