NCPA - National Center for Policy Analysis

HOSPITAL DEFIBRILLATOR USE APPEARS SLOW

January 3, 2008

About half a million patients suffer cardiac arrest inside a U.S. hospital each year.  Less than a third survive.  In many cases, a medical device called a defibrillator can restart a stopped heart by delivering an electrical shock, but only if it is used quickly.  Since 1991, the American Heart Association has recommended that hospitals be ready to shock a stopped heart within two minutes after detecting cardiac arrest. 

However, American hospitals frequently take too long to restart stopped hearts after cardiac arrest, according to a study published in the New England Journal of Medicine.

Other major findings:

  • In 30 percent of cardiac-arrest episodes, hospitals waited longer than two minutes, leading to more deaths.
  • Between 2000 and 2005, only 70 percent of patients received a shock within the recommended two minutes; for those patients, the chances of leaving the hospital alive were 39 percent.
  • About 17 percent of the patients were shocked in the third through the fifth minute; for them, the survival rate was 28 percent and when hospitals took longer than five minutes to shock a patient, the survival rate fell to 15 percent.
  • Facilities with fewer than 250 beds did worse than larger ones, the study found and the participating hospitals were about 23 percent more likely to be tardy in shocking a black patient than a white one.

Dr. Paul Chan of the University of Michigan and lead author of the study suggested the following ways to improve the statistics:

  • Allowing nurses to administer shocks with manual defibrillators, installing automated defibrillators that anybody can use.
  • Expanding use of automated monitoring systems that detect cardiac arrest.

Source: Keith J. Winstein, "Hospital Defibrillator Use Appears Slow," Wall Street Journal, January 3, 2008.

For text:

http://online.wsj.com/article/SB119930151799862787.html 

For study:

http://content.nejm.org/cgi/content/short/358/1/9 

 

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