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Doctor, get involved
Dr Welsford believes that
primary care providers can play three important
roles in local PAD programs:
- Learn to use PADs. "It's
handy to actually know what to do when you're
called on as the physician."
- Inform people about PADs.
"You can [talk] about the more medical aspects
of why PADs are useful."
- Get involved in a local PAD
program. "All public access programs need a
medical director. The director, usually a local
physician, doesn't have to actually do any training.
They make sure guidelines are being followed
and people are getting retrained."
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Does this story sound familiar?
A seemingly healthy man 'drops dead' of a heart attack
in a local shopping mall. Helpless bystanders look on
in horror as the man gasps his last breath and dies
before the paramedics are even out of the ambulance
bay.
The chance of a patient surviving
an out-of-hospital cardiac arrest is a dismal 5%, according
to a recent report by the Heart and Stroke Foundation.
A growing number of Canadian towns think the only way
to turn this trend around is to install defibrillators
in public places. "CPR doesn't save lives by itself,"
says Dr Michael Shuster, a spokesperson for the Heart
and Stroke Foundation and an emergency doc. "The earlier
you get the patient defibrillation the more chance of
survival."
Dr Shuster believes public access
defibrillators (PADs) can be very useful in high traffic
locations — "Areas like airports, casinos, even
exercise facilities," he says. "In some of these places
resuscitation rates are 80% [with a PAD]."
Dr Michelle Welsford, a McMaster
professor and physician in Hamilton Health Sciences
Centre's ED, agrees. "PADs have been shown to actually
save lives, especially when used in very strategic locations,"
she says. "A few studies have shown amazing outcomes
and large benefits primarily in places like casinos
where there are a high number of elderly people and
lots of surveillance."
RIGHT
LOCATION, RIGHT TRAINING
Three suburban Montreal municipalities are the latest
to jump on the bandwagon and will be installing 20 new
PADs in public arenas and pools. The towns also plan
to train staff to use the machines properly, as well
as how to know the symptoms of a heart attack and how
to do CPR. But some detractors say the trend is more
about scoring political points — at a high cost
to taxpayers. The machines are about $3,000 a pop.
"The cost benefit might not play
out," notes Dr Welsford. "The best benefit will be that
people will be trained in CPR." Low CPR training rates
are a huge issue, she adds, so getting more people trained
up — wherever they are — will mean more lives
will be saved.
The devices themselves are easy
to use. "The PADs are pretty smart," says Dr Shuster.
"While it may not be impossible to fool the machine,
it's pretty close." Machines are able to analyse a victim's
heart rhythm and prompt the rescuer to press the appropriate
button when the heart begins to fibrillate. But both
Dr Shuster and Dr Welsford stress the importance of
proper training. "In an emergency people are excited
and scared. It's not the best time to be learning to
use these things."
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