Immediate defibrillation is the cornerstone of treatment of cardiac arrest (pulseless ventricular fibrillation and tachycardia). The faster defibrillation after the start of the cardiac arrest takes place, the better the survival. When ventricular fibrillation in emergency departments and intensive care for the success of defibrillation is almost 100%. If a cardiac arrest outside the hospital is done, the success rate is much smaller.
In Belgium, an estimated 10,000 people a sudden cardiac arrest outside the hospital. Usually, as a result of a myocardial infarction. That is an acute lack of oxygen to the heart muscle by narrowing or blockage of a coronary artery to the heart with blood. This may lead to fatal heart arrhythmias occur: ventricular fibrillation.
At that moment the heart is not really silent, but it will be fast and trembling. There will be no more blood is pumped round in the body. The brain does not get more oxygen and the victim loses consciousness almost immediately. There is only one way to stop the fibrillation and the heart to pump again: administering an electric shock (defibrillator definition =).
The ambulance or mobile emergency group (MUG) is often only after ten minutes on the spot, and it's usually too late. After several minutes cardiac arrest results in the lack of oxygen after damage to the brains of the victim. It is therefore very important that anyone who witnesses the cardiac arrest, immediately begin chest compressions and rescue breathing. Thus, blood pumped with oxygen until the ambulance or the MUG due to electric shock.
Even better is when the bystanders immediately the electric shock itself could give. Until recently that was unthinkable, because administering an electric shock resuscitation lot of knowledge and experience and therefore a strictly medical act was (so reserved to physicians). But now there are portable devices that CPR itself can make the diagnosis of ventricular fibrillation and could give an electric shock. Consequently, you no longer have to doctor them to serve. These devices are called automated external defibrillator or AED.
What is an AED?
An AED is a portable defibrillator on battery power. Some devices may weigh no more than 2 kg. They are extremely easy to operate. As a rule they have only two buttons: one to the unit on and another to the defibrillation shock. Some AEDs is the 'on' button even omitted. These devices to start automatically upon opening of the lid.
The AED provides voice instructions, so the user just follow its instructions. He must uncover the victim's chest and two large adhesive pads on application. Then the unit analyzes the heart rhythm of the patient. In a shockable rhythm (ventricular fibrillation or rapid ventricular tachycardia) loads the AED on and gives the instruction to the defibrillation button. Some AEDs will automatically administer the shock even.
Usually, then chest compressions and ventilation needs. That also says the device. After two minutes, the AED analyzes the heart rhythm again to see if you still have to give a shock. And if you usually go on until the ambulance or the MUG spot. So you can not forget to turn in the beginning the central 100-notify.
If you use an AED, CPR is classic than useless? No, not at all. Chest compressions and ventilation make sure that the brains oxygen, but that the fibrillation of the heart does not stop. You only ensures that the blood continues to circulate. It also happens in many cases the heart is not started immediately after the shock. Then it is very important to continue good chest compressions and ventilation to be carried out until the arrival of the emergency services.
AEDs should be used only in a patient in cardiac arrest and that the patient should absolutely not be manipulated while the AED is analyzing the rhythm. These are essential conditions to prevent the unit is charging in a conscious patient with tachyarrhythmia, not charging a patient with ventricular fibrillation or wrongly charged under CPR artifacts.
Greater availability of AED devices
The Ministry of Health decided in 2006 to provide additional AEDs available to ensure that in future all ambulances that are on the "100-system but" an AED available. Yet the ambulance arrives too late in the cardiac patient for early defibrillation.
AEDs are so cleverly constructed, that everyone can administer life-saving defibrillation shock. That it is indeed feasible to defibrillation should be performed by people without medical training was in the 90s proved in AED experiments, including in casinos and airplanes.
There is no doubt that early defibrillation can save many lives. But for that you must make sure that at any time and anywhere an AED is within reach. An American study showed that you so very much to bet and a lot of equipment to train people.
It is then also the question of whether AEDs in public, crowded places something out of it. 70 to 80% of the cardiac arrests is done at home. In that case it might be better for good ventilation and chest compressions to perform pending the emergency services. The firm's recommended course for anyone to operate the equipment purchase and home store. There are already numerous websites online where you can buy an AED. The cost is around € 2000, - to 2500 - and soon there might be a "light" version for € 1000, -.
Some devices in public places are likely an important example and promotional function, but as a strategy to save lives is not enough. There are abroad experiments in which the alarm in case of resuscitation not only sends specialized medical services, but also a number of trained volunteer counselors who live near the victim. These go beyond the first "public" get AED, by showing to the house of the victim to go to the resuscitation already starting.
CPR is still needed
To successfully carry out resuscitation techniques, you should follow a course. This applies to the use of an AED, as well as chest compressions and rescue breathing. It is even so that chest compressions, and carry out rescue breathing more difficult to use than an AED. This device tells you step by step because you have to do.
Statistics show that in Belgium, compared with eg Scandinavian countries, bystander CPR is used far too little in anticipation of the emergency services. However, bystander CPR can the chances of survival two to three times increase. It is certainly worthwhile. The best way for everyone to learn CPR is by the high school as a compulsory lesson in building. This is actually already the case, because recently in Flanders resuscitation included in the objectives of secondary education. From the first grade are more techniques practiced step by step, so that in principle at the end of every secondary pupil a reanimatieles followed would have.
Unfortunately, there are often practical reasons why this does not happen: no or insufficient manikins, inadequate teachers, no organized training of trainers. Until today, the final term so often unheeded. A lesson is also insufficient, as it is shown that after a few months, most students learned the skills not properly apply. Regular updating of the techniques is necessary to correct to continue CPR.
The government currently ensures that every ambulance in the 100-system a defibrillator on board. This is an important step. In addition, many schools reanimatieles traditional associations, such as the Red Cross or Bloso, their teachers now also to the section 'defibrillation with AEDs their students to learn. The defibrillator appears already in pools and associations that cross preventive services do as a football match.
No comments:
Post a Comment