(Circulation. 2000;102:e9028.)
© 2000 American Heart Association, Inc.
Cardiovascular News |
Cardiovascular News
Defibrillator Disagreement
The issue of automated external defibrillators (AEDs), how many there should be and who should have them, sparked controversy in the pages of the September 20, 2000 issue of the Journal of the American Medical Association. On one side of the issue is Mickey Eisenberg, MD, PhD, director of the emergency medicine service at the University of Washington Medical Center in Seattle, who calls for widespread dissemination of AEDs—to the point that he thinks consideration should be given to selling them to consumers for use in their own homes (Eisenberg M. Dissemination of defibrillators—medical vs consumer scenarios. JAMA. 2000;284(11):1435–1438). On the other side of the issue are Arthur Kellerman, Jr., MD, MPH, and Jeremy Brown, MD, who pose the question: Have AEDs been oversold? (Brown J, Kellerman, Jr. A. The shocking truth about automated external defibrillators. JAMA. 2000;284(11);1438–1441).
Dr. Eisenberg compares AEDs with cardiopulmonary resuscitation (CPR). He states that CPR was restricted to the surgical suite for years, then it went to emergency departments and hospital rooms, and now it is taught to thousands of people each year. "CPR has become a lay procedure—anybody can learn it, and it is assumed that bystanders will use it in emergency situations." He thinks that AEDs are very similar.
In his editorial, Dr. Eisenberg estimates that survival of
out-of-hospital cardiac arrest is probably between 2% and 3%, despite
sophisticated emergency medical services programs and community CPR.
According to Dr. Eisenberg, this is because the four links in the chain
of