Public Defibrillation Access Program (PAD) - to increase the survival rate of sudden cardiac arrests

"(...) is too healthy to die." Professor Claude Schaeffer Beck said these words in 1947. Just before pioneering defibrillation perioperative ventricular fibrillation in a 14-year-old boy who developed after successful surgery to correct a malformation of the heart. The defibrillation finished successful. Thanks to her, the boy recovered completely, and defibrillation became the gold standard in emergency cardiac arrest.

The first successful human defibrillation took place over 70 years ago. The progress of technology and research on defibrillation gives hope for saving more and more lives with such a simple procedure as defibrillation. Every year, over 2,800,000 European Union citizens die from cardiovascular disease and over 940,000 die from coronary heart disease (According to Eurostat data).It turns out that sudden cardiac arrest is responsible for 60% of deaths related to coronary heart disease. Sudden stopping can occur in 4 mechanisms. These are:

  • electromechanical dissociation of the heart
  • ventricular fibrillation
  • asystole
  • ventricular tachycardia without pulse
  • At the moment of unconsciousness by a patient with sudden cardiac arrest, the percentage of ventricular fibrillation may constitute up to 76%. When we combine statistics on population mortality, as a result of sudden cardiac arrest and a huge percentage of ventricular fibrillation, it turns out that ventricular fibrillation is by far the largest unit risk of sudden cardiac death. It is worth remembering that rapid defibrillation is the only effective method to treat ventricular fibrillation. According to statistics, defibrillation performed within 1 minute of sudden cardiac arrest is 90% effective, after 5 minutes - in 50%, and after 7 minutes - in 30% effective. Here we can see that it drops by around 10% with every minute. Current guidelines show that the standard to which we should strive is to perform street defibrillation within no more than 5 minutes of unconsciousness by a person with sudden cardiac arrest. The only systemic way of proceeding in creating solutions that increase the survival rate in sudden cardiac arrests in human communities is the mass placement of devices capable of defibrillation in public places and universal access to training in the use of these devices.This is because it seems impossible to create a specialized system based on professional emergency medical teams capable of using defibrillation with a maximum 5-minute response time in both urbanized and non-urbanized areas. Unfortunately, in most European societies, the average time it takes from 8 to 11 minutes for a medical emergency team to call for first defibrillation.

    The device for the fastest defibrillation of sudden cardiac arrests that occurs in public space is an automatic external defibrillator - in short: AED. An automatic external defibrillator is a device that has been designed and constructed in such a way that after gluing self-adhesive electrodes to the patient's chest, he is able to analyze the heart rhythm, decide on the need for defibrillation, inform the rescuer about the decision, and after the lifeguard's informed acceptance of this decision, pass the current pulse electrical through the patient's heart.When we start the device, it issues clear and understandable voice commands. In addition to audio messages, the device itself and its individual components are marked so that even the deaf person is able, following the pictorial instructions, to operate the device without complications. The messages cover the operation of the device, as well as provide advice and tips on the procedure of first aid.

    Suppose the automated external defibrillator is so common that its availability is within 1 minute of sudden cardiac arrest. We are talking about a chance to save a considerable number of almost 390,000 European Union citizens per year. If we translate European statistics into Poland, we receive almost 20,000 people a year. The stake is high and it is absolutely necessary to fight for it.

    Every year, the number of automated external defibrillators in the public space increases, both in Poland and other European countries. People's awareness as well as the increase in the number of available devices give high hopes for improving the survival rate of people who have sudden cardiac arrest. Certainly Poland as a country has not yet achieved a satisfactory number of these devices in public space.Satisfactory - providing free access to them to anyone who witnesses a sudden cardiac arrest, regardless of the location of the situation. Nevertheless, a significant increase in the number of devices and an evident increase in the speed of emergence of new ones give us a chance as a society to achieve this satisfactory level. It is influenced by the increasing public awareness in the context of providing first aid. As a Rescue Center, we hope that thanks to our activities we contribute to this awareness. Another reason for this upward trend is definitely easier access to automated external defibrillators, which results from the increasing number of device distributors on the market, and thus their increasingly affordable prices. Increasingly, this type of device appears in public buildings.350/5000 Information that inside such a building we can look for an automatic external defibrillator is very often located on all the entrance doors to the facility. Horizontal and vertical marks often lead to the device. In addition, the storage location of the device itself is most often marked using the international AED logo.

    NUnfortunately, at the moment there is no uniform system in Poland that would register all new devices and provide willing people with information about their location. Such a system is definitely an indispensable future. As of today, you can search for information on this topic on your own on the web. There are websites collecting voluntarily sent data from persons, companies and institutions on the location of AED devices.

    • European Funds - Smart Growth
    • Republic of Poland
    • European Union - European Regional Development Fund
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