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Challenging Sudden Death A community guide to help save lives

The book shows how communities can augment their emergency medical systems with automatic external defibrillators so as to save a significant number of people from dying of sudden cardiac arrest (SCA) , which is one of the leading causes of death among adults in North America. Victims of sudden cardiac arrest are generally middle-aged or elderly. Most SCA occurs at home (75-80%), and for many there was no previous history of heart problems. The SCA is often the first symptom.

More than 90% of victims in ventricular fibrillation who get an AED within 2 minutes survive. Delays have extreme consequences: if the AED is applies in 6 minutes there is a 45% survival rate, 6 minutes 30% survival, and typical community >10 minutes have < 5% survival rate.

The 40% of the SCA, which are not witnessed by bystanders, virtually always results in Sudden Cardiac Death. However, virtually all SCA victims wearing an emergency watch would get defibrillated in less than 5 minutes.

While the American Heart Association had been advocating early defibrillation initiatives since the late 1980’s only 6 states allow (1998) lay rescuers to use AEDs, even though is it far easier to learn how to use AED than to learn CPR. . Any less than 20% of the US emergency medical technicians are both trained and equipped to defibrillate.

The majority of the community cost to having AEDs is personnel cost. The example given on page 87 shows an annual cost of $55,000 for a community of 50,00 adults to save 20 lives per year = cost of about $3,000 per life.

The book was reviewed by representatives from 13 organizations, including the American Heart Association; American Red Cross; Heart & Stroke Foundation of Canada; International Associations of Fire Chiefs, Chiefs of Police, and Fire Chiefs; and the National Association of EMS Physicians.

Update late  2000 : Author has an organization with a web site

National Center for Early Defibrillation {Dead July 2001?} - new organization has an excellent overview
   and a great set of position statements by organizations that support the concept  updated 12/06/00
    which include:
    American College of Emergency Physicians, AHA, American Red Cross,
    Emergency Care Research Institute, Heart and Stroke Foundation of Canada,
    International Association of Chiefs of Police, International Association of Fire Fighters,
    The National Association of EMS Physicians