Cardiac defibrillation by ambulance attendants

Rose, Leonard B.

doi:10.1001/jama.219.1.63

Cited by 13 publications

(3 citation statements)

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“…After each attack he immediately felt well and denied any prior chest pains or palpitations. There was no relevant past history, apart from angina pectoris for 12 years, but, on further questioning, he admitted that for two months he had noticed a sensation of his food "sticking" at the lower end of his sternum.…”

Section: Case Reportmentioning

confidence: 99%

Carcinoma of the oesophagus with "swallow syncope".

Tomlinson¹,

K²

1975

BMJ

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BRITISH MEDICAL JOURNAL10 MAY 1975 315 energy shocks were successful then. The initial shock was unsuccessful in 7%O (two out of 28) of patients with primary fibrillation, but a second shock of identical energy was successful in both patients. The success of the second shock when the initial one has failed29 may be related to the decreased impedance with successive shocks.30 Apart from allowing smaller and lighter defibrillators these lower energy shocks cause less myocardial damage.Our findings indicate the need for further investigation of the energy needed for defibrillation. Tacker et al.28 claim that defibrillators should have a much higher output capacity than they do at present, but high capacity output instruments would be much heavier, more cumbersome, and more expensive and, therefore, less generally available. If it is confirmed that lowenergy direct current shocks, particularly when repeated, will almost invariably correct ventricular fibrillation a cheap and generally available pocket defibrillator will be a possibility.

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Section: Case Reportmentioning

confidence: 99%

Carcinoma of the oesophagus with "swallow syncope".

Tomlinson¹,

K²

1975

BMJ

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“…The obstacle to this was that each 20 State had to implement laws in order to permit these groups to use a defibrillator. This was first achieved in California where an act was passed allowing paramedics to start resuscitation and use a defibrillator without the order of a physician and also in Oregon where it was ruled that using a defibrillator was to be considered an emergency procedure rather than a medical act (Lewis, Ailshie and Criley, 1972;Rose and Press, 1972).…”

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confidence: 99%

Training lay-people to use automatic external defibrillators: Are all of their needs being met?

2006

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This thesis draws upon data gathered during research undertaken with a grant from the Resuscitation Council (UK). It explores the use of Automatic External Defibrillators (AEDs) by laypeople, which is known as Public Access Defibrillation (PAD). Whilst an abundance of research has been undertaken about this phenomenon, it has predominately been conducted using quantitative methods; however the data I am using was collected using a qualitative approach. During the research, fifty-three semi-structured interviews were carried out. Most of these were with laypeople who had been trained to use AEDs, and nine involved those who delivered the training. These interviews were conducted at sites typical of those where these devices have been introduced, such as railway stations and airports. The geographical area of these locations covered the East and West Midlands, South and West Yorkshire, Lincolnshire and Essex. The aims of the research were quite broad and included exploring how to make training more realistic, how debriefing and support for those who had used an AED should be organised and how the interviewees perceived the technology inherent in the AED.This thesis reanalyses the data that was collected during that research and focuses on two themes. Firstly, some of the theories of technologies in transition are used to illustrate how AEDs were developed in a laboratory and progressed from that setting to become commonplace in public locations. The actor-network theory is adopted to argue that these technological devices exert an influence on the human actors in the networks that exist within society. Specifically, my analysis is informed by the work of Timmermans (1998; 1999; 1997) whose theories about external chest compressions I have developed and applied to AEDs. They suggest that these devices achieved universality, in part, through the influence of debates and medical protocols.One significant factor was that AEDs allowed for defibrillation to be redefined from a medical, to a first aid procedure. Eventually, using these devices was included in the protocols for first aid and this legitimised their use by laypeople. These theories are observable in the data through the interviewees" accounts of how they came to accept being trained to use AEDs. The experiences of those who had used an AED during a resuscitation attempt are provided and suggest that these are distressing and unpleasant events.Consequently, a key component of this thesis is a discussion of the necessity to provide psychological debriefing for those who have been involved in these incidents.The findings of this thesis suggest that laypeople who have used an AED usually have questions about the actions they took during the attempted resuscitation and need to address these with someone soon afterwards.

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“…Most sudden deaths from ischaemic heart disease occur outside hospital but they are preventable since the correction of ventricular fibrillation outside hospital is a practicable proposition.8 Paramedical workers are capable of correcting ventricular fibrillation, [9][10][11][12] and various prehospital coronary care schemes have been evolved. 9 10 13-15 Furthermore, attempts have been made to identify individuals at risk of sudden deathl6-18; and the implantation of defibrillators has been considered,'9 though there are apparently insurmountable problems.20 Friedberg2l has suggested that those at risk should have a defibrillator available, even at home.…”

Section: Introductionmentioning

confidence: 99%