It was in March 2012 when we all witnessed the dramatic events surrounding the Bolton footballer Fabrice Muamba. The Premiership star suffered a cardiac arrest during an FA cup clash against Tottenham Hotspur at White Hart Lane.
Automated External Defibrillator
Against all the odds, with resuscitation for over one hour, Muamba survived and was discharged from the London Chest Hospital four weeks later. It may be sensationalist to describe such an outcome as a “miracle” but in one sense it was. Every year an estimated 60,000 people suffer an out of hospital cardiac arrest with an abysmal survival rate of approximately 8%.
The single most important factor that determined Fabrice’s survival was the timely delivery of a life saving electric shock from an automated external defibrillator or AED.
The fact that this was applied within minutes of his collapse also significantly reduced the chance of him developing brain injury because of lack of oxygen. Unfortunately the overwhelming majority who suffer a sudden cardiac arrest are not as fortunate as Fabrice. England Football captain Steven Gerrard, the Royal College of Paediatrics and the British Medical Association co-signed a letter to the Prime Minister calling for legislation that ensures that every public building including schools, leisure centres and football stadiums have access to an automated external defibrillator (AED).
This was following a government e-petition, set up by the Oliver King Foundation in memory of a 12-year-old boy who sadly died after suffering a sudden cardiac arrest whilst swimming at school, amassed over 100,000 signatures.
It has been supported by figures from the sporting world including Amir Khan, Ricky Hatton, Michael Owen, Gareth Bale and Kenny Dalglish.
The Liverpool first team doctor Zafar Iqbal said: “12 to 16 young people die from a sudden cardiac arrest every week.”
Surely just as we have access to a fire extinguisher in the event of a fire, should AEDs be immediately available if someone suffers a cardiac arrest?
The Oliver King foundation deserve tremendous praise by ensuring the provision of an AED in every primary school in Liverpool.
AEDs should be widely available to many more. I know that if I had a cardiac arrest the one thing I hope someone would have access to is an AED.”
The delay between collapse to onset of the first shock is the single most important factor in determining survival. If defibrillation is delivered promptly survival rates as high as 75% have been reported. There have been huge advances and improvements in the provision of cardiac emergency services in the past ten years.
Londoners who have suffered a Sudden Cardiac Arrest (SCA) in public are six times more likely to survive than 10 years ago and great credit must be given to the ambulance service and the NHS for improved response times. There are various groups such as the British Heart Foundation who should be congratulated for raising awareness of the importance of the public performing CPR through a television campaign.
CPR and the use of an Automated External Defibrillator
CPR, when used alongside an Automated External Defibrillator – AED significantly increases the survival rate from 5% to 50%. But with every minute that passes without a life-saving defibrillation shock the chances of surviving a SCA decreases by seven to 10%.
Reassuringly the defibrillators are very user friendly. The Resuscitation Council states that AEDs are sophisticated, reliable, computerised devices that can be used safely and effectively without previous training. There are many causes of a cardiac arrest. Unlike Fabrice Muamba and Oliver, who likely had an underlying genetic predisposition, the majority suffer a cardiac arrest because of a “heart attack” where a sudden blockage of a coronary artery cuts off the blood supply to an area of heart muscle, starving it of oxygen and causing chest pain.
It is a lottery which one of these patients suffers an abnormal heart rhythm that leads to a cardiac arrest and up to half don’t make it hospital alive mainly because they weren’t able to be treated with a life saving shock. Many of the remainder now undergo a life saving procedure called angioplasty carried out in specialist cardiac centres where we can unblock the artery through keyhole surgery using small balloons that can access the heart arteries through the wrist or groin.
Many of those fortunate enough to survive and receive such a treatment are able to continue leading normal and fulfilling lives through a combination of lifestyle changes such as stopping smoking, regular exercise and adopting healthier diets in combination with some powerful medication.
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