Everyone knows that quick action is needed in case of cardiac arrest – preferably within six minutes. But new research from Amsterdam UMC shows that a rapid shock with an AED within a few minutes is lifesaving. And that in three out of four cases, those six minutes are not met. “We're doing well, but we can do better.”

The Netherlands has a nationwide resuscitation network. Due to the many AEDs and volunteers, everyone with cardiac arrest could be resuscitated within six minutes of an emergency call. But how important are those six minutes, really? Because scientific evidence for those six minutes is limited.

Unique data

Very important, says Hans van Schuppen, he is an anesthesiologist and leader of the ARREST resuscitation research, a collaboration between emergency services and hospitals in North Holland. Their database contains data from 30,000 resuscitations, collected since 2005. This makes it one of the largest resuscitation databases in the world.

“We have also collected the data from all AEDs, which is unique because few regions in the world actually go to the AEDs to read the data,” says Van Schuppen.

Data from 3723 patients who experienced cardiac arrest outside the hospital were analyzed. It appears that if the first shock with an automated external defibrillator (AED) is administered within six minutes, the underlying arrhythmia causing the cardiac arrest is stopped in 93 percent of cases.

For example, if the first shock was only given after more than 16 minutes, this percentage dropped to 75 percent. For every minute the shock was delayed, the chance of survival decreased by 6 percent. “Therefore, a quick shock with an AED is crucial for survival.”

AED often too late

More important information emerges from the research by Amsterdam UMC. For instance, it appears that three out of four resuscitations do not reach the six-minute mark. “We are doing very well in the Netherlands; internationally, we are at the top for rapid response. In more than 60 percent of resuscitations, an AED is connected before the ambulance arrives. That is a utopia for many countries.”

This is due to the deployment of ‘first responders’, such as volunteer first aiders connected to a call system, or police or fire department personnel. Good figures then, but the reality is also that in three-quarters of cases the AED was not connected within six minutes.

More help in the neighbourhood

To meet the deadline, according to Van Schuppen, you need a few things, such as a good call-up system. “There are over 200,000 people in the citizen aid system. That's good, but it's probably not enough. More people are needed who can retrieve an AED and apply it. Additionally, AEDs are located in places that are not yet registered in the system and therefore are not found by citizen volunteers. They sometimes have to walk further than was later found necessary.”

The Heart Foundation emphasizes that community first responders are never sent to a location where an inaccessible AED is installed.

“If there is no AED in a neighborhood, someone must ensure that one is available,” says Van Schuppen. “In the Netherlands, it is not legally stipulated anywhere who is responsible for administering that shock within six minutes. It would be fantastic if we could organize the system even better so that everyone can receive a shock with an AED within those six minutes. That would absolutely save lives.”

Source: RTL News