Blog | Thursday, August 8, 2013

QD: News Every Day--More AEDs at nontraditional exercise facilities might save more lives

Early CPR and access to an automated external defibrillator (AED) likely lead to better survival rates for people who work out at exercise facilities instead of facilities where people exert themselves but the devices are less common, such as bowling alleys, dance studios or community centers, a study found.

People experiencing sudden cardiac arrest at exercise facilities (broadly defined as any public indoor location where exertional activities are done for physical training and/or recreation) have a higher chance of survival than at other locations according to a study that appeared online Aug. 7 at the Journal of the American College of Cardiology.

The findings underscore the importance of having AEDs in places where people exert themselves and are at greater risk of sudden cardiac arrest, said researchers, who looked at 849 sudden cardiac arrests that occurred at public indoor facilities in Seattle and King County, Wash., from 1996-2008, where emergency medical responders maintain a registry of such information.

Researchers compared outcomes on cardiac arrests before, during and after exercise from commercial health clubs and fitness centers compared to nontraditional exercise facilities such as bowling alleys, workplace or hotel gyms or dance studios, or other non-exercise public spaces such as banks, restaurants, shopping centers or airports.

In total, 52 sudden cardiac arrests occurred at traditional exercise facilities, 84 at alternative exercise facilities and 713 at non-exercise facilities. Survival rates were 56%, 45% and 34%, respectively. Where information was available on the activity at the time of arrest, in 77% of cases the sudden cardiac arrest occurred during exercise, with only 18% occurring after exercise and 4% before exercise.

Researchers also collected information on what type of exercise people were doing when the sudden cardiac arrest occurred. The most common activity was basketball (20.5%), which is often played at community centers or church gyms. Following basketball was dancing and working out, both at 11.6%; treadmill at 8.9%; tennis at 6.3%; bowling at 5.4%; and swimming at 4.5%.

“Our findings should encourage broader implementation of and adherence to recommendations for AED placement and sudden cardiac arrest response protocols at traditional exercise facilities,” said Richard L. Page, MD, FACP, lead author of the study and chair of the Department of Medicine at the University of Wisconsin School of Medicine and Public Health. “In addition, these standards should be extended to alternative fitness facilities, where sudden cardiac arrest incidence is comparable to that seen at traditional exercise facilities.”

Editorialists from the Washington University Department of Biomedical Engineering commented that a vast percentage of the general community could perform resuscitation—children age 9 have been taught to do it—if there was more access to AEDs in public.

“It is not possible for the ideal collapse-to-shock interval threshold to be met with these devices in the hands of only EMS personnel,” they wrote. “Therefore it becomes essential to optimize the interface between these devices and the lay community who will use them in an emergency.”