One use every seven years makes automated external defibrillators a good buy

September 05, 2003

Automated external defibrillators -- user-friendly, heart-shocking devices that treat people with cardiac arrest -- are showing up more frequently in locations such as airports, schools, houses of worship, hotels and retail stores. With their pricey tag of about $3,000, you might wonder what types of places make a defibrillator purchase a "good buy."

Researchers at the University of Iowa and University of Michigan evaluated the value -- in terms of saving lives and the necessary costs to rescue people with cardiac arrest -- of installing defibrillators in various public locations. The team found that a defibrillator was a good investment if the specific location was expected to have at least one cardiac arrest every seven years, a slight extension of current American Heart Association guidelines. The findings, based on a comprehensive review of existing studies and data on defibrillator placements in the Seattle, Wash. area, appear in the September issue of the Journal of General Internal Medicine.

The study also found that locations such as large retail stores (1 in 2,000 annual probability of being used) and hotels (1 in 100 annual probability) apparently are not cost-effective candidates for defibrillator placement.

"Our conclusions support the American Heart Association recommendation that defibrillators should be placed in public locations where there is a one in five chance that the defibrillator will be used in a given year to treat a person with cardiac arrest," said Peter Cram, M.D., UI assistant professor of internal medicine and the study's principal investigator. "However, defibrillators also are being placed in a number of low-risk public locations where the money might be better to spent in other ways, such as improving the existing EMS program."

A. Mark Fendrick, M.D., professor of internal medicine at the University of Michigan and the study's senior author, identified the three crucial factors that should drive where a defibrillator should be placed: how many people are at the site, how long they are there, and whether those people are at risk for having cardiac arrest.

"In an ideal world, a defibrillator would be present wherever large numbers of high-risk people congregate," Fendrick said. "What concerns me is that instead of being routinely placed in high-risk locations such as crowded senior centers, these devices are frequently put in locations such as elementary schools, where their use is very unlikely."

Cram noted that, at the other end of the spectrum, international airports are a good place to have defibrillators because the sites are constantly in use.

"There are people there 24 hours a day, seven days week, they're densely populated and the population is at moderate risk. Evidence suggests that a defibrillator in an airport will be used once every two years," Cram said.

In contrast, public schools or houses of worship are generally sparsely populated for a limited number of hours each week with a low- to moderate-risk population. Yet many of these institutions are buying defibrillators.

According to the study, "it doesn't appear to make a whole lot of sense for these low-risk sites to have defibrillators," Cram said. Yet he understands the impulse for groups to buy the devices. After all, an estimated 250,000 people nationwide die each year from out-of-hospital cardiac arrest.

"For good reason, the public is worried about cardiac arrest. It is an extremely common cause of death in the United States," he said. "It is the individual's or organization's money, and if they want to buy a defibrillator, that's their choice. But the question is: Is that the best way to improve the well-being of your populations? Maybe not."

A better investment for low-risk sites might be to offer free counseling about smoking cessation or weight loss, provide free preventive health screenings or pay for effective services for those who cannot afford them, Cram said.

In a follow-up study, the researchers are surveying public schools to determine whether they are buying defibrillators and the number of cardiac arrests at the sites. Public schools are one of the markets that have been targeted very aggressively for defibrillator placement, Cram said.
University of Iowa Health Care describes the partnership between the UI Roy J. and Lucille A. Carver College of Medicine and UI Hospitals and Clinics and the patient care, medical education and research programs and services they provide. Visit UI Health Care online at

STORY SOURCE: University of Iowa Health Science Relations, 5137 Westlawn, Iowa City, Iowa 52242-1178

University of Iowa

Related Cardiac Arrest Articles from Brightsurf:

Outcomes for out-of-hospital cardiac arrest during COVID-19 pandemic
This study used a large US registry of out-of-hospital cardiac arrests to asses the association between the COVID-19 pandemic and the outcomes of out-of-hospital cardiac arrests, including in areas with low and moderate COVID-19 disease.

Cardiac arrest is common in critically ill patients with COVID-19
Cardiac arrest is common in critically ill patients with covid-19 and is associated with poor survival, particularly among patients aged 80 or older, finds a study published by The BMJ today.

In-hospital cardiac arrest in COVID-19
Outcomes of in-hospital cardiac arrest among patients with COVID-19 are examined in this case series.

New risk tool developed for cardiac arrest patients
Experts have developed a risk score to predict cardiac arrest patient outcomes.

Intravenous sodium nitrite ineffective for out-of-hospital cardiac arrest
Among patients who had an out-of-hospital cardiac arrest, intravenous sodium nitrite given by paramedics during resuscitation did not significantly improve their chances of being admitted to or discharged from the hospital alive, according to research presented at the American College of Cardiology's Annual Scientific Session Together with World Congress of Cardiology (ACC.20/WCC).

Getting to the heart of epinephrine use in pediatric cardiac arrest patients
The effectiveness of epinephrine treatment during resuscitation of adult patients with cardiac arrest is generally promising, but little is known about its effects in pediatric patients.

Bystanders can help more cardiac arrest victims survive
Only 8% of Americans survive cardiac arrest outside a hospital, but that percentage could increase significantly if bystanders recognize cardiac arrest and perform simple lifesaving tasks, a UVA Health physician says in a New England Journal of Medicine article.

Opioid-related cardiac arrest patients differ from other cardiac arrests
People who suffer cardiac arrest due to an opioid overdose are younger, have fewer chronic medical conditions and may be more likely to be to receive bystander CPR, according to a review of emergency response records in Maine.

Selective coronary angiography following cardiac arrest
In the current issue of Cardiovascular Innovations and Applications volume 4, issue 2, pp.

Sudden cardiac arrest in athletes: Prevention and management
It's marathon season, and every so often a news report will focus on an athlete who has collapsed from sudden cardiac arrest.

Read More: Cardiac Arrest News and Cardiac Arrest Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to