A new study in the journal BMC Medicine is calling into question one of the hottest new medical device markets.
The market is for portable defibrillators. A 2008 story touting the devices stated "having these portable devices stored in public institutions is the difference between life and death."
Turns out, maybe, not so much. (Picture from Wikipedia.)
A team of emergency room physicians at the University of Michigan headed by Comilla Sasson (now at Colorado) found that simple chest compression is just as effective in the first five minutes after a heart attack, the minutes that are critical to survival.
If the ambulance is more than five minutes away, in fact, chest compression may offer a better chance of survival.
It must be added this is still a slim chance. Only 8% of people who suffer sudden cardiac arrest outside a hospital survive.
This is the second study to turn thumbs-down on portables. A 2008 study of 7,000 records in Seattle showed that having a defibrillator at home offered no more hope of survival than knowledge of CPR.
Rapid chest compressions can be performed, in an emergency, even by someone who has never been trained in the procedure. Rescue breathing (the dreaded mouth-to-mouth) is no longer considered necessary.
The assumption that fibrillation is best has spawned a decade-long boom in the market, with both new and used gear in strong demand.Even hotels and resorts have been urged to keep them on hand (at nearly $3,000 each) or risk a lawsuit if someone dies and there wasn't one available.
There are actually three defibrillator markets, and the latest study only impacts one of them:
- Implanted defibrillators, like one long used by former Vice President Cheney, are installed following an extensive history, by professional cardiologists, and work well.
- Hospital defibrillators, used in emergency rooms or cardiac wards, are used by trained professionals and work well.
- Portable defibrillators, often used by people with little training, turn out to be no better than CPR chest compression.
The rush to market, however, has resulted in some recalls and lawsuits.
It's all a great example of something important. An expensive solution to a deadly problem is not always the right one. Sometimes a cheap, even free solution can work just as well, or better.