Anyone buy a home defibrillator?

[hillview]

My parents live with us -- they are in their mid 60s and dad has an irregular heart but so far no issues. BP is slightly high. I am thinking of getting a home defibrillator just in case. Does anyone else have one? Thoughts?
Thanks!
/hillary

[shilo]

i have had patients who have owned one and they usually keep them in their cars so that it is always close by. i think the studies are pretty clear at this point that an AED combined with a person knowledgeable of and willing/able to perform CPR at least doubles survival rates of SCA (sudden cardiac arrest). SCA is different than a heart attack. in a heart attack, only a portion(s) of the wall of the heart muscle stops function, but the heart itself usually continues beating. this often results in symptoms, leads to a patient seeing their doctor and being diagnosed, etc, but you can have a silent heart attack in which there are no symptoms or they are mild enough at the time that people ignore them. in SCA, the whole heart stops beating resulting in an immediate lack of blood supply to the brain and other organs. this is when an AED usually winds up saving a life.

sorry if this is a review of stuff you're already familiar with, i forget who has medical knowledge around here, sorry. sounds like the first step might be to talk to/have your dad talk to his cardiologist and find out if the kind of irregular rhythms he's experiencing or any structural issues or blockages he may have are prone to lead to SCA. my educated guess is that if he did have a known irregular rhythm that was considered to be at clinically significant intervals, then the subject of a pacemaker or AICD (automatic internal cardiac defibrillator) would have already been discussed. so it would seem that the next piece of info you'd want to have is if either of your parents have any 'silent' issues going on that would make them prone to SCA (remember, one in every 3 SCA victims is a woman, usually past menopause).

ignore this if you already understand what the AED does. most commonly, the circumstances leading up to SCA involve previously damaged heart muscle (ie. from a known or silent previous heart attack) that results in scar tissue or damage to the electrical system of the heart itself. a blockage of one or more of the major cardiac vessels that bring blood to the heart can also cause SCA if just the right spot gets deprived of oxygen, but more commonly, if blockages are involved, it involves lots of little vessels that feed large areas of the heart wall becoming diseased over time. the muscle wall doesn't get the blood supply and therefore the oxygen it needs to function. which then leads to the regular electrical systems of the heart 'misfiring' (a bit of an oversimplification, but it gets the point across) and causing a rhythm in the heart that isn't compatible with moving blood around the body. so even tho there is still technically a rhythm there the person will probably not have a detectable pulse b/c the blood isn't being moved. the AED can read this irregular rhythm (most commonly ventricular fibrillation) and deliver the defibrillation to try and convert the heart muscle back into a normal rhythm that will result in blood being pumped.

so all that to say, you or they need to have a convo with your parents docs and get a picture of what their risk factors for SCA might be. if one of them were to have a heart attack, odds are better that you would have a chance to get them to the hospital for diagnosis and treatment. SCA - that would totally depend on the availability of defibrillation to improve the outcome (which is pretty much certain death without prompt intervention).

which leads to the other part of what would go into my decision making - which is how close is the nearest fire or police station? in my town all emergency vehicles carry an AED, including the unmarked and supervisor type vehicles. the closest fire station to us, for example is about 2 minutes away even with stop lights. but, in a true emergency, assuming someone is with whomever is having the heart attack, thats still probably 1 minute to call 911 and start the dispatch process, 2? minutes to mobilize at the station and another 2 minutes over to here. so 5 minutes total. i know i could keep up CPR for 5 minutes because i've done it before, altho never on a loved one. but i'd be banking on one of those vehicles getting there with the AED pretty darn soon. i do know that i've heard or read somewhere that for every 1 minute following cardiac arrest that CPR is not performed there is a 7-10% drop in the survival rate. but i'm not sure i've ever heard/read a similar per minute statistic on if CPR is being performed until the AED arrives.

so anyway, not a cut and dry answer by any means, but i do hope that helps with the thought process.

lori

[hillview]

THANKS!!
Doctor said it was an abnormal aortic aneurysm (sorry just asked) that they are watching but so far have not done anything for.
Here is the medline info on this:
http://www.nlm.nih.gov/medlineplus/ency/article/000162.htm
It would apprear from this that the AED wouldn't help if this became critical.

That said I am still considering it ... My parents live downstairs and both are over 60 in okay shape (my mom is a stage IV colon cancer survivor and both are slightly overweight etc. They were both smokers for 20 years but have quit.).

For our town published EMT response time is 5 minutes for first responder. I am certified in CPR (never had to do it thankfully).

For some reason I just feel like it might make sense ... is that over anxious?

/hillary

[Sillygirl]

Hillary - you are correct that if the aneurysm ruptures, the AED is not going to be of any help. People at high risk for sudden cardiac death include those with preexisting heart muscle damage, usually from heart attacks, as well as those with certain electrical abnormalities of the heart. Also, dialysis patients and others at high risk for heart attack, including people with diabetes and hypertension.

Lori is right that a run of the mill heart attack doesn't usually require an AED. However, a heart attack (which is a blockage of the blood supply to a portion of the heart muscle) can trigger an abnormal rhythm if the blocked, oxygen-starved area is big enough. The abnormal rhythm, called ventricular fibrillation, causes sudden death, and an AED is meant to treat it.

If it's not a big financial strain for your parents, and they have some risk factors, it may give them some peace of mind. My parents have one, mostly for when they're at their vacation house and the rescue squad is twenty minutes away.

[ThreeofUs]

Hillary, I really agree with you. I was worried sick about my mom, who had a heart attack with no risk factors, and was very sick for the last year of her life. I was 6 hours away.

My first response is to go with your gut (if you have the money and will get the training to use the AED correctly).

My second is that you or someone will need to be there with them quickly if there is a problem. I, personally, might think more about this question - if only because of my experience.

How, for example, would one of them home alone let you or the emergency folks know they are in trouble? Some people have cell phones with "panic buttons" - quick dials to family or 911. Other folks install intercoms that are 911 capable, or take other measures.

Don't mean to scare you, but thought you might want to weigh different situations where your parents might be at risk.

[hillview]

Ivy thanks! My parents live downstairs from me :)

I will talk to DH about this idea ...

/hillary

[elephantmeg]

if its an abdominal aneurysm in my experience (as a nurse not personal) no amount of CPR or AED will do anything-you "bleed out" and there is no blood to circulate. HOwever for a SCA it would be usefull. Go with your gut-and maybe call the teacher who taught your CPR class and get input on if and what to buy.

[hollybloom24]

We have a Phillips HeartStart. My husband is a physician and feels strongly that we have one in the house. He actually wants to get another for his car.

[hillview]

Holly ... do you have a medical reason to need one in the home or just seems like a good idea (like a first aid kit)?

PS we live in the same town!!
/hillary

[linsei]

I don't have one at home, but I would probably consider one if they were more reasonably priced.

You have already received great info, but a couple of other thoughts...

I just took ACLS and learned that they have changed the programming of defibrilators. Before, they delivered 3 stacked shocks and now the protocol is 1 shock, then CPR, etc. I'm not trying to say that the old type would not save a life, but just keep in mind that they might change the protocol every couple of years with what AHA considers to be better, and your unit would be considered outdated and you would be encouraged to upgrade (at a cost).

Also, I would think of it as a purchase for your family, not just for your parents. With this, I think of student athletes that have no prior diagnosed history that are at practice and their heart suddenly goes out of rhythm and an AED would save their life.

Another comment I wanted to make is that they are now really stressing the importance of doing "good quality cpr", and that is what really saves lives. They focused on our cpr technique for this last class. (We had to practice cpr all day and it was exhausting!) I had not been critiqued on technique that closely in prior classes.

Just a couple things to keep in mind.