Use of automated external defibrillators in the House of Representatives Brazil, the first in Latin America: a 2-year experience

Background

Passengers who have ventricular fibrillation aboard commercial aircraft rarely survive, owing to the delay in obtaining emergency care and defibrillation.

Methods

In 2002, after the incorporation of automated external defibrillators (AEDs) by other PAD initiatives, a major Latin American House of Representatives (HR) began equipping its major building (Chamber of Deputies) – 513 Representatives, around 5000 people working and more than 20,000 people transiting every day – with automated external defibrillators (Lp 500). We chose the healthcare professional (more than 30) as the focus of the training program conducted according to the guidelines of the American Heart Association in the use of the defibrillator and applied the device when people had a lack of consciousness, pulse, or respiration. The AEDs were also used as a monitor for other medical emergencies, generally at the direction of a physician. We placed a separate cardiac monitor without the capacity for defibrillation, to be used when the strict definition of cardiac arrest has not been met (Lp 12). The electrocardiogram that was obtained during each use of the device was analyzed by two physicians for appropriateness of use. We analyzed data on all six instances in which the defibrillators were used between 1 February 2002 and 1 September 2004.

Results

Automated external defibrillators were used for six patients, including six patients in ventricular fibrillation with documented loss of consciousness. Electrocardiographic data were available for all patients. The administration of shock was advised in all six patients who had electrocardiographically documented ventricular fibrillation (sensitivity and specificity of the defibrillator in identifying ventricular fibrillation, 100%). One patient had atrial flutter with high-degree atrioventricular block. All six episodes of ventricular fibrillation were properly treated with establishment of a final rhythm potentially perfusional in five cases. The first shock successfully defibrillated the heart in six patients (100%). No complications arose from use of the automated external defibrillator as a monitor in conscious passengers.

Of the six patients, four (66%) left the locality alive and three (50%) were discharged home from hospital. In all cases the initial rhythm was ventricular fibrillation.

Conclusions

The use of the automated external defibrillator in the HR is effective.