Dr Amit Jindal
Attending Consultant Cardiology,
Dharma Vira Heart Centre, Sir Ganga Ram Hospital

Defibrillator Installation: Pros And Cons

Life is precious! It should not be allowed to go easily and one should be always prepared to take all possible necessary actions to save it. A single shock, if given at the right time can prevent someone from dying. Every year, a lot of people die of heart attack and severe arrhythmia (irregular heartbeat) resulting in sudden and uncertain cardiac death due to the lack of medical knowledge amongst the people around. Basic knowledge of cardio-pulmonary cerebral resuscitation (CPCR) can save lives of many such human beings. There are a lot of instances, where people lost their lives, in the absence of immediate medical help and needful measures, even in the presence of necessary medical devices like defibrillators.

The defibrillator is a device which is used to convert/revert life-threatening arrhythmias of the heart or to regain the normal rhythm of the heart. There are certain other maneuvers like cardiac thumping and pharmacological measures, which may or may not be helpful in doing  all that a defibrillator can do. The most common arrhythmias which are shockable are ventricular tachycardia and ventricular fibrillation and detecting these kinds of arrhythmias is very difficult and quite impossible for a layman, who is dealing with a patient at a distant area or far apart to get immediate medical help.

The government has taken appropriate steps and made it mandatory to install such devices at crowded places like airports, railway stations, bus stands, work places, and parks.

There are three different kinds of defibrillators available in the market, which are classified based on the nature of shocks delivered: the monophasic, which are outdated and not being used in day-to-day life; bi-phasic, which are most commonly used in all the medical centers and ambulances, should be used under supervision of a trained medical practitioner or by an expert healthcare professional; and the third is the automated external defibrillator (AED), which detects the rhythm on its own and shocks, if required. There is another class of defibrillators, that is the implantable cardioverter defibrillator (ICD) or automated internal cardiac defibrillator (AICD), which can be implanted in the human body and which may detect the rhythm on its own and deliver the shock, whenever required.

Defibrillator installation at public places

In today’s rapidly changing world, it has been seen that such devices are being installed and made mandatory at all the public places; but in a country like India, where more than 50 percent of the population is living in villages and does not understand the gravity of the disease/cardiac arrhythmias and other ailments, one may not expect such devices will be used in a proper manner. Still, one life saved using such device, helps achieve goals and expectations. The AED is usually installed at public places. It does not require a trained health provider to determine the rhythm. This device has improved the outcomes in the situations of life threatening arrhythmias and out-of-hospital sudden cardiac death. There is a possibility of damage, breakage, mishandling, and even theft of these devices, but use of modern techniques of theft prevention such as tracking devices and damage control systems can help to change the scenario. A step taken with a positive thought can definitely help to avert the tides favorably.

The government must make it mandatory to install such devices at all public places, schools, colleges, institutions, and all work places. Moreover, it should be made mandatory for each and every student of schools, colleges, institutions, and each and every worker of any government or private work place to know, how to operate the defibrillator and proceed for CPCR and have basic life support (BLS) training.

The government should take necessary action and give some sort of subsidy in procuring such devices at the above mentioned places. Not only the government, but each and every health professional should also take the initiative to teach and inform about the use of such an important device, to all his colleagues and people around. This will definitely change the scenario and will make a new beginning in the process of saving lives.

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