On mass transit systems worldwide, automated external defibrillators (AEDs) are becoming an increasingly welcome sight, as transit staff and passengers respond to and save the lives of sudden cardiac arrest victims.
AEDs are now available worldwide on transportation systems serving passengers in locations such as Amsterdam, Boston, Chicago, Dusseldorf, New Jersey, Madrid, Washington, D.C., and Warsaw and on Canadian and French rail. These devices have saved lives by being available in the right place at the right time. However, these devices still remain underutilized on mass transit and elsewhere, leading to 7 million deaths from sudden cardiac arrest each year worldwide. Sudden cardiac arrest is the leading cause of death in the United States, according to the Cleveland Clinic.
More AEDs Could Save Up To 100,000 Additional Lives Each Year
A Johns Hopkins study of more than 13,000 out-of-hospital cardiac arrests published in the Journal of the American College of Cardiology showed that survival increases from a national average of about 8 percent to 38 percent when victims receive AED treatment before EMS arrives. “If more victims had access to defibrillation and we could get the national average to 38 percent survival, this translates to 100,000 additional lives saved each year,” says Mary Newman, the co-founder and president of the Sudden Cardiac Arrest Foundation.
Increasing numbers of mass transit authorities understand the link between AEDs and life saves, one made very clear over the past several years by their counterparts in the airline industry. Since AEDs were mandated by federal law to be onboard flights, AEDs have saved hundreds of lives in the air, as well as inside of airport terminals. For example, the Phoenix Sky Harbor International Airport recently touted its 33rd life save since AEDs were deployed there in 2000. Well over 35 lives have been saved in Chicago airports and 19 in Dublin, Ireland. News reports have told stories about saves in airports in Atlanta, Austin, Boston, Detroit, Duluth, Hawaii, Melbourne, New Orleans, Perth, Pittsburgh, San Diego, Warsaw, and many other places.
As trains and other mass transportation modes begin to match the AED deployment occurring in airliners and airports, similar life save statistics are expected, and saves have already begun to occur. For example, at Boston’s North transit station, three bystanders saved the life of a sudden cardiac arrest victim with an AED placed at the station by the Massachusetts Bay Transportation Authority (MBTA). New Jersey Transit Corp. (NJ Transit) has reported six saves since 2006.
“Automated external defibrillators save lives,” said William Maisel, M.D., deputy director of science and chief scientist at the FDA’s Center for Devices and Radiological Health. The FDA stated that it “will make sure that automated external defibrillators remain available so that they can continue to save lives.”
Public health experts also agree that having AEDs readily available is the best way to reduce sudden cardiac arrest mortality. AED makers foresee business as usual as new FDA regulations are reviewed and established, expressing confidence that any new FDA regulations will be met with devices now in use.
Experts recognize “speed to shock” as the most important aspect of AED lifesaving. That’s because up to 90 percent of victims receiving AED treatment within two minutes survive, but the chances of survival decrease with each passing minute. By 10 minutes, most die. Therefore, rather than depending on EMS to travel some distance to the scene of sudden cardiac arrest, increasing numbers of mass transit authorities now have AEDs available for use by AED/CPR-trained staff, as well as by untrained bystanders if necessary. The Johns Hopkins study found that “speed is more important than training.” Non-medical volunteers operating AEDs achieved the highest survival rate, followed by healthcare workers and police. “On average, early AED defibrillation before EMS arrival seems to nearly double a victim’s odds of survival after OHCA (out-of-hospital cardiac arrest),” the study’s authors wrote.