Cardiac Care in Aisle Six

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  • 01/03/2008
Where are you likely to receive better cardiac care, your hospital's ER or the men's department at Nordstrom's?

A recent study from the NEJM suggests that the refusal of hospitals -- perhaps out of litigation fear -- to allow the use of automatic defibrillators -- might be a reason thousands die of heart attacks who would otherwise still be alive.

Automatic defibrillators that have come into use in public places like airports and casinos during the last decade or so are meant to be used by laymen: trained employees or even bystanders. Connected to the chest of someone who has collapsed, the machine senses electrical activity in the heart and delivers a shock only if it is needed. These devices are designed to be essentially foolproof, making it impossible to harm someone by firing off an unnecessary shock. But so far they have not been used much in the care of hospitalized patients.

Dr. Saxon said the automatic defibrillators should be used more, along with the type of heart monitoring now given mostly to cardiac patients. Not everyone needs such monitoring, she said, but it may be in order for those who are very ill with kidney problems, diabetes or pneumonia, even if they have no history of heart problems. Their information would be transmitted to a computer network that would send out an alert if needed. In addition, she said, automatic defibrillators could be installed in every hospital room.

“You can get them for $500 on eBay,” she said. “It wouldn’t even take a nurse. You could train the cafeteria workers if you wanted to.”

Speaking on her cellphone, Dr. Saxon said, “You’re better off having your arrest at Nordstrom, where I’m standing right now, because there are 15 people around me.”

What's the hold up? My guess is fear of lawsuits. It would only take one idiot represented by John Edwards to sue a hospital for being shocked improperly by a hospital aide instead of the chief of cardiology for that nobel experiment to end.

The Precautionary Principle is killing common sense in health care. And people.

Center for Medicine in the Public Interest is a nonprofit, non-partisan organization promoting innovative solutions that advance medical progress, reduce health disparities, extend life and make health care more affordable, preventive and patient-centered. CMPI also provides the public, policymakers and the media a reliable source of independent scientific analysis on issues ranging from personalized medicine, food and drug safety, health care reform and comparative effectiveness.

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