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Heart-Saving Shocks Delayed

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By STEPHANIE NANO, The Associated Press

Published: January 3, 2008

NEW YORK - Just because you're in the hospital doesn't mean you'll quickly get treated if your heart stops beating. About one-third of patients don't get a potentially lifesaving shock within the recommended two minutes, a new study found.

Those who don't get prompt defibrillation are more likely to die or end up with brain damage or disabled, the study showed. For every minute of delay, the chances of survival worsens, researchers reported in the New England Journal of Medicine.

"It is probably fair to say that most patients assume - unfortunately incorrectly - that a hospital would be the best place to survive a cardiac arrest," Leslie A. Saxon, a cardiologist at the University of Southern California, wrote in an editorial in the journal.

Recent attention has focused on getting quicker treatment for heart attacks that occur outside hospitals, and adding defibrillators to public places such as airports and schools. The researchers instead looked at what happens inside hospitals and how response time affects survival.

Their study found that 39 percent of those quickly treated survived to leave the hospital, compared with only 22 percent of those whose treatment was delayed past the two-minute guideline.

"We still have a lot to learn as to how to deliver treatment in an effective way," said lead author Paul S. Chan of St. Luke's Mid America Heart Institute in Kansas City, Mo.

More than half of the patients got a jolt from a defibrillator in one minute or less, but it took more than two minutes - sometimes more than six minutes - for about 30 percent to get zapped.

The research showed delays were more likely at smaller hospitals, after-hours or on weekends, and for patients who weren't constantly being monitored or were admitted for nonheart problems.

One potential way to speed up response times, Chan suggests, is to make automated external defibrillators, or AEDs, available throughout hospitals so that nurses could readily use them.

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