The Shocking History of the AED

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The number of public places one can find an Automated External Defibrillator (AED) in Australia (and the developed world) rises every year.

Barring a few key differences, what used to exist only as a defibrillator is now an overwhelmingly automated version found in fitness centers, office spaces, and even in the waiting areas of hospitals.

There are so many AEDs in the world today, the question everyone should be able to answer is, where is the nearest one?

For health professionals who know how to use a set of paddles, they might prefer the more manual version of defibrillation. With good reason. Those paddles offer more of customised treatment.

For the rest of us, we’d appreciate any help saving another’s life, lest it was us who needed the saving next time. We’d like to see AEDs everywhere.

The AED solves a modern problem. People don’t die of diseases the way we used to. We still die from diseases, of course, but we've gained longer life expectancies in the last century.

In other words, the problem is we don’t die so early anymore. Now we live long enough to suffer more dysrhythmias, which is a treatable misfire in the body’s electrical system.

The good news is, in today's world, even someone with zero experience can save another’s life with an AED, correcting a dysrhythmia.

The AED is the most important medical technology of the last century placed in the hands, everyday people. We have yet to see the full scope of possibilities from this awesome technology.

It started with some pretty crude devices…

 

First Electricity

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Leading up to the first electrical medical devices for the heart was the discovery or if you prefer the word harnessing... of electricity in the 18th century.

For most of Humanity’s history leading up the 20th century, the medical role for electricity was to determine if someone had died. A quick zap to the tissue would wake someone who'd passed out. A dead patient would stay dead.

In Europe and Russia, researchers in the 1890s started playing with electricity to revive animals. A pair of physiologists from the University of Geneva, Jean-Louis Prévost and Frederic Batelli began this work with undetermined success.

Others followed their work, but none of that research resulted in a successful case of defibrillation in a human being.

Then, in the 1930s, a new York cardiologist, Albert S. Hyman with his brother Charles, created the first artificial pacemaker. It wasn’t a defibrillator as such, but this was our first foray into applying electricity to the heart to keep it going.

Prior to this, doctors might attempt to massage a heart on the operating table to stop a case fibrillation, but results varied. (That's code for it didn't work very well.)

 

First Defibrillator

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Those varied results were the experience of another cardiac surgeon, Claude Beck, who worked at the University Hospital in Cleveland, Ohio, U.S.A. Sometimes he could massage a heart to defibrillate, but usually, fibrillation meant the surgery was over.

Beck first applied current to the hearts of animals whom he’d placed into ventricular fibrillation, attempting to defibrillate them. He was not done with this research when presented with a case in 1947.

During a surgery on a 14-year-old boy, the patient’s heart stopped. Beck had his assistants retrieve his experimental equipment from his basement, a crude defibrillator, and transistor.

The paddles of Beck’s system were modified spoons with wooden handles to shield him from the shock. They plugged in the transistor and Beck applied the first shock.

It did not work, but the second shock was a success. (Hollywood immediately made a note and started writing this event into every movie script, adding the line, “clear!”)

Beck’s crude defibrillator might not have been ready for what came next. The tale made national headlines. People like news about saving lives. Others picked up the mantle of research.

 

Portable Defibrillator

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The work of Beck inspired others to further his findings. In 1950 Paul M. Zoll (the same Zoll, which is now a household name in AED technology) developed an external pacemaker, designed to stimulate the heart without opening up a patient’s chest.

Zoll's 150-volt system required a medical professional to apply two one-inch diameter metal discs covered in electrode jelly on the right and left sides of the chest. They stayed in place via a rubber strap.

By 1952, Zoll published papers on the success of his resuscitation work with patients heart block and asystole conditions. It wasn’t perfect though. Patients suffered burns and pain after treatment, but it was better than suffering death.

Zoll’s Pacemaker may have been crude, but it was something, and it was portable. It just needed a little work.

 

Automated External Defibrillation

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A man from Northern Ireland, Professor James Francis "Frank" Pantridge, who also happened to be a cardiologist, took Zoll’s idea to the next level.

As a side note, he also happened to be the same person who, with his colleague, Dr. John Geddes, outlined the first standards for CPR. On top of that, he introduced the first Mobile Coronary Care Unit (MCCU), which was an early ambulance with equipment and trained medics aimed at providing care en route to the hospital.

In 1965, Pantridge added a 70-kilo defibrillator to the ambulance, run on car batteries. Again, crude, but it worked.

By 1968, he’d refined that technology in a three-kilo device, made possible by borrowing NASA technology; a mini-capacitor.

It would take decades for defibrillators to become standard in ambulances around the world, but today most ambulances have both a standard defibrillator and an AED.

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Today we are at the cusp of incorporating our best drone technologies with our lightest portable AEDs. Researchers in different parts of the world are testing different versions of this system.

The key for moving the needle on saving lives will likely include some sort of machine learning (artificial intelligence) where drones can recognise the symptoms of an arrest before the prospective patient’s symptoms become critical.

If a drone knew before the patient knew, we could see a huge shift in the success rate of treating heart attacks.

When it happens, you can be sure Medshop Australia will be there.

Sources: ncbi.nlm.nih.gov, artsci.case.edu, medgadget.com
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