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Benefits vs the Harms of Automated External Defibrillator Use
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To the Editor: The Commentary on clinical benefits and legal liability associated with automated external defibrillators (AEDs) by Dr Estes and colleagues1 addresses litigation prospects from harm resulting from use of an AED when a patient receives an inappropriate shock or fails to receive a needed shock. However, the clinical benefits and risks that are the private interests of each successful shock recipient and family are less fully clarified. For a person whose heart stops for more than 250 seconds before cardiopulmonary resuscitation (CPR) is initiated, the liability is not tort litigation; it is an approximately 50% probability of permanent brain disability.2 Most legislators and citizens are unaware of this downside of CPR survival.3
AEDs have been shown to improve the primary outcome of CPR by increasing the percentage of cardiac arrest patients surviving to hospital discharge (14% vs 23%; P = .03).4 But in that study, the range of brain . . . [Full Text of this Article]
William M. Landau, MD
landauw@neuro.wustl.edu
Washington University School of Medicine
Saint Louis, Mo
Allan S. Jaffe, MD
Mayo Medical School
Rochester, Minn
Richard D. Wetzel, PhD
Washington University School of Medicine
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