As defibrillator technology develops they will become not only cheaper and smaller but also smarter. The lower cost will allow greater numbers in public places and also may begin a trend for families of high-risk patients to purchase them. Advisory defib-rillators currently inform the operator when a shock is appropriate. In the future the machine may also be able to analyse the rhythm while chest compressions are ongoing, thus improving perfusion to the vital organs.
There is ongoing study into the benefits of performing CPR before defibrillation in unwitnessed arrests. This is due to the risk of defibrillation shocking the patient's heart into asystole if they have had a period without CPR. Advancements in defib-rillator technology may allow the machine to look at the rhythm to predict whether the shock should be delivered immediately or after a period of CPR. The voice prompts of the machine can then advise the operator whether CPR should precede defibril-lation or vice versa.
Administering drugs mid-arrest, such as thrombolysis, has been shown to improve survival in individual case studies but larger studies have yet to prove their benefit (Baubin 2001).
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