Curso Tactical Emergency Casualty Care

Curso Tactical Emergency Casualty Care
TECC-SEMES Andalucia

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lunes, 2 de enero de 2017

Public Access Defibrillation AED in Vending Machine. Japan

Public Access Defibrillation AED in Vending Machine. Japan
First-time visitors to Japan might be surprised to see a vending machine containing an automated external defibrillator (AED; Figure 1A). This interesting innovation is just one of the ways in which AED use in Japan is being increased. Until just a few years ago, public access to AEDs was something that the Japanese medical profession would not have thought possible. A change in Japanese law in 1991 allowed paramedics to defibrillate patients at the scene of an out-of-hospital cardiac arrest. Contrary to expectation, however, this approach was not satisfactory. According to a report from Osaka Prefecture (population 8,800,000), the survival at 1 year for witnessed out-of-hospital cardiac arrests was 3.0% during the period 1999–2001. [1] Defibrillation was given at a median of 11.5 min after the emergency call in the third year (2001), which was too late to improve survival. Survival decreases by 7–10% for each minute between cardiac arrest and defibrillation; [1] it is clear, therefore, that shock has to be delivered before the arrival of paramedics, which is only possible with AED use by a lay witness. Changing the rescue system paradigm was not easy, however, and the way that Japan has dealt with this problem could serve as a reference for other countries.