Here's an interesting bet for gamblers: the odds of surviving a heart attack in a casino may be better than in a hospital.
That is according to Medtronic, which happens to be a manufacturer of automated external defibrillators, or AEDs. The life-saving devices are growing increasingly ubiquitous in public areas such as shopping malls, health clubs, hotels, airplanes and casinos. Hospitals are starting to place AEDs in high-traffic, nonclinical areas, Medtronic says, but apparently not enough of them to match the impressive outcomes at other public gathering areas-or to satisfy the market share appetite of Medtronic.
AEDs are considered supplemental to the non-AED devices that are used by doctors and life-support personnel. They are designed to stabilize a patient rather than provide long-term monitoring. But since time is of the essence in treating cardiac arrest, the American Heart Association recommends that enough AEDs should be placed around the world to satisfy a three-minute-to-treatment radius. The AHA also is encouraging hospitals to put AEDs in more remote areas such as waiting rooms.
Some public locations such as casinos that comply with these recommendations had survival rates as high as 74%, according to Medtronic. A study published in 2000 in the New England Journal of Medicine found that 49% of the casino patients who received defibrillation after three minutes survived, compared with rates of 15% and 35% among patients in urban areas with excellent emergency medical systems. A sudden cardiac arrest survival rate of 10% to 15% of non- monitored hospital beds has not changed in nearly 40 years, Med- tronic says. Citing a study in the journal Resuscitation, published in June 2003, only 33% of the 207 participating hospitals reported having some kind of AED technology in any part of the facility while 17% of cardiac arrest victims survived to hospital discharge, Medtronic says.
"The thing I think is interesting is that (the survival rate in hospitals) has not changed much in the last 30 years," says Mary Ann Peberdy, a cardiologist and lead author of the Resuscitation study.
A bear walks into a hospital ...
Here are the lessons from a story involving a Virginia hospital: When you have automatic doors in front of your hospital, try to have someone close by who can spot the full-grown adult black bear walking through them. If one does stroll in, try not to shoot it. If you do shoot it, make sure it's for a good reason. And when the press calls about it, be as open as possible.
Carilion Franklin Memorial Hospital in Rocky Mount, a town located in the southwest Virginia Blue Ridge Mountains, was visited by a large male black bear one night earlier this month. The animal was wandering through the area and triggered the sensor that operates the doors.
The bear walked down a hall where it encountered several startled people. After people began yelling, an off-duty police officer and a hospital security officer came to the scene. They followed the bear until it went into a small computer room. They yanked the door shut behind the bear. They then called animal control and law enforcement personnel. The bear, an old male weighing 345 pounds, appeared frightened and did not threaten anyone, officials told the Roanoke (Va.) Times.
Karl Martin, a state game warden, told the Times that he considered tranquilizing the bear before deciding to shoot the bear to death as a safety precaution. The bear was partially hidden behind a desk, preventing a clear shot with a tranquilizer gun. He said sedating the bear might have endangered people in the hospital because bears often become angry and disoriented before losing consciousness.
Animal rights groups protested the killing. The bear story was reported worldwide, with newspapers from Australia to Scotland reprinting a wire service item.
Outliers' attempts to get a comment from the hospital and parent Carilion Health System in Roanoke were rebuffed. "We have had nonstop disruption over this incident," says system spokesman Ed Hamilton. "We won't comment for fear of antagonizing the animal rights groups that may not have understood what the hospital was confronting in this situation."
It does appear the hospital was between a bear and a hard place on this one, but we wonder if clamming up is the best way to deal with this kind of publicity.
Bailing out of Riyadh
HealthSouth Corp. employees joined the tide of Americans leaving Saudi Arabia this week after the recent kidnapping and beheading of an American engineer there.
The Birmingham, Ala.-based hospital chain temporarily pulled all six of its American employees from the 450-bed rehabilitation hospital it managed near the capital of Riyadh after a recent U.S. State Department travel advisory urged Americans to leave the region because of possible terrorist attacks. The U.S. employees at the facility within the Sultan bin Abdul Aziz City for Humanitarian Services served in "administrative and support functions not directly involved in patient care," according to Andy Brimmer, a HealthSouth spokesman.
HealthSouth's five-year contract to manage the hospital, which ends in January 2009, has been under criminal investigation in relation to the company's alleged massive accounting scandal. Two former HealthSouth executives, Vincent Nico and Thomas Carman, were charged with receiving kickbacks and bonuses to win the contract (March 8, p. 28).
U.S. companies are prohibited from making bribes to corporate and foreign officials in order to gain business overseas.