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Is it better if your heart stops in a mall?

Would you prefer if your heart stopped in a hospital or a mall?

That's the question asked by a recent New England Journal of Medicine paper -- or at least, that's how the study has been widely interpreted by the media.

The study, "Delayed Time to Defibrillation After Cardiac Arrest," looked at patients who had cardiac arrests in 369 hospitals. It recorded how long it took these patients to receive a potentially-lifesaving shock of electricity from defibrillator paddles. Surprisingly, about 30% of patients received the shocks two minutes or more after the arrest, longer than guidelines recommend.

And the study concluded that a delay in defibrillation makes a difference: patients who had a cardiac arrest who received the shocks after two minutes were almost half as likely to survive to hospital discharge.

So what's the implication? You're better off arresting in a crowded mall with an automatic defibrillator nearby than you are in a hospital with trained personnel?

Apparently so. Here's the money quote from Dr, Saxon (who wrote an accompanying editorial to the study) in the New York Times: "You’re better off having your [cardiac] arrest at Nordstrom, where I’m standing right now, because there are 15 people around me.”

Saxon's proposal is that all patients at risk for heart rhythm abnormalities should be monitored by computers and that automatic external defibrillators should be available in each hospital room. “You can get them for $500 on eBay,” Saxon said. “It wouldn’t even take a nurse. You could train the cafeteria workers if you wanted to.”

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About the Author


Dr. Schwimmer's blog explores the intersection of medicine, new technologies, and the Internet.