I wish to respond to an article by Dr Ogungbo biodun on the above named. While i still hold grudges against him for publicly degrading Nigerian Nurses and labeling them cockroaches, i would not fail to set him straight and educate him on issues relating to public and patient safety. 

 

As a an american heart association certified basic life support (BLS) Course instructor, i wish to highlight some deficiencies in Dr. Biodun's write up. For starters, the basic life support survey consists of four (4) basic steps which include checking for responsiveness in a victim of cardiac arrest, activating the emergency response system and getting an AED, Circulation and finally Defibrillation.

 

I was disappointed that such an extensive write up on the BLS lacked any detail on a priority component of the BLS which is Defibrillation. In his write up, Dr biodun bemoaned the lack of necessary medical equipments to save a life, he then delved into the BLS and somehow missed out on the use and unavailability of AED's in major teaching hospitals, organizations and private facilities. 

 

While an AED/ Defibrillation does not restart the Heart, it "stuns" the heart and stops all cardiac muscle electrical activity. If there is viable heart muscles present, its normal pacemakers may eventually resume electrical activity that ultimately leads to a return of spontenous circulation (ROSC). Research evidence has shown that the interval from collapse to defibrillation is one of the most important determinants of survival from cardiac arrest.

 

It is also a well known fact that most cardiac arrest patients present in ventricullar fibrillation (VF), wherein the heart quivers and is unable to pump blood effectively. thus electrical defibrillation (ie delivery of shock to the heart to stop the VF) is the most effective way to treat ventricullar fibrillation. Hence, the likelihood of restoring a perfusing rhythm is greatly enhanced with immediate CPR and defibrillation within a few minutes of the initial arrest.

 

In summary, i would agree with Dr. Biodun that all hospitals, organizations and establishments must as a matter of urgency ensure the availability of resuscitation equipments especially the Automated external defribillator (AED), because it may be either of us or a relative that might be the next patient in the Emergency room.

 

By Jude Chiedu

He is an  an american heart association certified basic life support (BLS) Course instructor in association with the Resuscitation Council of South Africa.