AHA Advisory Statement on Public Access Defibrillator

The American Heart Association (AHA) has released an advisory statement to highlight the findings of the Public Access Defibrillation Trial, which studied the effects of lay rescuer automated external defibrillators (public access defibrillation). The trial was funded by the National Heart, Lung and Blood Institute, the AHA, and others. The full report was published in the June 21, 2005, issue of Circulation.

The trial findings, which included outcomes of more than 200 episodes of out-of-hospital sudden cardiac arrest with attempted resuscitation, supported the AHA’s current guidelines for public defibrillator use. The guidelines emphasize the importance of program planning, rescuer training, linking with local emergency medical service systems, device maintenance, and quality improvement monitoring. The AHA is currently reviewing the trial results to refine its recommendations for resuscitation and lay rescuer automated external defibrillator programs. More information on public defibrillation programs is available online at http://www.americanheart.org/ecc.PAD.

ACOG Guidelines for Treating Prenatal Hemoglobinopathy

The Committee on Practice Bulletins–Obstetrics of the American College of Obstetricians and Gynecologists (ACOG) has released a practice bulletin on screening for and managing hemoglobinopathies during pregnancy. Practice Bulletin Number 64, “Hemoglobinopathies in Pregnancy,” was published in the July 2005 issue of Obstetrics & Gynecology.

Antepartum Evaluation for Hematologic Assessment of Persons from High-risk Groups

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Figure 1.

Algorithm for specialized antepartum evaluation for hematologic assessment of patients of African, Southeast Asian, or Mediterranean descent. (CBC = complete blood count; Hb = hemoglobin; MCV = mean corpuscular volume; RBC = red blood cell.)

Adapted with permission from American College of Obstetricians and Gynecologists. ACOG Practice bulletin no. 64. Hemoglobinopathies in pregnancy. Obstet Gynecol 2005;106:206.

The ACOG recommendations, which are based on good, consistent evidence, include the following:

• Persons of African, Southeast Asian, and Mediterranean descent are at increased risk of carrying hemoglobinopathies and should be offered screening and genetic counseling. Figure 1 is an algorithm for the antepartum evaluation for hematologic assessment of persons from high-risk groups.

• Appropriate hemoglobinopathy screening should include a complete blood count and hemoglobin electrophoresis. Solubility tests alone should not be used as screening tools.

• Parents at high risk of having a child with sickle cell disease or thalassemia should be offered genetic counseling, and a prenatal diagnosis should be obtained through DNA analysis of cultured amniocytes or chorionic villi.