Category Archives: Cardiac Arrest

What is Public Access Defibrillation (PAD)

Public access defibrillation is the term used to describe the use of AEDs by laypeople. Two basic strategies are used.

In the first, AEDs are installed in public places and used by people working nearby. Impressive results have been reported with survival rates as high as 74% with fast response times often possible when an AED is nearby.

In a complementary strategy, first responders are dispatched by an ambulance control centre when they might reach a patient more quickly than a conventional ambulance. The greater delay in defibrillation resulting from the need for such responders to travel to a patient has been associated with more modest success rates. However, this strategy does enable treatment of people who arrest at home, the commonest place for cardiac arrest to occur.

Further information may be found on the RC(UK) web site.

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Defib as easy to use as a smartphone?

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The latest scientific studies show the importance of the bystander as a first responder

(HealthNewsDigest.com) – Sudden cardiac arrest (SCA) differs from a heart attack in a couple of important ways. First, SCA is the leading cause of death in the U.S., according to the Mayo Clinic, and is more common than heart attack. Second, SCA can be successfully treated by a bystander with an automated external defibrillator (AED), according to several peer-reviewed medical studies.

Virtually every day in America, AED technology enables an individual with little or no medical training to save the life of another human being. This fact makes SCA unique among other leading causes of death such as heart attack, stroke and cancer – afflictions that require interventions from medical professionals.

SCA is an arrhythmia – an electrical disorder of the heart – that can be corrected by a shock from an AED. Heart attack is caused by a blocked artery, which must be cleared or bypassed in a medical facility. Still, only about 8 percent of about 380,000 annual SCA victims in America survive to hospital discharge – primarily because they do not receive shocks quickly enough from an AED. This 8 percent survival rate is dismal, especially when compared to the roughly 85 percent survival rate of heart attack victims.

In any workplace, every employee can be and should be a potential lifesaver.

Too often, workers suffer SCA and die because a defibrillator is not available in time to save them. Conversely, about 90 percent of SCA victims who receive shocks within the first minute after arrest survive, according to the Sudden Cardiac Arrest Association. The chances of survival decrease by 7 to 10 percent with each passing minute. After 10 minutes, less than 5 percent of victims survive.

The aggregate SCA survival rate, recorded across various populations, has remained around 8 percent for the past 30 years, according to a study published in the American Heart Association’s Circulation: Cardiovascular Quality and Outcomes. However, the authors noted that survival was “greatest in locations in which a defibrillator is available.” They also said that because most out-of-hospital cardiac events are witnessed, efforts to improve survival should focus on the prompt use of an AED and CPR by those who witness the event.

While receiving AED/CPR training obviously has its benefits, a Johns Hopkins study published in the Journal of the American College of Cardiology emphasized that “speed is more important than training.” In a review of 13,759 out-of-hospital cardiac arrests, the authors found an average survival rate of 7 percent. However, the survival rate increased to 38 percent when patients received an AED shock before EMS arrival. Non-medical volunteers operating the AED achieved the highest survival rate (40%), followed by healthcare workers (16%) and police (13%). “On average, early AED defibrillation before EMS arrival seems to nearly double a victim’s odds of survival after OHCA,” the authors wrote.

Speed saves

With speed recognized as the most important aspect of AED lifesaving, the focus shifts away from relying on EMS response to having AEDs available in workplaces and public places. While AED/CPR-trained individuals are sometimes present in these areas, SCA victims are often rescued by untrained bystanders.

These Good Samaritans use AEDs successfully, even though they may have never used them before. A survey of 1,018 travelers from 38 nations passing through the Amsterdam central railway station found that roughly half of these individuals would be willing to use an AED in an emergency. Among those expressing reluctance, the most common barriers to using an AED were a lack of knowledge of how to work the AED and concerns about harming the victim.

Approaching the tipping point to higher SCA survival

Today, AEDs are approaching a tipping point similar to the one that happened with the introduction of the iPhone. Before Apple launched this product, most consumers were intimidated by smart phones. The iPhone made smart phones easy – this innovation and its impact on other manufacturers made text and email by phone commonplace, turned mobile devices into the most common way to access the Internet, and merged it all with music, video and a world of apps. Now, many people manage their lives from their smart phone.

In a similar fashion, new AED technology merges audio, video, training and maintenance capabilities into an easy-to-use lifesaving device that inspires confidence in the minds of potential rescuers. A survey by AED designer and manufacturer Defibtech and Harris Interactive asked the question: In addition to audio instruction (provided by the AED during a rescue situation), what would give you greater confidence to use an AED? The answer? Video. With video, text and voice, 97 percent of the respondents said they would be able to use an AED to save a life.

In response, Defibtech introduced the VIEW AED, which has an innovative, exclusive LCD video feature that literally shows rescuers how to perform each step of an SCA rescue in real time – in accordance with the latest American Heart Association (AHA) guidelines. The color video is reinforced by loud and clear audio and corresponding text that can be understood in noisy environments. For example, when the VIEW’s audio says and text reads, “Place pads on patient’s chest,” the video shows exactly where to place the pads.

The VIEW also has embedded help videos that can be used during training to review the critical steps of a rescue, providing reassurance to rescuers that they will be ready during the stress of an emergency. In addition to the help videos, the VIEW has a patented status screen that shows the readiness of defibrillation pads and the AED’s battery, as well as the overall AED operational status. The VIEW AED virtually maintains itself through automated daily self-tests. Choosing an AED that’s easy for bystanders to use is important because not all AEDs are created equal.

Enable your workers to rescue a fellow employee

From any standpoint, it makes complete sense to encourage and enable workers to rescue a fellow employee striken by the most common killer of Americans. While medical advances in virtually every area of medicine have reduced mortality rates, SCA mortality has remained the same for 30 years, even though it can be treated by a person with no medical training if there is an AED onsite. That fact alone calls for workplaces to have AEDs available and to empower their employees with the confidence to use them.

Greg Slusser is a vice president for Defibtech, the designer and manufacturer of the Lifeline™ and ReviveR™ families of AEDs and related accessories, Click Here 1-866-DEFIB-4-U (1-866-333-4248).

Abridged with permission from the August 2012 edition of Facility Safety Management magazine (www.fsmmag.com)

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Cardiac arrest more common in young than thought

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Cardiac arrest is relatively rare in young people, but it may be more common than experts have thought, according to a new study.

Using 30 years of data from King County in Washington, researchers found that the rate of cardiac arrest among children and young adults was about 2.3 per 100,000 each year.

That’s not a big risk. But the figure is substantially higher than the “widely accepted” estimate for young athletes (not just young people in general), said senior researcher Dr. Jonathan Drezner.

According to that estimate, one in 200,000 young athletes (up to age 35) suffers cardiac arrest each year.

Cardiac arrest occurs when the heart suddenly stops pumping blood to the rest of the body. It is fatal within minutes without immediate treatment.

A major cause of cardiac arrest is ventricular fibrillation, where the heart’s main pumping chamber starts to quiver chaotically. A device called a defibrillator can “shock” the heart back into a normal rhythm – though even with treatment, cardiac arrest is often deadly.

The good news from the current study is that young people’s survival of cardiac arrest got much better over the 30-year period. It rose from 13 percent in the 1980s, to 40 percent between 2000 and 2009.

“It’s very gratifying to see that our efforts are paying off,” said Dr. Dianne L. Atkins, a pediatric cardiologist at the University of Iowa in Iowa City.

Research over the years has allowed experts to figure out the best way to perform cardiopulmonary resuscitation (CPR), and public campaigns have been done to encourage more people to learn CPR.

CPR cannot “restart” the heart, but it can keep blood and oxygen moving through the victim’s body until medical help arrives.

“Learn CPR and be willing to do it,” said Atkins, who wrote an editorial published with the study in the journal Circulation.

The true rate of cardiac arrest among kids and young adults has long been debated.

Drezner said he thinks his team’s findings come closer to the “real” figure than most past studies, because of its methodology.

The findings come from a cardiac arrest database kept by King County in Washington State. Emergency medical services report all cases of cardiac arrest to the registry.

Drezner’s team also used other records, like autopsy reports and hospital records, to try to figure out the cause of each cardiac arrest.

Between 1980 and 2009, there were 361 cases of cardiac arrest logged for children and adults age 35 and younger – including 26 toddlers under 3, most of whom had congenital abnormalities.

That amounted to a rate of 2.28 cases for every 100,000 young people each year.

Atkins agreed that this study gives a clearer picture of the true incidence of cardiac arrest in young people. “It’s the best data we have.”

And, she said, researchers should know how common the problem is before widespread screening programs, if any, can be put in place.

The idea of screening kids for heart problems that could cause cardiac arrest is controversial. Some countries, including Italy and Israel, have mandatory electrocardiogram (EKG) screening for young athletes. The U.S. is not one of them.

For now, Atkins suggested that parents be aware that cardiac arrest can strike children — but also keep the risk in context.

“It is still a very uncommon event,” she said. “I don’t think the message is that parents should be so frightened that they don’t let their kids go out for competitive sports.”
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First aid training for primary students has long-term benefits

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“When children are given professional first aid training at primary school, the benefits can be felt long term. That’s why training in the early years is so incredibly important,” says Fritz Sterz from the University Department of Emergency Medicine at the MedUni Vienna as pupils start school this week. The results of a recent study by Katrin Steiner from the MedUni Vienna, who is writing her thesis, also highlight this fact. The anaesthetist and emergency medicine physician has demonstrated that primary school children who are given first aid training in the first to fourth grades of school score highly when it comes to using a defibrillator or performing chest compressions.

 

The study centres around a class of 25 school children from Vienna’s 16th district. In first grade, the children were given a professional first aid lesson as part of a project organised by Thomas Uray from the University Department of Emergency Medicine which involved practical exercises, video clips and questionnaires. After it, 47.8 per cent of the children were able to execute an emergency call perfectly, 56.6 per cent were able to operate the defibrillator correctly and 28.6 per cent were able to perform chest compressions appropriately. The class has now undergone further training and testing in fourth grade by a team led by Katrin Steiner from the MedUni Vienna. “The children were able to remember the practical, hands-on actions very well and tackled the problems in a very motivated way without any inhibitions. Only the theory side of things had slipped a little in their memories,” explains Steiner. Three years later, 100 per cent of the children were able to operate the defibrillator correctly after a refresher course, 95 per cent made the emergency call clearly and understandably, while 72.2 per cent were able to perform chest compressions correctly. Parents learn from their children “The results clearly speak in favour of first aid training at primary school,” says Steiner. In Austria, this training is not currently on the curriculum – unlike countries such as Canada, the Czech Republic or Norway, for example. Just two to three hours of training per academic year are enough to perfectly prepare children for these types of emergency. The added bonus is that “parents learn from their children and benefit from their lower inhibitory threshold for providing first aid,” says Steiner. First aid courses for children are currently provided by the Austrian Red Cross Youth, the Samaritans and as part of the Children’s University programme at the MedUni, which is held every year during the summer holidays. One third can be saved A recent study by the MedUni Vienna has shown that someone who is given cardiac massage by a first aider straight after a cardiac arrest has a 70% higher chance of survival. “Unfortunately, there is often no first aider on hand, or people are afraid of doing something wrong during resuscitation. Chest compressions never do any harm, unlike doing nothing,” says Fritz Sterz from the University Department of Emergency Medicine at the MedUni Vienna. In Vienna alone, around 3,000 people die every year from cardiac arrest.

 
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All Liverpool primary schools to get defibrillators after £100k boost to Oliver King Foundation / Liverpool ECHO Heartbeat campaign

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ALL Liverpool primary schools will be given life-saving defibrillators thanks to a £100,000 boost to the Oliver King Foundation and the ECHO’s Heartbeat campaign.

The machines, which restart the heart when a person suffers cardiac arrest, will be placed in all 122 of the city’s junior schools.

Today supporters of the Oliver King Foundation said the news would greatly improve the chances of youngsters’ lives being saved across the city.

Oliver was swimming in the pool at King David High School in March last year the killer condition Sudden Arrhythmic Death Syndrom (SADS), struck, and despite efforts to revive him he died.

Oliver’s dad Mark, 51, said he was “shaking with excitement” over the news that all primary schools would have the machines – especially as SADS , which causes the heart to suddenly stop, tends to strike healthy, active youngsters.

He added: “It’s absolutely fabulous news, and a great push in the right direction.

“The government should take note now of the need to have these in all schools.

“It’s not rocket science to see that they save lives.”

 
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James Barry (16) real CPR story

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Having practiced CPR and attending many first aid courses that my dad has run I was amazed that when I needed to perform CPR for real how my reflexes took over and I automatically got on with the job in hand.

I was at college when the caretaker collapsed. People stood around looking but not doing anything. When I approached the man a member of staff was shaking him trying to get him to respond. I immediately tilted the casualties head to open his airway, I then listened for breathing whilst counting to 10. This seemed an eternity but I was sure that the man was not breathing. I asked the member of staff to call for an ambulance and say that this was a cardiac arrest.

I started CPR. This felt similar to what I had practiced on the courses but there was a little bit more resistance on the chest than on the Brad manikin. I actually felt the chest give on a couple of occasions as ribs gave way.

Giving breaths was as practiced in the classes and I used a face shield which I keep in a pouch on my keys. I continued with CPR for about 3 minutes and then an ambulance arrived. I continued with the CPR whilst I spoke to the paramedics and explained what had happened. It was only at this time that I realised how out of breath I was. It was a real relief to see the paramedics although I had heard the sirens of the ambulance as they came along the driveway.

The paramedics told me to keep doing chest compressions whilst they set up their equipment and inserted an airway. One paramedic stuck defib pads to the mans chest, I was told to move away from the casualty and they delivered a shock. The casualty lifted off the floor when he received the shock. Just as this was happening a second ambulance arrived.

It appeared that the shock from the defib had worked as the paramedics could see a heart beat on their monitor and the man was trying to breath himself. All 4 paramedics got the casualty onto a stretcher and set off for hospital on blue lights and sirens.

I have since met the man involved in this incident at a college open evening and will be starting this college in September.

I was really surprised how the training I had just took over but I must admitted I was in shock afterwards and felt sick. I would get involved in a medical emergency again and this has given me confidence to want to become a first aid instructor and follow my dream of becoming a paramedic.

James Barry (aged 16)

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Understanding Sudden Cardiac Arrest

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Sudden cardiac arrest is often confused with a heart attack. Although a prior heart attack increases one’s risk for sudden cardiac arrest, the two are quite different, with distinct risk factors, treatment options and outcomes.

Anatomy of a Heart Attack

A circulation problem of the heart causes a heart attack when one or more of the arteries delivering blood to the heart are blocked. Oxygen in the blood cannot reach the heart muscle, and the heart muscle becomes damaged. You can think of a heart attack as a “plumbing problem” in the heart.

This damage to the heart muscle can lead to disturbances of the heart’s electrical system. And a malfunction of the heart’s electrical system may cause dangerously fast heart rhythms that can lead to sudden cardiac arrest.

Anatomy of Sudden Cardiac Arrest

In contrast to a heart attack, sudden cardiac arrest is caused by an “electrical problem” in the heart. It occurs when the heart’s lower chambers (ventricles) suddenly develop a rapid, irregular rhythm (ventricular fibrillation) causing the ventricles to quiver rather than contract. The chaotic quivering motion of the ventricles renders the heart an ineffective pump that can no longer supply the body and brain with oxygen.

Within seconds, the person loses consciousness and has no pulse. Only immediate emergency treatment, such as cardiopulmonary resuscitation (CPR) and external defibrillation, can prevent death from sudden cardiac arrest. Time is key to surviving sudden cardiac arrest, with chances of survival decreasing about 10 percent every minute without defibrillation. The American Heart Association recommends defibrillation within five minutes of collapse or sooner.
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