Anyone can suffer a sudden cardiac arrest (SCA). Many victims appear healthy with no known heart disease or other risk factors. Being well-equipped with an emergency plan that includes proactive program management, training, service and support could help save a life.
The National Center for Health Statistics (NCHS) states that 310,000 coronary heart disease deaths occur outside of a hospital or emergency department annually. This amounts to approximately 850 incidents each day, and most of these deaths are caused by cardiac arrest.
When an SCA event occurs, the heart stops pumping blood to other organs within the body due to an irregularity in the heartbeat. This irregularity cannot be corrected without the use of cardiopulmonary resuscitation (CPR) and possibly even an automated external defibrillator (AED). According to the American Heart Association (AHA), for every minute that passes between collapse and defibrillation for witnessed SCA, survival rates decrease 7 to 10 percent if no CPR is provided. Administering CPR before defibrillation can double or triple survival rates from a witnessed SCA incident at most intervals of the rescue process.
THE CHAIN OF SURVIVAL
The AHA Chain of Survival process prepares first responders to react effectively to an SCA incident. Upon successful application of the following four steps, a victim's chances of survival from an SCA event can greatly increase:
Early Access — In an SCA event, timing can mean life or death. Early recognition of an emergency means the victim will receive more immediate care. Call 9-1-1 as soon as an emergency is recognized.
Early CPR — Trained rescuers should begin CPR immediately on an unresponsive victim. CPR moves oxygenated blood to other vital organs, including the brain and heart, until other advanced care can be applied to restore normal heart rhythm and activity.
Use the AED — The AED is used to treat certain types of abnormal heart rhythms. The sooner recommended defibrillation is provided with an AED, the better the victim's change of survival.
Early Advanced Care — Emergency Medical Service (EMS) personnel should provide advanced care and basic life support procedures.
BE PREPARED, SAVE A LIFE
In December 2007, a spectator at a high school wrestling tournament collapsed in the stands and was found without a pulse and no vitals. He had suffered an SCA event. A local EMT happened to be present and responded immediately, administering CPR for 4 minutes. Unfortunately, it was not enough to restore the victim's normal heart rhythm.
According to witnesses, EMS took more than 10 minutes to arrive due to traffic patterns and weather conditions in the area. Fortunately, a local high school competing at the tournament was equipped with an AED device, which was brought out to the victim. Following the unit's analysis, the victim received a shock that was able to restore vitals. Once EMS personnel arrived, they provided advanced care following CPR and AED treatment. This response — and the onsite AED — helped the victim survive the event.
Wanda Lamle, a sales representative from ZEE Medical who sold the AED device to the school district, said, “This success story really belongs to the schools. It's up to them to make the decision to purchase equipment like this, and I'm so proud of the people who make that choice to really make a difference.”
In February 2008, Terry West, a master trainer at ZEE Medical, was on his way to lunch when he discovered a man lying on the ground surrounded by a small crowd. Upon arrival, the man was unresponsive with no visible signs of breathing. EMS had been notified and was on the way, and Terry began administering CPR. He continued the process to keep oxygen flowing through the body until EMS personnel arrived and administered advanced care.
“I am so glad that I was trained in CPR,” said West. “You never know when you might be faced with needing these skills, and you never know who you might save. It's amazing to think that the time spent in a training class could have such a dramatic impact on someone's life.”
The victim, a marathon runner, survived the incident and has since gone on to raise his family with his wife and pursue his passion as a NASA engineer.
MANAGING AN AED PROGRAM
Because of the proven effectiveness of early care and treatment in an SCA event, AHA has developed guidelines that support community lay rescue programs and hands-only CPR to help increase SCA victim survival rates. The implementation of a comprehensive AED program can be a time-consuming and intimidating process. This process can involve compliance requirements with many local, state and federal regulations, as well as training, tracking and maintenance requirements.
When making a decision to implement an AED program, look for a distributor who is able to assist with managing all of the required components:
Site Assessment — A thorough analysis of the facility should be conducted to determine the locations and number of units needed.
Unit Selection — While many units may be available, each manufacturer should be evaluated for quality and performance, and the unit's features should be most appropriate for workplace needs.
Medical Direction — In most states, medical direction is a required component when purchasing an AED unit and includes physician oversight to manage the compliance of the AED program.
Training — Training in general first aid, CPR and the use of an AED is a required component in most states when implementing an AED program.
Program Tracking — To remain compliant, every AED program should be reviewed on an ongoing basis. Units should be properly installed and maintained regularly to ensure that batteries and pads are functioning and operable. Training certification and medical direction renewals also should be tracked to avoid untimely expirations.
Multiple Site Support — Many businesses have several facilities scattered throughout the United States. Having the ability to monitor those facilities from a single site provides consistency across all locations, and helps reduce manual processes that can be time-consuming.
Being prepared for a sudden cardiac arrest emergency can make a difference when seconds count. Making the decision to invest in potentially life-saving initiatives such as an AED program is a significant responsibility. Purchasing an AED unit involves much more than selecting the device itself. Many factors must be considered when implementing a complete program that is compliant with regulations. When preparing to implement an AED program, look for vendors who can assist with choosing an AED unit and provide the resources to help support the proper maintenance of each of the various components involved.
Sandy Devine is the product manager, AEDs and training, for ZEE Medical Inc., a leading provider of van-based first-aid, safety, emergency and training solutions. Providing more than 50 years of service, ZEE operates in over 25 locations with approximately 1,000 representatives across North America. ZEE Medical is headquartered in Irvine, Calif., and is a subsidiary of McKesson Corp.
According to AHA, the Federal Drug Administration (FDA) may require a physician's prescription to buy an AED. But physician involvement doesn't end there: AHA recommends additional physician oversight for AED programs to ensure their safety and effectiveness.
ZEE Medical also stresses the importance of physician oversight in an AED program. This oversight may include:
- Federally required prescriptions;
- Physician-reviewed protocols for rescuers;
- MS notification;
- Support with downloading data to EMS or a hospital following an event;
- An annual review of AED/CPR training programs; and
- Regulatory updates.