Early Defibrillation

Automated External Defibrillator (AED) and Products

What is an AED?
AED stands for Automated External Defibrillator. An AED is a portable device that can be used by trained laypersons to deliver an electric shock to the heart of someone experiencing Sudden Cardiac Arrest (SCA.) AEDs are portable, easy to use, and the key to increasing the survival rate of SCA victims. Having an AED within minutes of a victim of SCA could be the difference between life and death.

What is Sudden Cardiac Arrest?
Each year, sudden cardiac arrest (SCA) strikes about 220,000 Americans. Unlike a heart attack, in which blood flow to the heart muscle is temporarily blocked, the primary cause of sudden cardiac arrest is ventricular fibrillation, a life-threatening condition in which the heart's normal electrical signals become erratic, causing the heart to cease pumping blood effectively. When this occurs, the victim immediately becomes unresponsive, stops breathing, has no detectable pulse and-without intervention-will die within minutes. Defibrillation, or restoring the heart's natural rhythm by applying an electrical shock, is the only definitive treatment for SCA.

What causes SCA?
The underlying cause of SCA is not well understood. Many victims have no history of heart disease, or, if heart disease is present, it has not functionally impaired them. SCA strikes both men and women, with the average age of victims being 65, but with many being in their 30s or 40s. In addition, it often strikes without warning. Cardiopulmonary resuscitation (CPR) and early defibrillation are the most critical factors in determining survival of SCA. Published studies indicate that survival rates from ventricular fibrillation can exceed 70 percent if defibrillation is administered within the first few minutes of SCA.

Why is it critical to have access to an AED?
It has been reported that the chance of survival decreases by approximately ten percent with each minute that passes after the time of attack (Cummins, RO et al, Annals of Emergency Medicine, 1989; 18:1269–1275). However, response times for paramedics or emergency medical technicians to arrive on site with a defibrillator are often more than ten minutes, resulting in average SCA survival rates in the United States of less than five percent. Widespread deployment of automated external defibrillators (AEDs) is the only feasible method of achieving early defibrillation. Public access proponents estimate that the broad deployment of AEDs among trained responders could prevent an estimated 45,000-50,000 unnecessary deaths each year in the United States

Cardiac Chain of Survival
Early defibrillation is an important step in the cardiac "Chain of Survival" –a series of four critical steps for resuscitation:

• Step One: Early access to care (for example, calling 911 or another emergency telephone number)

• Step Two: Early CPR

• Step Three: Early defibrillation

• Step Four: Early institution of advanced life support (for example, intravenous medications) as needed.

AEDs are now available in a wide range of settings, including airplanes, office buildings, industrial plants, casinos, golf courses, ski resorts, cruise ships and health clubs. With the widespread availability of AEDs, a critical and logical step in strengthening the sudden cardiac arrest "Chain of Survival" is now available. A break in any of the four links in the chain can compromise the victim's chance for survival; however, CPR and early defibrillation are recognized as the most critical steps in restoring an effective cardiac rhythm and resuscitating a victim of SCA. The likelihood of successful resuscitation following SCA decreases by approximately ten percent with each minute that passes before defibrillation. After ten minutes, few attempts are successful.

Does the St. Paul Area Chapter sell AEDs?
To help the Red Cross meet its mission of saving lives, an Agreement has been established with Philips Medical Systems to allow the St. Paul Chapter the opportunity to facilitate the purchase of the FR2 AED unit and its accessories and to provide CPR and AED training to customers. This partnership gives you the opportunity and the convenience to purchase your training and your AEDs from the American Red Cross, a trusted name in health and safety education. The St. Paul Area Chapter offers a variety of AED/Training Packages as well as the option to purchase an AED and accessories.

The American Red Cross, a humanitarian organization led by volunteers and guided by its Congressional Charter and the Fundamental Principles of the International Red Cross Movement,
will provide relief to victims of disasters and help people prevent,
prepare for, and respond to emergencies.

Is a prescription from a physician necessary to purchase an AED in a workplace environment?
According to FDA rules, a physician prescription is needed in order to purchase an AED. This means that the medical director of a facility must prescribe and oversee the AED program at any workplace or other facility that houses an AED. Call the St. Paul Area Chapter for more information on Medical Direction.

Could a responder deliver an unnecessary shock?
An AED is designed to allow the operator to deliver a shock only when the device has detected the presence of a life-threatening arrhythmia.

Are AEDs easily portable?
Yes. An AED is about the size of a laptop computer. It is small, light and easy to carry.

Early Defibrillation

Early defibrillation means having immediate access to a properly working automated external defibrillator (AED). This allows trained lay rescuers to give a potentially lifesaving electrical shock to the victim's heart during a cardiac arrest.

Early defibrillation is often called the critical link in the chain of survival, because it's the only way to successfully treat most sudden cardiac arrests. When cardiac arrest occurs, the heart starts to beat chaotically (fibrillation) and can't pump blood efficiently. Time is critical. If a normal heart rhythm isn't restored in minutes, the person will die. In fact, for every minute without defibrillation, the odds of survival drop 7-10 percent. A sudden cardiac arrest victim who isn't defibrillated within 8-10 minutes has virtually no chance of survival.

Emergency Medical Services providers have traditionally performed defibrillation, but quick EMS response isn't always available. Even the best EMS systems are delayed by heavy traffic, secured buildings and gated communities. Large building complexes and high-rises also pose problems. In some communities and facilities, EMS personnel or traditional first responders with AEDs can't reach sudden cardiac arrest victims within the necessary four minutes after a collapse. For these situations, the American Heart Association advocates establishing public access defibrillation (PAD) programs. This helps ensure that the people most likely to arrive first at a medical emergency are equipped to help. These people include firefighters, law enforcement and security officers, industrial facility personnel and retirement community workers, among others.

The American Heart Association recommends that PAD programs do the following:

Train designated rescuers in Heartsaver AED (a CPR and AED training program).
Have physician oversight to help ensure quality control.
Work together with the local EMS system on equipment interface and protocols.
Use and maintain AEDs according to the manufacturer's specifications.

To learn more about implementing PAD programs in your community or to become trained in Heartsaver AED, call 1-800-AHA-USA1 (1-800-242-8721) or visit our Emergency Cardiac Care and CPR content area.

Heart Attack, Stroke & Cardiac Arrest Warning Signs

Act in Time
The American Heart Association and the National Heart, Lung, and Blood Institute have launched a new "Act in Time" campaign to increase people's awareness of heart attack and the importance of calling 9-1-1 immediately at the onset of heart attack symptoms.

Dial 9-1-1 Fast
Heart attack and stroke are life-and-death emergencies -- every second counts. If you see or have any of the listed symptoms, immediately call 9-1-1. Not all these signs occur in every heart attack or stroke. Sometimes they go away and return. If some occur, get help fast! Today heart attack and stroke victims can benefit from new medications and treatments unavailable to patients in years past. For example, clot-busting drugs can stop some heart attacks and strokes in progress, reducing disability and saving lives. But to be effective, these drugs must be given relatively quickly after heart attack or stroke symptoms first appear. So again, don't delay -- get help right away!

Statistics
Coronary heart disease is America's No. 1 killer. Stroke is No. 3 and a leading cause of serious disability. That's why it's so important to reduce your risk factors, know the warning signs, and know how to respond quickly and properly if warning signs occur.

Heart Attack Warning Signs
Some heart attacks are sudden and intense -- the "movie heart attack," where no one doubts what's happening. But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren't sure what's wrong and wait too long before getting help. Here are signs that can mean a heart attack is happening:

Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
Shortness of breath. This feeling often comes along with chest discomfort. But it can occur before the chest discomfort.
Other signs: These may include breaking out in a cold sweat, nausea or lightheadedness

If you or someone you're with has chest discomfort, especially with one or more of the other signs, don't wait longer than a few minutes (no more than 5) before calling for help. Call 9-1-1... Get to a hospital right away.

Calling 9-1-1 is almost always the fastest way to get lifesaving treatment. Emergency medical services staff can begin treatment when they arrive -- up to an hour sooner than if someone gets to the hospital by car. The staff are also trained to revive someone whose heart has stopped. You'll also get treated faster in the hospital if you come by ambulance.

If you can't access the emergency medical services (EMS), have someone drive you to the hospital right away. If you're the one having symptoms, don't drive yourself, unless you have absolutely no other option.

Stroke Warning Signs
The American Stroke Association says these are the warning signs of stroke:

Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
Sudden confusion, trouble speaking or understanding
Sudden trouble seeing in one or both eyes
Sudden trouble walking, dizziness, loss of balance or coordination
Sudden, severe headache with no known cause

If you or some with you has one or more of these signs, don't delay! Immediately call 9-1-1 or the emergency medical services (EMS) number so an ambulance (ideally with advanced life support) can be sent for you. Also, check the time so you'll know when the first symptoms appeared. It's very important to take immediate action. If given within three hours of the start of symptoms, a clot-busting drug can reduce long-term disability for the most common type of stroke.

Cardiac arrest strikes immediately and without warning. Here are the signs:

Sudden loss of responsiveness. No response to gentle shaking.
No normal breathing. The victim does not take a normal breath when you check for several seconds.
No signs of circulation. No movement or coughing.

If cardiac arrest occurs, call 9-1-1 and begin CPR immediately. If an automated external defibrillator (AED) is available and someone trained to use it is nearby, involve them.