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What is sudden cardiac arrest (SCA)?
Most victims of sudden cardiac arrest have an abnormal heart rhythm
known as ventricular fibrillation. The heart does not beat in a normal and
coordinated manner and the blood does not circulate to the heart and brain.
When this occurs, the pulse will stop. After the pulse stops, the breathing
will cease as well.
What is the current treatment for SCA?
A series of four critical steps, called the “Cardiac Chain of Survival,” (JAMA,
1992) have been identified for the optimal treatment of SCA:
A break in any of the four links in the chain can compromise the victim's
chance for survival; however, early defibrillation is recognized as the most
critical step in restoring cardiac rhythm and resuscitating a
victim of SCA.
What is an Automated External Defibrillator?
An Automated External Defibrillator (AED) is a device that can assess a
person's heart rhythm, determine if it abnormal, and if necessary, administer
an electric shock to restore it back to a normal rhythm. The computer algorithm
in an AED is designed to assess the patient's heart rhythm. The AED
differentiates normal from abnormal heart rhythms and advises a shock only if
needed. Visual and/or audible prompts guide the user through the exact
procedure.
How does an AED work?
A microprocessor inside the defibrillator analyzes the victim's heart
rhythm through adhesive electrode pads. The computer advises the operator of
the AED whether a shock is needed and will be administered. When the operator
responds to the prompt to give a shock, an electric current is delivered
through the victim's chest wall. This electric current essentially resets the
abnormal heart rhythm back into a normal sinus rhythm.
Why are AEDs important?
An Automated External Defibrillator provides electricity, which is the only
mechanism that can restore a normal heart rhythm in victims of sudden cardiac
arrest. Some causes of sudden cardiac arrest include a heart attack, heart
failure, a dilated heart, a congenital defect, and electrocution.
According to the American College of Emergency Physicians, when
a person suffers a sudden cardiac arrest, the chance of survival decreases by 7
percent to 10 percent for each minute that passes without defibrillation.
Experts estimate that 100,000 lives could be saved each year if AEDs were
widely used.
Who can use an AED?
AEDs are designed to be used by laypersons (people without medical
backgrounds) in any type of community and workplace environment. They are very
simple devices to use. Studies show that even a 6 th grader can use one. AEDs
are most effective when standards and protocols are in place for appropriate
training, equipment maintenance and ongoing quality-of-care monitoring. Anyone
trained by the GWLIFESAVERS to administer cardiopulmonary resuscitation (CPR)
is also trained to use an AED.
If treatment for SCA exists, why are survival rates low?
Survival rates may be low due to time. Only one out of every twenty
SCA victims survives – though many of these lives could be saved through early
defibrillation. Studies performed in casinos showed that making AEDs available
to victims of SCA within 3 minutes of collapse greatly improves the odds of
survival. The average response time for an ambulance in most urban areas is 8
minutes. By the time help arrives, the victim's chances of survival are slim.
Is oxygen needed during the use of an AED?
When using an AED, oxygen is not needed. After the victim is revived,
EMS can apply oxygen when they arrive to the scene.
How often should an AED be monitored?
Maintenance and monitoring of an AED depends on type of AED you own.
Each manufacturer and product has different specifications. Your AED should be
examined at regular intervals to make sure it is working properly. This
primarily consists of looking at the AED box and making sure the GREEN ready
light is on. Other monitoring considerations include making sure batteries and
pads do not expire.
When a person's heart stops beating, why should an AED be
used?
Electricity, from a defibrillator is the ONLY way to return the heart to a
normal rhythm. AEDs allow lay persons to provide that lifesaving electricity to
a victim of sudden cardiac arrest as soon as is possible. For every minute a
victim must wait for help, their chance of survival decreases nearly 10%. The
average response time for EMS is around 8 minutes. By that time, the arrest
victim's chances for survival have dropped significantly.
Will an AED always resuscitate someone in cardiac arrest?
No, an AED can only resuscitate those people who have suffered cardiac arrest
and have one of the two abnormal rhythms called ventricular fibrillation and
ventricular tachycardia . Some AEDs can also shock people in supraventricular
tachycardia. AEDs cannot help people who have other abnormal rhythms. Those
rhythms typically have poor prognosis, and even in the hospital, there is
little that doctors can do to help.
Do AEDs replace the use of CPR?
No, CPR should be performed along with the use of an AED. CPR is a technique
that helps the body get air and circulation to the vital organs until an AED
can shock the heart back into a normal rhythm so the body can support these
functions itself. CPR and activation of an emergency response are the only help
a bystander can provide for a victim that has one of the abnormal rhythms that
do not respond to electrical shock, like asystole .
What's the difference between an AED and the defibrillators
used in hospitals?
AEDs are similar to defibrillators used in hospitals in that they provide
electricity to restart the heart. The AED does an automatic analysis of the
rhythm and advises the user what to do. In the hospital, the doctor interprets
the rhythm on a monitor on the defibrillator and makes a decision as to whether
to shock or not and with how much energy to shock with. The AED takes all the
medical decision making away, and allows a lay person bystander the opportunity
to help a victim of sudden cardiac arrest.
Are there liability issues associated with the use of AEDs?
Nothing can stop a plaintiff from filing suit against a business or person,
whether it be filed against a business who has an AED or whether it be filed
against a business who does not have an AED. However, for those businesses and
persons who choose to have an AED available for the protection of employees,
visitors or patrons, there are laws enacted to protect those with AEDs, which
greatly improve a business or person’s chances in obtaining the dismissal of
claims. These laws were enacted to provide incentives for purchasing these
life-saving products. For example, the Cardiac Arrest Survival Act (CASA), a
federal law enacted in 1996, provides limited immunity from lawsuits to AED
owners and users if the owner has (1) notified local emergency systems of their
AED location; (2) provided periodic testing for the device; and, (3) provided
AED training for some – but not all - expected users. This immunity attaches
even if the AED is used by someone who does not have training. All 50 states
have now enacted legislation or regulation tracking this federal law and these
state laws also provide immunity to uncompensated lay person rescuers who use
an AED in good faith. In contrast, in multiple suits filed across the country
against organizations for failing to have established AED programs, these laws
are not available. If you have any further questions about these laws we can
refer you to counsel who has already researched these laws.
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