V-Fib Lead II – Credit Glenlarson Wikipedia Commons
Thirty-ahem years ago, I was lucky enough to have one of the first truly portable EKG/Defibrillators in my EMS rig. It was a Life-Pak 5, a museum piece now, but state of the art in 1976.
While having it did increase our ability to revive ardiac arrest patients, the sad truth was that it could take 10 minutes for us to arrive on scene.
Often too long to be of much use to the patient unless effective CPR was started before our arrival.
Today, there are thousands of AED’s (automated external defibrillators) stationed in public areas like shopping malls, airports, bus terminals, schools, and other venues. Their early use during a cardiac arrest could easily make the difference between a patient’s survival or death.
AEDs are designed to be used by laypersons who ideally should have received some AED training. Like doing CPR, the required skills are relatively simple, but they do require some degree of familiarity.
A buddy of mine (thanks, Cliff) passed along a link to an online training site that, in a few short minutes, can familiarize the layperson with what to do when confronted by a sudden cardiac arrest, and what to expect when opening and using an AED.
If you see someone collapse suddenly, check if the victim is responsive. If not, remember these three easy steps.
Have them send help. Stay on the line and listen for further instructions.
Start Chest Compressions
If the person is not breathing normally, start chest compressions. Push down hard and fast in the center of the chest. Keep your arms straight. Send someone to find an AED.
Use An AED
The AED (automated external defibrillator) is a portable medical device that delivers an electrical shock to restart a person’s heart. It provides voice prompts that tell you exactly what to do and will only administer a shock if needed, so there’s no reason to hesitate.
It only takes a few minutes to familiarize yourself with the operations of an AED by visiting the following website. And if you haven’t taken a CPR class recently, make it a priority to get recertified.
I should point out that not all cardiac arrests can be corrected by defibrillation, even if conducted in a timely manner. There are non-shockable arrhythmias that an AED cannot convert to sinus rhythm.
Non-shockable cardiac arrest arrhythmias are asystole (flat line) and PEA (Pulseless Electrical Activity) – what we used to call back in the stone age of EMS, electromechanical dissociation.
Neither of which respond to defibrillation.
Patients can sometimes still be saved with CPR alone, at least until the right cardiac meds can be administered. For more on all of this, we have the press release from the American Heart Association.
April 02, 2012
- CPR can save someone with cardiac arrest even if they don’t respond to a defibrillator.
- People with non-shockable cardiac arrest are more likely to live if they receive CPR based on recent guidelines emphasizing chest compressions.
- The American Heart Association’s CPR guidelines emphasizing chest compressions are saving more lives, according to a new study.
Of course, despite your best efforts, many SCA victims will not survive. But early and coordinated action taken by bystanders (calling 911, starting CPR, using AED if available) can substantially improve their chances.
For more on heart attacks, and CPR, you may wish to visit some of these earlier blogs.