Only 5% survive sudden cardiac arrest According to the Heart and Stroke Foundation of Canada, 35,000-40,000 people die from sudden cardiac arrest (SCA) every year in Canada.
When sudden cardiac arrest strikes, the electrical system of the heart short-circuits, causing an abnormal rhythm known as ventricular fibrillation. Shocking the heart—known as defibrillation—is the only way to effectively treat this abnormal heart rhythm. Cardiopulmonary resuscitation (CPR) can buy time for someone in cardiac arrest, but only a defibrillator can deliver a potentially life-saving shock.
Often no prior symptoms There are risk factors for sudden cardiac arrest, including age (45 and over), smoking, poor diet, and lack of exercise, among others. But the fact is that most SCA victims have never shown any prior symptoms of heart disease. This is true for 50% of the men, and for 63% of the women who die from sudden cardiac arrest. In rare cases, sudden cardiac arrest can also result from accidents such as drowning, electrocution, choking and trauma.
The 10-12 minute survival window For defibrillation to be effective, the shock must be delivered within the first few minutes of collapse. In fact, for every minute that goes by without defibrillation, a victim's chance of survival decreases by 7-10%. And after 10-12 minutes, it is unlikely that the person will survive. That's why over the past 20 years there has been a widespread movement to place defibrillators in ambulances, fire and police vehicles, and public places such as workplaces, health clubs and sports arenas. Today, every major North American airline equips its planes with defibrillators.
Defibrillators at home More than 80% of sudden cardiac arrests occur at home. When called, Emergency Medical Services arrive ready—with equipment and experience—to deliver a shock with a defibrillator. But for most people in Canada, it takes at least 5 minutes for emergency help to arrive on the scene. Add to this the time from collapse to call, as well as delays, and it's clear why the next logical place for defibrillators is in the home, where they can be quickly and easily accessed in an emergency.
Making defibrillators easy to use Over the years, advances in technology and design have made defibrillators easy to operate for people like police, fire fighters and airline personnel. As defibrillators go forward into the home, they must have the same professional-grade, life-saving technology, in a streamlined design that's easy and safe to use. People with minimal training need to feel confident that they can operate the defibrillator in a life-threatening, emergency situation. Plus, defibrillators must remain ready for long periods of time and still perform if and when needed. Safety, ease of use and device readiness are paramount when taking defibrillators into the general public.
1. What is an AED? AED stands for Automated External Defibrillator. This is an electronic device which; when attached to a patient via sticky pads called electrodes; analyzes the electrical activity of the heart, and allows a rescuer to deliver a shock to the patient if necessary.
The AED is looking for two distinct cardiac rhythms, Ventricular Fibrillation, or Pulseless Ventricular Tachycardia.
Ventricular Fibrillation, or V-Fib, is a chaotic rhythm which causes the heart to quiver in an uncontrolled, irregular manner. In this state, the heart cannot pump blood to the rest of the patient's body. It is known as a non-perfusing rhythm.
Pulseless Ventricular Tachycardia, or V-Tach, is a rhythm in which the heart is beating excessively fast, sometimes more than 180 – 200 beats every minute. There is no time for the ventricles (large chambers in the heart) to fill properly, so once again, the heart cannot pump blood to the body. This is another non-perfusing rhythm.
When the AED detects either of these two cardiac rhythms, it will prompt the rescuer to push the “SHOCK” button, thus delivering an electric shock to the heart. This shock is intended to disrupt the abnormal rhythm, so that when the heart starts again, it will do so in a manner that allows is to move oxygen rich blood around the body.Back to FAQ
2. Does the shock work every time? Not always! That is why it is so important to be able to perform the steps of CPR, or Cardio Pulmonary Resuscitation. As soon as a shock is delivered, or if the AED does not find one of the two shockable rhythms; it will prompt the rescuer to begin the steps of CPR. After a designated cycle of CPR, the AED will prompt the rescuer to stop compressions, and allow it to re-analyze the patient’s heart rhythm. It will then advise if a shock needs to be delivered, or if CPR should be continued. This process will repeat itself until EMS personnel arrive and remove the AED electrodes from the patient, replacing them with their own equipment. If the patient still has no perfusion; or circulation of blood, they will continue with the CPR and AED use.Back to FAQ
3. Can anyone use an AED? Yes! AEDs are simple and easy to use. Although they are still a medical device; in most Canadian Provinces, using an AED does not require medical direction. That means that everyone can use an AED on a patient who is unresponsive and not breathing!Back to FAQ
4. What about the legal or liability issues? All Canadian Provinces have some form of Good Samaritan Law. In Manitoba, Bill 214, “The Good Samaritan Protection Act” protects the lay rescuer from liability, as long as they are acting in good faith. In other words, if you do your best to help someone in a medical emergency, and don’t intentionally try to hurt them further, you have no fear of legal action against you.
Having an AED at your location is much the same as having a fire extinguisher. You need to make sure that it is in good working order. With most AEDs on the market today, that means looking for a “Ready for Use” indicator is present, such as a flashing green light, making sure your AED Pads have not expired, and if there is an AED prep kit or response kit attached, that it has all it’s supplies. This simple inspection takes less only a couple of minutes, and should be done every month.Back to FAQ
5. What kind of AED do I need? The answer to that question depends of a couple of factors:
• Who will be responding with the AED? Other than healthcare facilities, most workplaces are not responding on a regular basis to medical emergencies. This can be a very stressful event for the lay rescuer. Having only done CPR on a manikin once a year, they may not be confident in their skills. Therefore, an AED which offers the rescuer clear, calm verbal instructions; and if required, coaches the rescuer in CPR; would be a very useful feature.
• In what environment will the AED be placed? Some AEDs are built to withstand a more rugged, or industrial setting, while others would be more suitable for placement in an office or clinical environment. Check the AED’s specifications for particulate/dust and moisture/water invasion. The higher number (listed as IPXX, where the Xs would be a number from 1 to 5, and indicate resistance to such invasion) means that the unit is better able to withstand smaller particles, like dust, and also water jet invasion rather than just water droplet testing. It should also be able to withstand the shock of a 1 metre drop to any corner or edge, and still operate normally.
If the AED is going to be kept in a vehicle, it will need to be maintained within its operating temperature range. Some AED manufacturers offer a temperature controlled case, so the unit does not get too hot or cold. Exposure to extreme heat or cold may adversely affect the AED’s ability to perform when required.Back to FAQ
6. Do I need to have the same brand of AED as the EMS has? This question always seems to be a contentious issue. Some AED distributors will say yes, you should have a machine that is compatible with the EMS equipment. But what does “compatible” mean? Does that mean that the pads on your AED can plug into the EMS units? Maybe it means that the software is the same, so that the EMS personnel have the ability to download event information from your AED. Typically, when EMS personnel arrive, they will remove the electrode pads from your AED, and attach their own Defibrillator/Monitor to the casualty.Back to FAQ
7. What equipment and supplies would be recommended for a typical AED placement? Heart Beat Inc. recommends the following as a typical AED placement:
• Appropriate AED
• Two sets of pads or pads cartridges
• Carrying case which will hold required supplies
• Response kit which includes a pocket mask for use during CPR; paramedic shears for cutting away clothing from the casualty’s chest; at least 1 pair of vinyl or nitrile gloves; a prep razor for shaving excess chest hair; a towel or other cloth for wiping the chest dry prior to placing the AED pads. Ideally, this kit would attach to the AED case.
• A wall mounted bracket, alarmed cabinet, or monitored alarmed cabinet for storing the AED and other supplies (the choice would depend on where the AED was to be located)
• Highly visible signage to indicate AED location to responders.
Other supplies could include paediatric pads or a paediatric key if the AED may be used on children between the ages of 1and 8 (children over 8 years old require the use of adult pads only). If the AED is to be kept in a wet environment, such as on a boat, or taken on wilderness excursions, a rigid, waterproof case would be recommended. Back to FAQ
8. Where should the AED be placed? For a Public Access AED Program (i.e., malls, schools, recreation facilities) the unit should be kept in a high traffic, high visibility area. Ideally, it would be placed in an alarmed cabinet, and placed at a height which makes it accessible to anyone who may be required to use the AED.
For placement in a corporate, industrial or institutional setting, the AED should be kept in a location where responders have quick access to it, such as in or near a First Aid Room, at a Security Location or Reception Area.
When locating multiple units in a facility, consideration should be given to time for accessing the AED once the need for its use is recognized. The guideline as recommended by Heart and Stroke Foundation is to have the AED to the casualty and the first shock delivered in 3 to 5 minutes.
