The Case for Automated External Defibrillators (AEDs)

Cardiac Arrest

Sudden cardiac arrest (SCA) claims about 350,000 American lives each year. In most cases this event occurs due to ventricular fibrillation, an abnormal heart rhythm that causes the heart muscle to fibrillate or quiver in a chaotic motion. If left untreated, this condition leaves the heart muscle unable to pump blood and death occurs within minutes. Because sudden cardiac arrest is one of the leading causes of death in our nation, it is a major public health problem.

Statistics show that less than 5% of those who experience cardiac arrest outside of a hospital will survive. Defibrillators, however, have been shown to boost a person's chances of survival when used immediately. Data from studies of lay rescuer defibrillation programs in public locations that show the highest survival from sudden cardiac arrest occurs when the arrest is witnessed and when bystanders provide immediate CPR and defibrillation within three to five minutes of the arrest.

Public Access Defibrillation (PAD) in Action

Employees of the NUMMI Toyota plant in Fremont have first-hand experience in the benefits of a PAD Program. Over the course of two years, two assembly line workers have experienced cardiac arrest while working. In any other company, they might have died. However, at NUMMI, their co-workers were trained in the use of an AED and promptly applied the AED pads, and let the machine analyze the rhythm and shock the employee back to a life sustaining rhythm. Both employees are back at work, with no health deficits, thankful they work at a company that supports PAD. Two arrests-two saves!

Chain of Survival

ChainSurvival5


A strong Chain of Survival can improve chances of survival and recovery for victims of heart attack, stroke and other emergencies. The 5 links in the adult Chain of Survival are:

• Immediate recognition of cardiac arrest and activation of the emergency response system
• Early cardiopulmonary resuscitation (CPR) with an emphasis on chest compress
• Rapid defibrillation
• Effective advanced life support
• Integrated post-cardiac arrest care

Who is at Risk? - Sudden Cardiac Arrest (SCA) is unpredictable. Although the average victim is about 60 years old, SCA can affect anyone, regardless of their age, race, or gender. However, according to the National Center for Early Defibrillation, some conditions can put people at greater risk for SCA including:

  • Age greater than 40 (men)
  • Post-menopausal status (women)
  • Inactive lifestyle
  • High blood pressure
  • High cholesterol
  • Diabetes
  • History of heart disease (either personal or in the family)

Unfortunately, SCA can affect children as well as adults. Some causes of pediatric SCA include SIDS, trauma or accident (e.g., electrocution, drowning, overdose/ poisoning), illness, and congenital heart disease. A hard blow to the chest (such as with a baseball) can also trigger cardiac arrest.

How AEDs Work

AED_handsoff

Highly sophisticated AEDs that are accurate, inexpensive and virtually maintenance-free enables their use in the home, workplace and public buildings. An AED is a device used to treat a patient with cardiac arrest whose heart is beating irregularly (fibrillating). If the heart does not return to a regular rhythm within 5-7 minutes, this fibrillation could be fatal. To stop the fibrillation, an AED is used to administer an external electric shock through the chest wall to the heart with the use of conductive adhesive pads. Built-in computers analyze the patient's heart rhythm, and interpret the rhythms that require defibrillation shocks. Audible and/or visual prompts guide the user through the process. Most AEDs require an operator to initiate the delivery of the shock in some way, such as pushing a button.

In order to have AEDs available more quickly for the persons who need them, some facilities (such as hotels, airports, and country clubs) are purchasing these devices under what is called a Public Access Defibrillation (PAD) program. However, since AEDs are prescription devices and must be labeled with the prescription statement required by law (CFR 801.109), a physician who oversees the PAD program at a facility must write a prescription for the AED in order for the facility to purchase it.

Public access refers to accessibility for trained users to use AEDs in public places. Public access does not mean that any member of the public witnessing a sudden cardiac arrest should be able to use the device. AEDs are to be used only by individuals with the proper training and certification in accordance with state and local laws.

Good Samaritan Protection

Since 1990, our county has had a successful First Responder Defibrillation Program. Now with the Good Samaritan Laws that give critical protection to the AED trainer, the prescribing physician, the AED owner, and individuals who use an AED in rendering emergency care, Alameda County EMS will be providing information for greater public access to defibrillation. Our goal will be to participate actively in strengthening the links in the chain of survival in our county by providing a resource packet for laypersons, corporations, work sites, and prescribing physicians with the information necessary to implement PAD programs.

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