AED’s – Saving Lives In American Homes

Statistics speak volumes, and given the statistics for heart disease, it’s hardly surprising that the AED, or automated external defibrillator as it’s more commonly know, is gaining ground as a safety item for the American home.

An AED is basically a portable defibrillator. A defibrillator is a machine used to restart the heart in the event of cardiac arrest. It does this by sending a brief but powerful charge of electricity to the heart, causing it to completely shut down momentarily and allowing it to “recalibrate” back to a normal rhythm.

So why would anyone want a defibrillator in their home? Well, as I said, statistics speak volumes, and where heart disease is concerned, bigger volumes you’ll have a tough time finding. Take a look at the following statistics:

• Approximately every 30 seconds someone in the US dies from heart disease.
• Over 2,500 Americans die from heart disease every day.
• Approximately every 20 seconds, an American has a heart attack.
• Over 250,000 people die of heart attacks outside of a hospital setting annually in the US.
• Cardiovascular disease causes close to 6 million hospitalizations each year in the US.
• Cardiovascular disease is the number 1 killer in the United States and has been for many years.

Very sobering, however, an AED is not used on “heart disease” per se, nor is it used for a heart attack victim. No, an AED is very limited in what it can actually do, and what that is, is to re-start the heart after it has suffered sudden cardiac arrest.

The condition that an AED is used for is technically called, ventricular fibrillation. By this is meant that the lower chambers of the heart, called the ventricles, are no longer beating as normal, but instead “fibrillating” or quivering in a fast, chaotic motion. In this condition they are no longer able to pump blood around the body, causing sudden death.

But here’s the rub. Although the AED is not used for other heart conditions, other heart conditions, especially heart attacks, tend to precede sudden cardiac arrest, so having an AED around is more than a good idea if you have a know heart condition.

AED’s were once used only by medical professionals, such as ambulance crews and other medical personnel. But before the mid 80’s they tended to be large, relatively cumbersome, and very technical to use.

Enter the 21st century AED. This new streamlined machine is not only slim, lightweight and consequently portable, it is, as its name suggests, extremely automated, allowing just about anyone to pick one up and use it in an emergency. So automated is it that it can monitor the victim’s heart activity to determine if defibrillation is necessary, then, if so, this AED will walk the operator through the defibrillation process using audiovisual prompts and instructions.

So why have an AED in the home? Well, let’s check out some statistics regarding sudden cardiac arrest:

• Sudden Cardiac Arrest (SCA) is a leading cause of death in the US, killing an estimated 325,000 Americans each year
• It is estimated that 95 percent of those who suffer cardiac arrest die before they reach a hospital or other source of emergency help.
• SCA kills on average 1,000 people every day. That’s one person every two minutes.
• Without emergency medical help, SCA leads to death within minutes.
• Victims of cardiac arrest can be saved if an AED is available to deliver an electric shock and restore the heart to its normal patterned rhythm.

Make no mistake, having an AED nearby in the event of a cardiac emergency, especially if you have know heart issues, is perhaps the best life insurance money can buy.

The Benefits of Portable Defibrillators

The onset of the portable defibrillator has single-handedly taken the life saving measures of the cardiac defibrillator out of the exclusive domain of the emergency room, and into the hands of a general public now able to help fight the tragedy of death by sudden cardiac arrest.

A defibrillator is a device developed to combat cardiac arrest or heart attack brought on by a fibrillation or irregular heart rhythm. This irregularity causes the heart to stop receiving enough blood and can result in sudden death if not treated properly.

The defibrillator delivers small electronic shocks to the heart designed to stimulate a return to a more manageable rate and rhythm. Specifically, an electric current is channel through the body into the heart via electrodes or paddles placed on the chest. The current causes the heart muscle to spasm or jolt, and hopefully ends any fibrillation threatening blow flow.

In years past the use of a heart defibrillator was place solely in the hand of heart physicians and emergency technicians. The bulky and difficult to use device was dangerous in the hands of anyone but a trained professional, and they typically were not seen outside of a hospital or medical setting. But with the development of smaller, easier to use, portable defibrillators, regular citizens can be called upon to be lifesavers.

These automated, portable defibrillators take much of the risk associated with their use by regular people. Most importantly, they come with the ability to assess whether or not the patient in question even needs an electric current, and if he or she does, it pre-determines the wattage or power level. A person cannot override the determination of the computer, so the potential for misuse is minimal.

In addition, the light weight and portable nature of the last defibrillators makes them perfect for storage and use at any number of public venues including schools, gate communities, airports and sporting events.

Zoll, one of the most well known makers of portable defibrillator products, have devices that make the life saving procedure easy, even for a person with little to no medical training or background.

The latest Zoll models specifically designed for public access are no bigger than a laptop computer and possess fully automated controls and instructions including voice prompts. They automatically detect what treatment, if any, is needed for the patient and give specific, step-by-step instructions on how to give the proper care. Minimally trained laypersons like security guards, flight attendants and office managers can use the portable defibrillator to potentially stave off death by cardiac arrest, or at least care for the patient until proper medical attention can be provided.

Despite some debate among experts regarding the benefits of a portable defibrillator in the home, there is no denying the advantage of increased access to life saving measures for cardiac arrest victims outside of the hospital setting. With nearly a million Americans dying each year as a result of cardiovascular disease, any measures that give a fighting chance to victims of sudden heart failure has to be regarded as a good thing.

Sudden Cardiac Arrest : Is It True ?

We’ve seen it all before, the middle aged victim staggers and clutches his chest, slumps to the floor and expires. A common sight, extremely deadly and as such 20 percent of all deaths in the US apparently are due to sudden cardiac arrest. Such is the lethal effect of these attacks in that apparently barely 5 percent of all those who suffer from them survive.

The commonly held perception of these incidents is that like the name i.e. a sudden cardiac arrest, is that they come out of the blue. However a more detailed study by German Researchers would indicate that they are actually more like real lightening in that they are usually preceded by clouds, rain, wind and storms.

The problem with analysing the whole incidence of Sudden Cardiac Arrest is that since they are generally fatal, it is impossible to be able to ask the victims or sufferers how they were feeling prior to the attack starting?

Attempts to interview witnesses, relatives or bystanders can occasionally help but when by and large this carried out at least a few days or weeks later it means that results can be slightly suspect.

Researchers from the University of Berlin have tried to circumvent this delay by interviewing Doctors who have worked as part of the various emergency response teams within the city. The Doctors recorded where the arrest happened, whether cardiopulmonary resuscitation (CPR) was started and any other salient information that they could remember. The results of these investigations actually painted a more complex picture of sudden cardiac arrest which is more troubling.

In results from two thirds of the incidences, someone heard or saw the victim collapse. By and large that someone also happened to be a family member since 75 percent of these incidences occurred at home.

The warning signs reported were surprisingly common amongst those witnessed. The majority of these were chest pain, dizziness, nausea, shortness of breath and vomiting. Some of these warning signs were experienced in some cases hours before the arrest.

Apparently in 90 percent of these cases the warning signs lasted for at least five minutes and the most telling fact of all was that in 25 percent of all cases the victims had what is called true “out of the blue” attacks that were not preceded by any symptoms.

The bottom line is that although Sudden Cardiac Arrest would appear to be the first sign of Heart Disease, in reality most victims would already have displayed certain symptoms of cardiovascular problems already. This was apparently born out by the results of this study.

Again, apparently, two thirds of the victims whose cases were studied in this exercise had already been diagnosed with Heart Disease, also had survived a previous Cardiac Arrest or had Angina or other signs of heart disease.

One sad finding within all of the findings in this study was the fact that of those who had sudden cardiac arrests at home only 11 percent had any form of resuscitation started at home compared to 26 percent of those who suffered attacks in public.

The obvious point to be made here was that you are more likely to find some professional trained in CPR whilst out in public than you are at home. Whilst this may be on the slightly obvious side of findings for a survey such as this, the overall findings relating to this survey i.e. the fact that whole concept of a Sudden Cardiac Arrest being not necessarily totally out of the blue makes an interesting point.

Sudden Cardiac Arrest – Key Facts

• Sudden Cardiac Arrest (SCA) is a leading cause of death in the United States, accounting for an estimated 325,000 deaths each year
• In SCA, the heart abruptly and unexpectedly ceases to function (cardiac arrest). It is an “electrical problem” caused by a heart rhythm disorder called Ventricular Fibrillation (VF). In SCA, the heart is no longer able to pump blood to the rest of the body.
• SCA is NOT a heart attack – a condition technically known as a myocardial infarction (MI). MI is a “plumbing problem” in which a blockage in a blood vessel interrupts the flow of blood to the heart causing an “infarct” – an area of dead heart muscle. SCA may, however, occur in association with a heart attack.
• VF occurs when the electrical signals that control the pumping ability (contractions) of the lower chambers of the heart (ventricles) suddenly become rapid and chaotic. The ventricles begin to quiver and can not longer pump blood from the heart to the rest of the body.
• SCA is NOT a random event. Although it may occur in outwardly healthy people, most victims DO have heart disease or other health problems, often without being aware of it.
• Without emergency help, SCA leads to death within minutes.
• Victims of cardiac arrest can be saved if a defibrillator device is immediately available to deliver an electric shock to restore the heart to its normal rhythm.
• People who are at high risk for SCA may be treated with implantable cardioverter defibrillators (ICDs), devices that are implanted under the skin. ICDs monitor the heart’s rhythm and automatically deliver a short, high-energy shock when the individual develops an irregular heart rhythm that may lead to SCA.
• Studies have shown that ICDs are the best way to prevent cardiac arrest in certain groups of patients who are at high risk.

Characteristics & Diagnostics of Cardiac Arrest

Cardiac arrest is an abrupt cessation of pump function (evidenced by absence of a palpable pulse) of the heart that with prompt intervention could be reversed, but without it will lead to death.

However, due to inadequate cerebral perfusion, the patient will be unconscious and will have stopped breathing. The main diagnostic criterion to diagnose a cardiac arrest (as opposed to respiratory arrest, which shares many of the same features) is lack of circulation, however there are a number of ways of determining this.

In many cases, lack of carotid pulse is the gold standard for diagnosing cardiac arrest, but lack of a pulse (particularly in the peripheral pulses) may be a result of other conditions (e.g. shock), or simply an error on the part of the rescuer. Studies have shown that rescuers often make a mistake when checking the carotid pulse in an emergency, whether they are healthcare professionals or lay persons.

Owing to the inaccuracy in this method of diagnosis, some bodies such as the European Resuscitation Council (ERC) have de-emphasised its importance. The Resuscitation Council (UK), in line with the ERC’s recommendations and those of the American Heart Association, have suggested that the technique should be used only by healthcare professionals with specific training and expertise, and even then that it should be viewed in conjunction with other indicators such as agonal respiration.

Various other methods for detecting circulation have been proposed. Guidelines following the 2000 International Liaison Committee on Resusciation (ILCOR) recommendations were for rescuers to look for “signs of circulation”, but not specifically the pulse . These signs included coughing, gasping, colour, twitching and movement. However, in face of evidence that these guidelines were ineffective, the current recommendation of ILCOR is that cardiac arrest should be diagnosed in all casualties who are unconscious and not breathing normally.

Following initial diagnosis of cardiac arrest, healthcare professionals further categorise the diagnosis based on the ECG/EKG rhythm. There are 4 rhythms which result in a cardiac arrest. Ventricular fibrillation (VF/VFib) and pulseless ventricular tachycardia (VT) are both responsive to a defibrillator and so are colloquially referred to as “shockable” rhythms, whereas asystole and pulseless electrical activity (PEA) are non-shockable. The nature of the presenting hearth rhythm suggests different causes and treatment, and is used to guide the rescuer as to what treatment may be appropriate

What is Cardiac Arrest ?

A cardiac arrest, also known as cardiorespiratory arrest, cardiopulmonary arrest or circulatory arrest, is the abrupt cessation of normal circulation of the blood due to failure of the heart to contract effectively during systole.

A cardiac arrest is different from (but may be caused by) a heart attack or myocardial infarction, where blood flow to the still-beating heart is interrupted.

“Arrested” blood circulation prevents delivery of oxygen to all parts of the body. Cerebral hypoxia, or lack of oxygen supply to the brain, causes victims to lose consciousness and to stop normal breathing, although agonal breathing may still occur. Brain injury is likely if cardiac arrest is untreated for more than 5 minutes, although new treatments such as induced hypothermia have begun to extend this time.To improve survival and neurological recovery immediate response is paramount.

Cardiac arrest is a medical emergency that, in certain groups of patients, is potentially reversible if treated early enough (See “Reversible causes” below). When unexpected cardiac arrest leads to death this is called sudden cardiac death (SCD). The primary first-aid treatment for cardiac arrest is cardiopulmonary resuscitation (commonly known as CPR) which provides circulatory support until availability of definitive medical treatment, which will vary dependant on the rhythm the heart is exhibiting, but often requires defibrillation.