Why people need to support PAD (Public Access Defibrillation) programs in our communities.
Your head hits the cold sidewalk with a sickening thud, and thoughts flash briefly across your mind,
Am I dying?
Will somebody save me?
It’s a cold winter morning. You’re on your way to work feeling nervous, shaky and slightly nauseous. While crossing the car park towards the office entrance, your sense of impending doom increases.
At first, you assume it’s just stress about your upcoming presentation. But then you become aware of heavy pressure in your chest and shortness of breath. Dizziness fades to black, and you fall to the ground unconscious.
You’ve experienced a Sudden Cardiac Arrest (SCA). What happens next changes the course of your life.
You appear to be watching the scene from above.
A woman in a black jacket kneels beside you and taps your shoulder. “Hey, are you OK?” she asks with concern, but you’re unable to respond. Shaking with stress, she points at a teenage bystander and says,
“You in the blue hoodie, call 911 and say we’ve got an unconscious person. Ask them to send an ambulance and bring an AED. Do you understand?” The teenager nods and starts making the call.
Rain from the sidewalk seeps into your hair, sending chills down your spine. Cold, scared and unable to communicate, you’re grateful when the teenager slides their folded jacket carefully under your head.
The woman helping you finds you’re not breathing and starts pushing on your chest. You know she’s doing CPR and it’s supposed to help in these situations. Still, it’s uncomfortable having someone pressing hard on your chest. You wonder if she’ll break a rib. The Bee Gees’ tune “Stayin’ Alive” plays quietly in your head as she does her compressions.
A siren announces the arrival of the ambulance. Paramedics quickly assess the scene, check you over, unpack their equipment and connect you to an AED. You remember reading somewhere that an AED or Automated External Defibrillator is a device that delivers an electrical shock to the heart.
“Stand clear!” warns a paramedic, and everyone moves back.
Bright light, a hard jolt, and you feel like you’ve been kicked in the chest by a donkey. Time stops, and then quickly, everything starts to feel better. The pressure on your chest is gone, your body begins to warm up, you are no longer nauseous and shaking.
You can breathe.
Tears fall with the realization someone just saved your life. Without a courageous bystander stepping up to provide CPR, you’d be dead, but now, you’ve been given another chance.
Paramedics load you carefully into the ambulance. The woman in the black jacket squeezes your hand and wishes you well, and the ambulance, siren wailing, makes its way through busy, wet streets to the hospital.
Weeks later, when you’ve fully recovered, you’re having breakfast and reading the news. A Red Cross article tells you that cardiac arrest can occur at any age, without warning, to people of all fitness levels.
There’s nothing like a near-death experience to put things in perspective and reshuffle priorities. A bystander saved your life, and it all started with them calling EMS/911.
You realize if all you do in an emergency is call EMS/911, your actions could save a life. But you want to be able to do more. You register for first aid class and learn how to perform CPR and use an AED. Who knows, maybe you’ll pay it forward, be the hero and save a life one day.
What does CPR do?
CPR buys the casualty time. It helps circulate vital oxygen-rich blood to the heart and brain and increases the length of time a shock from a defibrillator can be effective.
Without bystander CPR, a sudden cardiac arrest victim’s chances of survival fall 7–10 percent for every minute of delay until defibrillation. Resuscitation attempts are unlikely to succeed without CPR and defibrillation within minutes of collapse. Only 1 in 10 survives a cardiac arrest outside of a hospital.
The good news is that the chance of surviving a cardiac arrest increases when early CPR is used in combination with an AED in the first few minutes. The American Heart Association states, “Effective bystander CPR, provided immediately after cardiac arrest, can double a victim’s chance of survival.”
What is an AED?
On countless medical shows, you’ve seen the doctor apply pads to a patient’s chest, yell, “CLEAR,” and press a button on the machine to deliver a shock. The patient’s back arches dramatically, and they thump down onto the operating table.
An AED is a lightweight, portable computerized device. It can analyze heart rhythm and deliver an electric shock to the heart. The shock can potentially stop an irregular heartbeat (arrhythmia) and allow a normal rhythm to resume following sudden cardiac arrest.
Through electrodes placed on a patient’s chest, a processor inside the AED detects electrical activity from the heart and analyzes the victim’s heart.
After an AED analyzes the heart rhythm and determines a shock is required, it delivers an electric current to the heart through the victim’s chest wall via adhesive electrode pads. The shock interrupts the chaotic rhythm and allows it to return to normal.
The machine will not shock unless necessary; AEDs are designed to shock only when certain heart rhythms are detected. For example, if the AED detects Ventricular Fibrillation (VF) or Ventricular Tachycardia (VT), it will instruct you to deliver a shock.
What are the different types of heart rhythms?
Ventricular Fibrillation (VF) is where the heart is a quivering, uncoordinated mess. VF on the EKG looks like a squiggly line.
Ventricular Tachycardia (VT) is where the heart is beating too fast. When the heart is in VF or VT is unable to pump blood and oxygen around the body effectively.
Asystole (cardiac flatline) is the absence of electrical activity from the heart. Asystole is the most serious form of cardiac arrest. It is usually irreversible. In this condition, the heart muscle is not contracting and cannot provide blood flow and oxygen to the body. A patient in asystole is unlikely to survive.
Sinus Rhythm is a normal heart rhythm. The heart has a natural pacemaker called the sinoatrial (SA or sinus) node, which is responsible for setting normal heart rhythm.
Who can use AED’s and are they safe?
AED’s are safe, and anyone can use them. It helps if you’ve had training, but many lives are saved every year by people using AED’s. Many of these people have no training — other than what they’ve seen on TV.
Why we need Public Access Defibrillation (PAD)
When the heart stops beating and circulating blood, there’s a window of about 3 minutes before the brain begins to die. After 10 minutes without CPR or AED, a person has almost zero chance of survival.
Although calling EMS/911 is critical in an emergency, we need to take immediate action to help a victim of SCA. If we rely on the ambulance to bring an AED and it’s slow to arrive, the casualty may not survive.
Having an AED onsite gives victims of SCA the best chance of survival until paramedics arrive and take over care.
Wouldn’t it be great if AED’s were more widely available and we all had training on how to use them?
PAD (Public Access Defibrillation) is a movement to make AED’s more readily available in our communities. The PAD program aims to reduce the number of deaths from sudden cardiac arrest in public places.
Where should AEDs be placed?
With PAD, AEDs are installed in areas where the density of people is high, and employees are trained to use them. The more AED’s there are, the better our chances of survival if we suffer an SCA.
All first-response vehicles, including ambulances, law enforcement vehicles and fire trucks, should carry an AED. AEDs should also be available in public areas such as sports arenas, shopping malls, airports, airplanes, businesses, conference centers, hotels, schools and medical offices.
They should also be in any other public or private place where large numbers of people gather or where people at high risk for heart attacks live. They should be situated near elevators, cafeterias, main reception areas, and on walls in main corridors.
Ideally, we’d all have an AED in our workplace, at home and in the trunk of our car. Maybe one day, we’ll have an AED app on our phones.
The future of AED’s
There is an exciting future for defibrillators. AED’s will likely become more widely available as research provides more information about their life-saving role. As with other forms of technology, AED’s will likely decrease in size and weight and contain enhanced communication capabilities.
Imagine this scenario. You’re sitting in your local coffee shop. A person staggers towards you, clutching their chest and collapses unconscious on the ground.
You call EMS/911 and ask for an AED. One minute later, a drone arrives and lands on the sidewalk outside the coffee shop. The drone is carrying an AED. You unstrap the AED, press the ON button, and the AED tells you precisely what to do to save the person’s life. Meanwhile, an ambulance makes its way to your location.
Worldwide, Sudden cardiac death is a major public health problem, accounting for 15–20 % of all deaths. It is the most common cause of death, accounting for 17 million lives lost per year.
Death from sudden cardiac arrest is not inevitable. If we all knew how to do CPR and use an AED, we could save more lives.
AED’s are safe and easy to use, and we need more of them in public areas. The more AED’s and the more people with training, the safer our world will be.
Encourage your employer to install an AED in your workplace. If you haven’t taken a first aid & CPR class recently now would be a good time to learn to save a life.