In the United States alone sudden cardiac arrest, or SCA, kills more than 450,000 of our family members, co-workers, customers, friends, and neighbors each year. That is more than car accidents, breast and prostrate cancer, handguns, fires, and AIDS combined.
As a practicing heart surgeon for more than 20 years, who has performed more than 5,000 surgeries, I applaud the recognition of the first week of June as National Cardiopulmonary Resuscitation and Awareness Week. Such recognition will help save lives at the community level from a killer that can strike at any time, regardless of age, background, ethnicity, and health profile. While education is important, it is only through legislation like this that true change will occur in timely fashion and communities, businesses, and local organizations will take the steps necessary to ensure that more lives are saved.
For a victim of cardiac arrest, time is of the essence. Unfortunately, only 5 to 7 percent of SCA victims survive, but recent studies have shown that these statistics can be dramatically improved through training and access to automated external defibrillators, or AEDs. In most emergencies, critical early minutes are lost because it often takes emergency response personnel too long to arrive on the scene. In fact, studies reveal that national EMS response times average six to twelve minutes in any emergency.
The only cure for most cases of SCA is immediate shock therapy from an AED. An astounding 50 to 70 percent of those who receive defibrillation within three to five minutes of sudden cardiac arrest survive. The key, then, is widespread AED deployment, so that the help can be delivered immediately, even by non-medically trained personnel.
How AEDs work. Think of the heart’s electrical system as a complex machine similar to a computer with lots of electrical wiring. A Sudden Cardiac Arrest is like the computer freezing up. The normal heart rhythm goes haywire and the heart can no longer pump the blood effectively. The victim collapses, stops breathing, and has no detectable pulse. Every minute that the heart is not beating lowers the odds of survival by 7 to 10 percent. After 10 minutes without defibrillation very few people survive.
There is usually nothing structurally wrong with a computer when it freezes up. Similarly, in most cases, there’s nothing structurally wrong with the heart when it goes into SCA. Just as a reboot will frequently restart a computer, an electrical shock by an AED resets the heart so that its electrical activity can resume its normal function and pump blood at its normal rhythm.
AEDs have become so easy to use that even a young child can be trained in minutes to save someone’s life. In most emergencies, the first people on the scene are lay people who may not be able to use traditional defibrillators. Since AEDs are automated and designed to deliver the appropriate shock correctly, they can be used by lay responders with minimal training. Voice instructions guide the user through the necessary steps. A computer inside the AED analyzes the patient’s heart rate and determines if a shock is required. If the victim doesn’t need a shock, there are safeguards built into the unit so that a shock will not be delivered.
AEDs at work. As employees and business leaders we spend more of our time at work, so it is no surprise that SCA is the second leading cause of death in the workplace following accidents. AED programs in individual businesses send a strong message to their employees and customers that they care about their well being by recognizing the risk of SCA in the workplace.
Organizations that deploy AEDs not only save lives, they improve the morale of the employees and also develop more CPR trained individuals. By training CPR and AED to employees these valuable skills are also transferred to their personal lives should they be presented with a cardiac event at home, school, church or the neighborhood where they live. Consider the very different experiences of employees that work for a firm that deployed AEDs and actually saved lives as a result, versus one that had not. Beyond the employee saved, or lost, it is not hard to figure which group of employees would feel better about their organization.
AEDs vs. CPR. Medical experts already know that traditional CPR only buys the SCA victim a little more time. While CPR can indeed keep open the window of opportunity for an extra minute or two, the fact remains that sudden cardiac arrest requires a shock from an AED to restore a normal heart rhythm. This is precisely why almost all new CPR courses offered by hospitals and schools today provide AED training for their students. It’s becoming part of basic medical training, not just for the professional, but for the layperson as well. In fact, the American Heart Association, American Red Cross, and the American Safety and Health Institute, among others, have added AED training to their CPR curriculum.
The message is getting out there. AEDs are becoming part of the daily American landscape, and one day, I hope, will be as common a sight as the fire extinguisher. Not only should they be carried by all emergency vehicles, they should be installed in all public spaces and eventually in all private homes. The Red Cross and the American Heart Association have a shared vision of having all Americans within four minutes of an AED device and someone trained to use it.
Glenn W. Laub is chairman of cardiothoracic surgery and director of Heart Hospital at St. Francis Medical Center in Trenton. He is also the co-founder and CEO Defibtech, a Guilford, Connecticut-based maker of automatic external defibrillators. He holds numerous patents in the medical field. Laub received his bachelor’s in engineering and applied science from Yale and his M.D. from Dartmouth.