Download BUSTING THROUGH THE 5 MYTHS ABOUT SUDDEN CARDIAC

BUSTING THROUGH THE 5 MYTHS
ABOUT SUDDEN CARDIAC ARREST
AND AEDs
Sudden Cardiac Arrest Prevention and Treatment: Strengthening the Chain of Survival
Sudden Cardiac Arrest Prevention and Treatment: Strengthening the Chain of Survival
Disclaimer
Elliot Fisch is the President/CEO and Co-Founder of Atrus, Inc. The
company’s principal product includes the National AED Registry™, a
free service to register AEDs and provide operational readiness
notices, and AED Link™ Lifesaving technology that quickly links
automated external defibrillators (AEDs), citizen AED users, and
sudden cardiac arrest victims through the community’s 9-1-1 center.
Elliot is also an independent manufacturer’s representative for the
State of Florida for Zoll Medical – a manufacturer of AEDs.
www.suddencardiacarrest.org
1133 Connecticut Avenue NW  11th Floor  Washington, DC 20036
2
Sudden Cardiac Arrest Prevention and Treatment: Strengthening the Chain of Survival
Disclaimer
Kim Harkins is the program manager for the Minnesota Resuscitation
Consortium(MRC). The MRC is an initiative of the University of
Minnesota, Cardiology Division and funded by the Medtronic
Foundation and a partner of the HeartRescue Project.
Kim also is a volunteer firefighter, has been teaching CPR and EMS
programs for 20+ years and was the previous Heart Safe
Communities program supervisor for Allina Hospitals & Clinics
www.suddencardiacarrest.org
1133 Connecticut Avenue NW  11th Floor  Washington, DC 20036
3
1
Sudden Cardiac Arrest Prevention and Treatment: Strengthening the Chain of Survival
www.suddencardiacarrest.org
1133 Connecticut Avenue NW  11th Floor  Washington, DC 20036
4
Sudden Cardiac Arrest Prevention and Treatment: Strengthening the Chain of Survival
www.suddencardiacarrest.org
1133 Connecticut Avenue NW  11th Floor  Washington, DC 20036
5
Sudden Cardiac Arrest Prevention and Treatment: Strengthening the Chain of Survival
The Five Myths
1. It’s never happened here so it must not happen a lot.
2. Heart Attack and Sudden Cardiac Arrest are the
same thing;
3. I’ll just call 9-1-1; the fire station is “just around the
corner”;
4. I’ll be sued if I do something wrong.
5. AEDs are expensive to purchase and maintain.
www.suddencardiacarrest.org
1133 Connecticut Avenue NW  11th Floor  Washington, DC 20036
6
2
Sudden Cardiac Arrest Prevention and Treatment: Strengthening the Chain of Survival
Myth #1 – It doesn’t happen a lot
Causes of Death in the U.S.
400,000
350,000
300,000
2009
250,000
200,000
150,000
100,000
50,000
Series1
House Fires
Prostate Cancer
Auto Accidents
Breast Cancer
Sudden Cardiac Arrest
3,327
27,360
37,261
40,610
350,000
www.suddencardiacarrest.org
1133 Connecticut Avenue NW  11th Floor  Washington, DC 20036
7
Sudden Cardiac Arrest Prevention and Treatment: Strengthening the Chain of Survival
Myth #1 – It doesn’t happen a lot
•
SCA also affects many young people. Approximately 10
percent of SCA events occur among people less than 40
years of age.
•
Approximately 7,000 children in the US every year have
an SCA event.
•
1 in every 200,000 to 300,000 children will have an SCA
event.
www.suddencardiacarrest.org
1133 Connecticut Avenue NW  11th Floor  Washington, DC 20036
8
Sudden Cardiac Arrest Prevention and Treatment: Strengthening the Chain of Survival
Myth #2: Heart Attack and Sudden Cardiac
Arrest are the same thing. “My Uncle Jim had
a heart attack and he’s fine.”
Here's how they differ
Heart Attack
Cause
Caused by an occlusion
(blockage) in an artery that
supplies blood to the heart
(coronary artery). The
affected heart muscle then
begins to die due to lack of
oxygen.
Sudden Cardiac Arrest
Caused by an abnormal
heart rhythm, usually
ventricular fibrillation.
Warning Signs
Often preceded by chest, arm, upper
abdomen, or jaw pain;
weakness, dizziness, nausea,
vomiting and sweating are
common.
Rarely a warning; victim collapses
suddenly and has no detectable
pulse
Victim's Response
Usually remains conscious and alert
Always loses consciousness;
unresponsive
Risk of Death
With proper treatment, many people
survive.
90 - 95% will die, unless a
defibrillation shock is delivered
within 10 minutes of collapse.
www.suddencardiacarrest.org
1133 Connecticut Avenue NW  11th Floor  Washington, DC 20036
9
3
Sudden Cardiac Arrest Prevention and Treatment: Strengthening the Chain of Survival
Heart Attack vs.
Sudden Cardiac Death
Heart Attack
Sudden Cardiac Death
Had A Heart Attack, His Fifth,
February 22, 2010
www.suddencardiacarrest.org
1950 - 2008
1133 Connecticut Avenue NW  11th Floor  Washington, DC 20036
10
Sudden Cardiac Arrest Prevention and Treatment: Strengthening the Chain of Survival
Children and Sudden Cardiac Death
Young people are often unaware of
the risk factors and don’t tell adults if
they experience the symptoms.
They may be frightened, embarrassed,
or simply unaware that what they are
feeling indicates a potentially fatal
condition.
Athletes don’t want to jeopardize their
playing time, so they may also avoid
telling their parents or coaches in
hopes that the symptoms will ‘just go
away’ on their own.
www.suddencardiacarrest.org
1133 Connecticut Avenue NW  11th Floor  Washington, DC 20036
11
Sudden Cardiac Arrest Prevention and Treatment: Strengthening the Chain of Survival
Myth #3: “I’ll just call 9-1-1” – They are
right down the street.
Really? How long does it take from the time you call to the time
they get to the victim?
Discovery/Time to call 9-1-1
Call processing time
1 minute
1.5 minutes
1.5 minutes
Activation time
Response (travel) time
Time from vehicle to patient
3 minutes
1 minute
These are absolute minimum times.
Brain death can occur in 4-6 minutes.
Do the math!
www.suddencardiacarrest.org
1133 Connecticut Avenue NW  11th Floor  Washington, DC 20036
12
4
Sudden Cardiac Arrest Prevention and Treatment: Strengthening the Chain of Survival
Myth #3: “I’ll just call 9-1-1” – They are
right down the street.
Question – can they get down the street?
www.suddencardiacarrest.org
1133 Connecticut Avenue NW  11th Floor  Washington, DC 20036
13
Sudden Cardiac Arrest Prevention and Treatment: Strengthening the Chain of Survival
Myth #3: “I’ll just call 9-1-1” – They are
right down the street – so are schools.
Even schools for young children have many adults present every day. Teachers,
teachers’ aides, custodians, office staff, administrators, reading specialists, and
parent volunteers are among those whose lives will be protected through placement
of an AED.
♥Schools provide a natural placement option for public access defibrillation
programs. Hospitals and other public buildings tend to be located in population
centers. Schools are more uniformly distributed. Placing AEDs in them puts life
saving technology nearer to those residents who are most likely to suffer long
delays from EMS services.
♥Schools serve as central gathering points within the community. Whether it is
parents attending a school concert or a school play or everyone in town attending a
basketball or football game, it is hard to imagine an institution that more regularly
attracts large numbers of people for extended periods of time.
www.suddencardiacarrest.org
1133 Connecticut Avenue NW  11th Floor  Washington, DC 20036
14
Sudden Cardiac Arrest Prevention and Treatment: Strengthening the Chain of Survival
% Chance of Survival
Chance of Survival
(no CPR or AED)
CPR/AED
100
90
80
70
60
50
40
30
20
10
0
Wait for EMS
1
2
3
4
5
6
7
8
9
10 11
Minutes Since Collapse
www.suddencardiacarrest.org
1133 Connecticut Avenue NW  11th Floor  Washington, DC 20036
15
5
Sudden Cardiac Arrest Prevention and Treatment: Strengthening the Chain of Survival
Myth #4: I’ll get sued if I hurt someone
First – a person in Sudden Cardiac Arrest (or
Sudden Cardiac Death) is already dead.
When they collapse they are clinically dead as
their heart has stopped beating.
In 4-6 minutes, by doing nothing, they will
become biologically dead.
FACT: YOU CAN’T KILL A DEAD PERSON. YOU
CAN ONLY HELP.
www.suddencardiacarrest.org
1133 Connecticut Avenue NW  11th Floor  Washington, DC 20036
16
Sudden Cardiac Arrest Prevention and Treatment: Strengthening the Chain of Survival
Take these steps….
1. Disclaimer – “I’m not a lawyer and I’m not qualified to give you legal
advice. Of course you should contact your lawyer and follow their advice.
2. But!
1. Make sure all the FACTS are available and that it’s just not a
discussion based on rumors and beliefs.
2. Do you have your state’s current Good Samaritan laws?
3. If the concept was rejected in the past, has the law changed in order
to further protect?
4. Have them research the cases.
3. It is evident that clinical benefits of the AED outweigh the minimal legal
risks. Adherence with all regulations for an AED program serves to
minimize any legal risks.
www.suddencardiacarrest.org
1
1133 Connecticut Avenue NW  11th Floor  Washington, DC 20036
17
Sudden Cardiac Arrest Prevention and Treatment: Strengthening the Chain of Survival
Anyone can sue anybody for anything –
but what’s the basis?1
Although some concerns remain over legal responsibility, these appear largely
unfounded because there has never been a successful lawsuit against an individual who
has purchased, used, or provided medical oversight for an AED.
It is evident that clinical benefits of the AED outweigh the minimal legal risks. Adherence
with all regulations for an AED program serves to minimize any legal risks.
With growing recognition of the survival benefit provided by AEDs, it is likely that, like
airbags, smoke detectors, and fire extinguishers, AEDs will be firmly established
in the realm of public safety in the near future.
1
The Automated External Defibrillator - Clinical Benefits and Legal Liability
England, Weinberg, Estes; JAMA, February 8, 2006—Vol 295, No. 6
www.suddencardiacarrest.org
1133 Connecticut Avenue NW  11th Floor  Washington, DC 20036
18
6
Sudden Cardiac Arrest Prevention and Treatment: Strengthening the Chain of Survival
Now, let’s talk about BOMA…..
BOMA stands for the Building Owner And Manager’s
Association.
BOMA International consists of 100 local associations with
over 19,000 members who own or manage over 9 billion
square feet of office space.
What is the BOMA 360 Performance Program?
BOMA 360 is a groundbreaking program that evaluates six
major areas of building operations and management and
benchmarks a building’s performance against industry
standards. Applicants must achieve the required number
of points to be recognized as a BOMA 360 Performance
Building.
www.suddencardiacarrest.org
1133 Connecticut Avenue NW  11th Floor  Washington, DC 20036
19
Sudden Cardiac Arrest Prevention and Treatment: Strengthening the Chain of Survival
If it’s good enough for BOMA…
BOMA 360 Criteria
The BOMA 360 Performance Program™ evaluates the following
operations and management practices.
Life Safety/Security/Risk Management
•Emergency and Disaster Preparedness and Recovery Plan
•Automated External Defibrillators in Buildings
•Established Emergency Communication Network with
Contiguous Properties and Law Enforcement
•Code Compliance—Certificate of Occupancy or Business
License— federal, state and local
•Fire and Life Safety Systems Inspected and Certified Annually
•Evacuation Drills Conducted at Least Annually
•Written Security Procedures Manual
•Access Control and Surveillance Systems
•ADA Compliance Plan
www.suddencardiacarrest.org
1133 Connecticut Avenue NW  11th Floor  Washington, DC 20036
20
Sudden Cardiac Arrest Prevention and Treatment: Strengthening the Chain of Survival
Liability in Schools?
Some school personnel may fear the liability of owning and operating AEDs.
However, with the increasingly widespread availability of these machines,
this concern may be shifting. Those without AEDs may be exposing
themselves to legal risk. (Note: In September 2000, United Airlines agreed
to pay $18 million in to a woman whose 37-year-old husband died on a
plane that had not been equipped with a defibrillator.) Although some
concerns remain over legal responsibility, these appear largely unfounded
because there has never been a successful lawsuit against an individual
who has purchased, used, or provided medical oversight for an AED.
In Fact : many states now mandate that AEDs are in public school
buildings
www.suddencardiacarrest.org
1133 Connecticut Avenue NW  11th Floor  Washington, DC 20036
21
7
Sudden Cardiac Arrest Prevention and Treatment: Strengthening the Chain of Survival
Myth #5: AEDs are expensive to purchase
and maintain.
Most important answer –
“you can’t put a price on a human life”
AED prices have dropped significantly in the last 10
years. In fact: from lowest to highest cost AED over 10
years of ownership-it ranges from $130 to $300 per year
– as little as $11 to $25 per month.
Local organizations, AED manufacturers and public sites
offer support for AED maintenance and updates.
www.suddencardiacarrest.org
1133 Connecticut Avenue NW  11th Floor  Washington, DC 20036
22
Sudden Cardiac Arrest Prevention and Treatment: Strengthening the Chain of Survival
Myth #5: AEDs are expensive to purchase
and maintain.
Get Creative in Funding
•
•
•
•
•
OSHA Grants
Safety Budgets
Fund Raising / Employee Giving
Special Funds
Community Grants
www.suddencardiacarrest.org
aedgrant.org
1133 Connecticut Avenue NW  11th Floor  Washington, DC 20036
23
Sudden Cardiac Arrest Prevention and Treatment: Strengthening the Chain of Survival
Myth #5: AEDs are expensive to purchase
and maintain.
What is the cost for safety?
As states mandate AEDs for school
funding may be available through
state education funds.
Other ideas:
•
Parent Clubs and Associations
•
Grants for School Safety
•
Civic Organizations
Think about combination uses with community groups
who may have additional funding
www.suddencardiacarrest.org
1133 Connecticut Avenue NW  11th Floor  Washington, DC 20036
24
8
Sudden Cardiac Arrest Prevention and Treatment: Strengthening the Chain of Survival
Start small:
• Identify minimal needs
• Focus on public locations
• Find a champion
MESA COUNTY, Colo. -- A local high schooler is heading
an effort to help keep fellow students alive. He's working
to get automated external defibrillators, or AEDs,
installed on his campus before next school year.
Cardiac-arrest victims' parents push for school
defibrillators
CARDIAC ARREST
March 04, 2008|By Mallory Simon CNN
www.suddencardiacarrest.org
1133 Connecticut Avenue NW  11th Floor  Washington, DC 20036
25
Sudden Cardiac Arrest Prevention and Treatment: Strengthening the Chain of Survival
Overcoming cost:
Keys to Implementation
School nurses oversee school-wide screening
programs for hearing, vision, and other health
issues, they are ideally suited to take the lead in
developing AED programs.
Athletic trainers and coaches often deal with these
emergencies and see first hand the need to
advance AED programs.
www.suddencardiacarrest.org
1133 Connecticut Avenue NW  11th Floor  Washington, DC 20036
26
Sudden Cardiac Arrest Prevention and Treatment: Strengthening the Chain of Survival
Who else endorses the use of AEDs?
•
•
•
•
•
•
•
•
•
•
•
American College of Emergency
Physicians
American Heart Association
American Public Health
Association
American Red Cross
Canadian Association of
Emergency Physicians
Citizen CPR Foundation
Emergency Care Research
Institute
Heart and Stroke Foundation of
Canada
International Association of Chiefs
of Police
International Association of Fire
Chiefs
International Association of Fire
Fighters
www.suddencardiacarrest.org
•
•
•
•
•
•
•
•
•
•
International Liaison Committee
on Resuscitation
National Association of EMS
Physicians
National Association of State
EMS Directors
National Association of State
EMS Training Coordinators, Inc.
National Heart Lung and Blood
Institute
National Safety Council
Occupational Safety and Health
Administration
Sudden Cardiac Arrest
Association
Sudden Cardiac Arrest Coalition
Sudden Cardiac Arrest
Foundation
1133 Connecticut Avenue NW  11th Floor  Washington, DC 20036
27
9
Sudden Cardiac Arrest Prevention and Treatment: Strengthening the Chain of Survival
In Summary
SCA and AEDs - Reasons for an AED
•
Time is critical, and an ambulance might be too far away to
make a difference in survival
•
They are very inexpensive and easy to use for a minimally
trained responder
•
The cold reality is that the death of an employee or patron is
extremely expensive to any organization- rehiring, retraining,
negative exposure, etc.
•
Legislation and litigation are increasing in support of widespread
deployment of AEDs
www.suddencardiacarrest.org
1133 Connecticut Avenue NW  11th Floor  Washington, DC 20036
28
10