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DEFIBRILLATORS Responding to Sudden Cardiac Arrest

DEFIBRILLATORS Responding to Sudden Cardiac Arrest. The Odds. Annual Deaths from Cardiovascular Disease – U.S. Sudden Cardiac Arrest. 250,000. All Other Cardiovascular. 695,800.

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DEFIBRILLATORS Responding to Sudden Cardiac Arrest

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  1. DEFIBRILLATORSResponding toSudden CardiacArrest

  2. The Odds Annual Deaths from Cardiovascular Disease – U.S. Sudden Cardiac Arrest 250,000 All Other Cardiovascular 695,800 American Heart Association. Heart Disease and Stroke Statistics - 2003Update. Dallas, TX.:American Heart Association;2002. Total Deaths: 945,800

  3. Common Causes of Death in the U.S. 2,895 House Fires (19981) 31,500 Prostate Cancer (20012) 40,800 Breast Cancer (20012) 43,300 Automobile Accidents (19963) 118,495 Total 250,000 SCA (annual1) 1 http://www.americanheart.org 2 http://www.cancer.org 3 U.S. Statistical Abstract of the United States, 1998, Table 138.

  4. The Stakes Annual Sudden Cardiac Arrest (SCA) Events – U.S. 680patients per day(one every 2 to 3 minutes) 80%out-of-hospital 50%of men, 63% of women, have no prior symptoms 95%die without very early treatment < 5% survive American Heart Association. Heart Disease and Stroke Statistics - 2003Update. Dallas, TX.:American Heart Association;2002.

  5. SCA Fiction vs. Fact STEREOTYPE REALITY Gender Male Male and Female Age Old Any Age Overweight Smoker High cholesterol Often No Clear Risk Factors RiskFactors Often No Cardiac History Medical History Heart Attack Presenting Symptoms Chest Pain Dizziness Often No Symptoms

  6. The Benefits of Early Treatment of SCA American Heart Association 100,000 SCA deaths prevented annually* Recovery prospects for survivors are high 80%alive at one year 57%alive at five years Total SCA Events: 250,000 *estimated

  7. The Heart Pump: a series of events... • An electrical event … • stimulates a mechanical event … • which results in a rhythmic and coordinated pumping action of the heart muscle

  8. Sudden Cardiac Arrest: A Heart in Distress • Uncoordinated, very fast heart rhythm • Ventricular fibrillation (VF) • Some ventricular tachycardias (VT) • Ineffective heart pump • Unconscious, no breathing, no pulse • Death certain without defibrillation

  9. What Is Defibrillation? • Electric shock to the heart • Stops uncoordinated activity • Allows coordinated heart rhythm and pumping action to resume • Only effective treatment for ventricular fibrillation

  10. Chain of Survival Defibrillation an EARLY priority Adapted from the American Heart Association

  11. Why “Early” Treatment? 100 90 Chances of success are reduced 7% to 10% each minute 80 70 60 % Success 50 40 30 20 10 Time (minutes) 0 0 1 2 3 4 5 6 7 8 9 Cummins RO, et al. Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care (ECC, Circulation (Suppl) 2001;102:8, August 22

  12. Survival Rates Defibrillation No CPR Delayed Defibrillation 0 - 2% survive CPR Defibrillation Early CPR Delayed Defibrillation 2 - 8% survive CPR Defibrillation Early CPR Early Defibrillation 20%survive CPR Defibrillation ALS Early CPR Very Early Defibrillation Early ACLS ? survive minutes 2 4 6 8 10

  13. What Happens When You Call 911? Identify emergency/ Activate emergency response plan 30 seconds 911 call 1 minute Alert ambulance and rescue squads (dispatch) 30 seconds Best Case Scenario Responders to their units 30 seconds Travel time to location 5 minutes* Unload equipment/ Distance to patient 2 minutes Assess patient/ Apply defibrillator/ Deliver shock 1.1 minutes** 10.6 minutes TOTAL *Travel time varies depending on weather, traffic, distance (vertical and horizontal), and ambulance (with defibrillator capability) availability. **Cummins RO, et.al. Automatic external defibrillators used by emergency medical technicians: a controlled clinical trial. JAMA. 1987; 257:1605-10

  14. AEDs to the Rescue Uniquely small, lightweight and rugged Low-maintenance Safe, effective,and easier than CPR Designed for lay rescuer Expand lifesaving opportunities

  15. HeartStart FR2+ DefibrillatorOPERATION

  16. Verify SCA • Assess ABCs unresponsive not breathing normally

  17. Using the HeartStart FR2+ 1 • Turn on defibrillator. • Apply pads to patient and plug in connector. 2 • Deliver the shock. 3

  18. HeartStart OnSite DefibrillatorOPERATION

  19. Verify SCA • Assess the victim unresponsive not breathing normally

  20. Using the HeartStart OnSite 1 • PULLgreen handle • PLACEpads on chest • PRESSshock button

  21. What if the victim has a pulse and I can’t feel it? Is there legal liability? Can I hurt someone using the defibrillator? • Cannot make things worse • HeartStart Defibrillators designed to shock only when needed • Product indemnification policy • Good Samaritan laws, AHA standard of care • Possible reverse liability

  22. What happens if I reverse the pads? Can I defibrillate on water, snow, ice or metal? Can I defibrillate a child? • Analysis & therapy not affected by pad reversal • OK to defibrillate on water surfaces and metal • Standard safety precautions • Using HeartStart FR2 and OnSite Defibrillators is acceptable < 8 years old with Infant/Child pads

  23. Sudden Cardiac Arrest DOES Happen • Early defibrillation programs have already demonstrated success by saving lives in a variety of environments • On-site Early Defibrillation Programs enhance 9-1-1 EMS systems… resulting in more lives saved • Rapidly becoming a standard of care Las Vegas (Clark County), Nevada

  24. The Ultimate Reward Jerome Fuentes Bob Adams Bridgette McDonald

  25. Something to think about “Public Access Defibrillation has the potential to be the single greatest advancement in the treatment of prehospital SCA death since the development of CPR.” AHA Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Textbook.

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