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COUNTDOWN TO SURVIVALPUBLIC ACCESS DEFIBRILLATION IN MALAYSIA

TABLE OF CONTENTS1

1. ABSTRACT3 2. PROBLEM STATEMENT.4 3. INTRODUCTION..5 3.1 Automated External Defibrillators.5 3.2 Public Access Defibrillators...6 3.3 Operating an AED..6 4. STRATEGIC LOCATIONS FOR AED.8 5. APPENDIX12 6. CONCLUSION..17 7. REFERENCE.18

1. ABSTRACT2

Every minute of every day in all over the world, sudden cardiac arrest (which often leads to heart attack) claims another victim. A heart attack occurs when the arteries that supply blood to the heart become blocked, the flow of blood which carries oxygen to the heart is slowed or stopped, and the muscle fibers contract chaotically rather than in synch with each other as they normally do. Placement of Automated External Defibrillators (AED) in strategic locations throughout the city, in addition to an ever-increasing number of citizens trained in their use will improve cardiac arrest survival rates in Malaysia. Once established, the Public Access Defibrillators (PAD) program will continue to fund itself in future years, without further need for grant source funding.

2. PROBLEM STATEMENT

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Everybody knows that heart disease is the number 1 killer in Malaysia and almost in every country in this world. It doesnt just lead the dangerous disease chart but the amount of death patients due to heart disease goes to 6,500 cases compared to loss of life due to accidents (6,000 cases). The possibilities Malaysians suffered heart disease is actually equal to developed countries population that is 1 case for every 200,000 people. Even though the rate is small but it cannot be neglected as there are many factors contributing to heart disease. It is estimated that 1/3 of world population that is about 17 million people died from cardiovascular disease every year. Most of these deaths occur with little or no warning, from a syndrome called sudden cardiac arrest. The most common cause of sudden cardiac arrest is a disturbance in the heart rhythm called ventricular fibrillation. Ventricular fibrillation is dangerous because it cuts off blood supply to the brain and other vital organs.

The ventricles are the chambers that pump blood out of the heart and into the blood vessels. This blood supplies oxygen and other nutrients to organs, cells, and other structures. If these structures do not receive enough blood, they start to shut down, or fail. If blood flow is not restored immediately, permanent brain damage or death is the result.

Ventricular fibrillation often can be treated successfully by applying an electric shock to the chest with a procedure called defibrillation.

In coronary care units, most people who experience ventricular fibrillation survive, because defibrillation is performed almost immediately. The situation is just the opposite when cardiac arrest occurs outside a hospital setting. Unless defibrillation can be performed within the first few minutes after the onset of ventricular fibrillation, the chances for reviving the person (resuscitation) are very poor. For every minute that goes by that a person remains in ventricular fibrillation and defibrillation is not provided the chances of resuscitation drop by almost 10 percent. After 10 minutes, the chances of resuscitating a victim of cardiac arrest are near zero.

Cardiopulmonary resuscitation, usually known as CPR, provides temporary artificial breathing and circulation.

It can deliver a limited amount of blood and oxygen to the brain until a defibrillator becomes available.

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However, defibrillation is the only effective way to resuscitate a victim of ventricular fibrillation.

3. INTRODUCTION3.1 Automated External Defibrillators (AED)

In the mid-1980s, a new generation of computerized defibrillators was introduced. Called Automated External Defibrillators or AEDs for short, these devices were capable of interpreting a person's heart rhythm and automatically delivering a defibrillation shock with only minimal input from the operator.

Variety of AED For the first time, EMS personnel such as basic emergency medical technicians (EMTs) were able to provide the life-saving technique of defibrillation without having to interpret ECG rhythms. As AEDs began to be placed in more and more "basic life support" ambulances (those not staffed by more advanced paramedics), the survival rates for out-of-hospital cardiac arrest began to rise. However, the problem of getting the defibrillator to the victim in less than 10 minutes remained a challenge. The next step in reducing the amount of time it took to get a defibrillator to a cardiac arrest victim came with the recognition that the police are often the first to arrive at the scene of a medical emergency, ahead of an EMS unit.

With this knowledge, some EMS systems began to train and equip police officers to provide defibrillation with AEDs. This allowed defibrillation to be performed sooner, often before an ambulance arrived.

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The use of AEDs by law enforcement personnel has begun to have a significant impact in resuscitating victims of sudden cardiac arrest. Public Access Defibrillators

3.2

The evolution of early defibrillation took another major step forward with the concept of public access defibrillation or "PAD."

It is now recognized that AEDs are extremely easy to use. Formal training programs, such as those offered by the American Heart Association's Heartsaver AED course, can be taught in as little as 4 hours. However, operating an AED is so simple that it can be done successfully even without formal training. Training is recommended for as many people as possible. Local and state regulations determine the training requirements for PAD programs.

The legal requirements that allow the lay public to use AEDs are determined on a stateby-state basis.

In some countries there is true public access defibrillation, meaning that anyone with knowledge of an AED can use one any time it is available. For example, a traveler in an airport may retrieve and use an AED mounted in a public location. In other coutries, use of AEDs is more restricted. Some states require a formal training program, the direct involvement of an authorizing doctor, or that the AED rescuer is part of a formal in-house response team. In most countries, any individual using an AED in a good faith attempt to save the life of a cardiac arrest victim will be covered by some form of a "good Samaritan" statute. Operating an Automated External Defibrillators (AED)

3.3

Regardless of which brand of AED is used, the only knowledge required to operate it is to press the "ON" button. Once the AED is turned on, it actually speaks to you in a computer-generated voice that guides you through the rest of the procedure. You will be prompted to place a set of adhesive electrode pads on the victim's bare chest and, if necessary, to plug in the pads' connector to the AED. The AED will then begin to automatically analyze the person's ECG rhythm to determine if a shock is required. It is critical that no contact be made with the

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person while the machine is analyzing the ECG. If the person is touched or disturbed, the ECG may not be accurate.

If the machine determines that a shock is indicated, it will automatically charge itself and tell you when to press the button that will deliver the shock. Once the shock is delivered, or if no shock is deemed necessary, you will be prompted to check to see if the person has had a return of normal breathing or circulation. If not, you will be reminded to start CPR.

Operating an AED is as easy as 1,2,3

4. STRATEGIC LOCATIONS FOR AED7

In Malaysia, Automated external defibrillators (AED) should be located in places where large groups of people gather and the risk of a sudden cardiac arrest incident is likely such as: Government office (Putrajaya and etc.)

Shopping Centers

Airport

Restaurants 8

Hotels

Stadium

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Schools and Universities

Fitness centers and Health Club

In some countries, all police vehicles carry an AED, and they are on board all commercial passenger airplanes. In order to make them highly visible, public AEDs often are bright red, green, or yellow in color, and are mounted in protective cases near the entrance of a building. When these protective cases are opened, and the defibrillator removed, most will sound a buzzer to alert nearby staff to their removal. Most of these alarms do not summon emergency services, so emergency services should be called as soon as an AED is sent for or used.

An AED at Chbu Centrair International Airport in Aichi, Japan. Typically, an AED kit will contain a face shield, for providing a barrier between patient and first aider during rescue breathing; a pair of Nitrile rubber non-allergenic gloves; a pair of Tuff cuts scissors, for cutting through a patient's clothing to expose the chest; a

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small towel for wiping away any moisture on the chest and a razor for shaving those with very hairy chests.

An AED at a railway station in Japan. The AED box has information on how to use it in Japanese, English, Chinese and Korean, and station staffs are trained to use it. AEDs can also be kept and used in the home, particularly important for those with existing heart conditions. The number of devices in the community will continue to grow as more and more citizens begin to understand their importance in providing first aid. Increasingly, many Ambulances are carrying AED or AED-Capable Defibrillators to allow Basic Life Support personnel such as First Responders and EMT-Bs/IVs to give electrical therapy to patients when the providers aren't trained in EKG administration or rhythm analysis.

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