defibrillators responding to sudden cardiac arrest
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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. - PowerPoint PPT PresentationTRANSCRIPT
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Responding toSudden CardiacArrest
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All Other Cardiovascular
Total Deaths: 945,800
Sudden Cardiac Arrest
The Odds
Annual Deaths from Cardiovascular Disease – U.S.
695,800
250,000
American Heart Association. Heart Disease and Stroke Statistics - 2003 Update. Dallas, TX.:American Heart Association;2002.
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Common Causes of Death in the U.S.
1 http://www.americanheart.org2 http://www.cancer.org3 U.S. Statistical Abstract of the United States, 1998, Table 138.
House Fires (19981)
Prostate Cancer (20012)
Breast Cancer (20012)
Automobile Accidents (19963)
Total
SCA (annual1)
118,495
43,300
40,800
31,500
2,895
250,000
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680 patients 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
The StakesAnnual Sudden Cardiac Arrest (SCA) Events – U.S.
American Heart Association. Heart Disease and Stroke Statistics - 2003 Update. Dallas, TX.:American Heart Association;2002.
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STEREOTYPE REALITY
Male
Old
OverweightSmoker
High cholesterol
Chest PainDizziness
Heart Attack
Male and Female
Any Age
Often No Clear Risk Factors
Often No Cardiac History
Often No Symptoms
Gender
Age
RiskFactors
MedicalHistory
PresentingSymptoms
SCA Fiction vs. Fact
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Recovery prospects for survivors are high
80% alive at one year
57% alive at five years
SCA deaths prevented annually*
Total SCA Events: 250,000
The Benefits of Early Treatment of SCA
100,000
*estimated
American Heart Association
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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
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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
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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
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Adapted from the American Heart Association
Chain of SurvivalDefibrillation an EARLY priority
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0
20
40
60
80
100
1 3 5 7 9
10
30
50
70
90
0 8642
Chances of success are reduced 7% to 10% each minute
Chances of success are reduced 7% to 10% each minute
Why “Early” Treatment?
Time (minutes)
% S
ucc
ess
Cummins RO, et al. Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care (ECC, Circulation (Suppl) 2001;102:8, August 22
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Early CPRVery Early
DefibrillationEarly ACLS
Early CPREarly
Defibrillation
No CPRDelayed
Defibrillation
minutes 2 4 6 8 10
?
survive
CPR ALSDefibrillation
20%
survive
CPR Defibrillation
0 - 2%
survive
Defibrillation
Early CPRDelayed
Defibrillation
2 - 8%
survive
CPR Defibrillation
Survival Rates
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What Happens When You Call 911?
*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
Identify emergency/ Activate emergency response plan 30 seconds
1911 call minute
Alert ambulance and rescue squads (dispatch) 30 seconds
Responders to their units 30 seconds
5 minutes*Travel time to location
Unload equipment/ Distance to patient 2 minutes
Assess patient/ Apply defibrillator/ Deliver shock 1.1 minutes**
TOTAL 10.6 minutes
Bes
t C
ase
Sce
nario
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Low-maintenance
Uniquely small, lightweight and rugged
Safe, effective,and easier than CPR
Designed for lay rescuer
Expand lifesaving opportunities
AEDs to the Rescue
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HeartStart FR2+ Defibrillator
OPERATION
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Verify SCA
not breathing normallyunresponsive
• Assess ABCs
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Using the HeartStart FR2+
1
2
3
• Turn on defibrillator.
• Apply pads to patient and plug in connector.
• Deliver the shock.
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HeartStart OnSite Defibrillator
OPERATION
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Verify SCA
not breathing normallyunresponsive
• Assess the victim
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Using the HeartStart OnSite
1
PULLgreen handle
PLACEpads on chest
PRESSshock button
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• 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
What if the victim has a pulse and I can’t feel it?
What if the victim has a pulse and I can’t feel it?
Can I hurt someone using the
defibrillator?
Can I hurt someone using the
defibrillator?
Is there legal liability?
Is there legal liability?
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What happens if I reverse the
pads?
What happens if I reverse the
pads?
Can I defibrillate
a child?
Can I defibrillate
a child?
Can I defibrillate on water, snow, ice or metal?
Can I defibrillate on water, snow, ice or metal?
• 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
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• Early defibrillation programs have already demonstrated success by saving lives in a variety of environments
Sudden Cardiac Arrest DOES Happen
Las Vegas (Clark County), Nevada
• On-site Early Defibrillation Programs enhance 9-1-1 EMS systems… resulting in more lives saved
• Rapidly becoming a standard of care
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The Ultimate Reward
Jerome Fuentes
Bob Adams
Bridgette McDonald
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AHA Guidelines 2000 for CardiopulmonaryResuscitation and Emergency Cardiovascular Care Textbook.
“Public Access Defibrillationhas the potential to be the
single greatest advancementin the treatment of
prehospital SCA deathsince the development
of CPR.”
Something to think about
