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All About AEDs: Don’t Think Twice About Using This Life-Saving Device

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After three games of five-on-five basketball, Teddy feeds off the adrenaline and wants more. With the remaining fire left in his tank, Teddy gets serious about his workout and sets the treadmill to 8 miles-per-hour. About a minute into his run, the room goes dark, and without enough life to call for help, he collapses to the ground — unresponsive and lifeless. Teddy is quickly surrounded by co-adrenaline junkies at the gym; one happens to be a paramedic, the other a physician. Quickly they grab the AED hanging on the wall, and attach it to his chest. It ‘s no longer possible to distinguish Teddy’s perspiration from that of his rescuers. The AED is activated and calls aloud, “Shock advised!” The team eagerly pushes the button, and Teddy’s body jolts off the ground. Surrounded by strangers, the young athlete opens his eyes, alive, having just survived sudden cardiac arrest.

The Basics of Sudden Cardiac Arrest

According to the American Heart Association, sudden cardiac arrest is one of the leading causes of death in the United States, and more than 350,000 people will suffer from it this year alone. What’s extremely frightening about sudden cardiac arrest is that it can happen without warning – in patients who are seemingly healthy. When sudden cardiac arrest is occurring, an AED is the only effective treatment for restoring a regular heart rhythm. It’s no secret that time is of the essence during a cardiac episode, and for each minute defibrillation is delayed, the chance of survival is reduced approximately 10 percent, which is why it’s crucial to locate these devices in public places, in case of emergency.

While many people are familiar with CPR, or cardiopulmonary resuscitation — and even trained in it — knowledge of AEDs just isn’t as prevalent. Here, I’m going to answer a few common questions surrounding this live-saving device:

 What is an AED? AED stands for automated external defibrillator. These devices allow the heart rhythm to be reset if a fast and dangerous arrhythmia is present. As the name implies, these devices are automated and provide instruction and feedback. Arrhythmias occur when the electrical system in the heart short circuits. Commonly, patients with life-threatening arrhythmias will lose consciousness, as occurred in Teddy’s situation. Often the only way of re-establishing a normal heart rhythm, and saving a victim’s life, is to apply an electrical discharge from an AED.
When should you use an AED? AEDs are used in circumstances when a victim is unresponsive and not breathing. An AED is not a substitute for CPR, but rather an adjunct. If a victim is unresponsive, the American Heart Association guidelines recommend initiating CPR first while at the same time activating an emergency response system. If two witnesses are available, one should perform CPR while the other attempts to locate an AED. CPR is then continued until the AED can be activated and used.

Does one have to be trained in order to administer the AED? Training to use an AED is available through CPR classes. It may seem surprising to hear that an AED is an easy tool for most people to operate — even someone with no medical background — but it’s true. Using an AED is, by design, simple and easy. In fact, a study performed compared trained sixth graders to EMS providers and found that sixth graders could efficiently and effectively use AEDs. Given the simplicity and impact, AED training should be considered by all.

Are there laws about AEDs? In Ohio, the state where I practice, House Bill 434 mandates that any public school be equipped with an AED. Most establishments with the capacity to accommodate large masses (such as airports and shopping malls) have AEDs as well. However, the presence of AEDs is not universal, and many establishments are still not equipped with this life-saving device. Most often, lack of access is unfortunately due to lack of investment. The presence of AEDs, and responders who know how to use them, help to greatly reduce the risk of sudden cardiac death in the community. Access to AEDs, and their prompt usage, is the key factor in determining the outcome of a cardiac arrest victim.

So, what happened with Teddy? Teddy suffers from a cardiac condition called hypertrophic cardiomyopathy. HCM is the No. 1 cause of sudden cardiac death in young athletes. During his treadmill workout, Teddy suffered from ventricular fibrillation. If not for the AED and the prompt response of total strangers, Teddy would have not survived this event. Fortunately, Teddy is now equipped with an implantable cardioverter defibrillator — a device that’s surgically implanted to provide protection in an automated fashion.