Advances In ResuscitationAutomated External Defibrillators

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Is your community a
HeartSave Awareness
community?
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As many as 40,000 people die from sudden cardiac
arrest (SCA) every year in Canada
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How Serious is SCA in Canada?
Source Health Indicators, Statistics Canada,
1996 (Released May, 2002)
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How Serious is SCA?(Deaths per year in the U.S.)
Statistical Abstract of the U.S. 1998, Hoovers
Business Press, 118th Edition
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Only 5-10 of its victims survive.
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It strikes people of all ages and fitness levels,
even the very young and athletic.
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Many people have no warning signs before the
arrest.
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Defibrillation The Only Effective Treatment for
Ventricular Fibrillation
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The Heart and Stroke Foundation of Canada
recommends defibrillation in less than 4-5
minutes, ideally in less than 3.
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Resuscitation Success vs. Time

• Recognition/ decision
• Dispatch information
• Time to unit
• Travel time
• Time to patient
• Time to first shock

Chance of success reduced 7-10 each minute
Success
Non-linear
Time (minutes)
Adapted from text Cummins R.O., 1989. Annals
Emerg Med.181269-1275.
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Factors influencing response time..

• Traffic delays
• Weather delays
• Rural locations
• High Rise Building
• Elevators
• Locating the correct address
• Locating the patient in large or crowded
  facilities
• Security delays
• Trains

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Chain of Survival

• Early access
• Early CPR
• Early defibrillation
• Early advanced life support

Heart and Stroke Foundation of Canada
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AED Automated External Defibrillator
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Advantages of AEDs

• Eliminates need to recognize rhythms
• Personnel with less training can defibrillate
• Makes early defibrillation practical and
  achievable

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Medtronic Physio-Control AEDs
LIFEPAK CR Plus automated external defibrillator
LIFEPAK 500 automated external defibrillator
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Defibrillation Electrode Placement
Anterior
Lateral

• Anterior-lateral placement

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Who is Using AEDs Today?

• Flight attendants
• Firefighters
• EMTs
• Corporate emergency response teams
• Security officers

• Police
• Golf pros
• Lifeguards
• Health club employees
• Coaches

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PAD Public Access Defibrillation
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Building a HeartSave Awareness Community

• Public Access Defibrillation, which places AEDs
  in the hands of trained laypersons, has the
  potential to be the single greatest advance in
  the treatment of VF cardiac arrest since the
  development of CPR. (AHA)

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HeartSave Awareness Communities

• Want to give every person in sudden cardiac
  arrest another chance at life
• Place automated external defibrillators (AEDs) in
  the hands of EMS, fire service and police
  personnel
• Deploy AEDs in key locations where people
  congregate, for use by anyone with minimal
  training

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Early Defibrillation Effectiveness

• Rural and urban U.S. studies
• Substantial increases in survival

30
Before
25
After
20
Survival
15
10
5
0
King CountyWashington
Iowa
SoutheastMinnesota
NortheastMinnesota
Wisconsin
Textbook of Advanced Cardiac Life Support,
Chapter 20, 1990, p. 289
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Early Defibrillation by Security Officers
Casino Study

• Landmark study AED use by nontraditional
  responders in out-of-hospital cardiac arrest
• Security officers in various gaming casinos were
  trained to use AEDs
• Goal to deliver first shock within 3 minutes of
  patient collapse

Valenzuela TD, et al NEJM 2000 343 1206-09.
Valenzuela TD, et al NEJM 2000 343 1206-09.
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Survival Rates for Witnessed VF
100
90
74
80
70
49
60
Percent
50
40
30
20
7
10
0
Shock lt3 min. after collapse (26/35)
Shock gt3 min. after collapse (27/55)
National Average
Valenzuela TD, et al NEJM 2000 343 1206-09.
Valenzuela TD, et al NEJM 2000 343 1206-09.
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Making Where You Work, Live and Play Heart Safe
Schools
Residential Dwellings
Transportation
Entertainment/Leisure
Fitness/Recreation
PublicBuildings
Manufacturing
Schools

• Universities
• High schools
• Middle schools
• Elementary schools

• Industrialandmanufacturingfacilities

• Hotels/casinos
• Theaters
• Stadiums
• Amusementparks
• Museums/zoos

• Airports
• Retail/shoppingmalls
• Businesscomplexes
• High risebuildings
• Governmentfacilities
• Churches
• Conventionhalls

• Golf facilities
• Healthclub/spas
• Ski resorts
• Pools
• Parks/campgrounds

• Rail/metro
• Buses
• Airplanes
• Watervehicles

• Gatedcommunities
• Condominiums
• Apartments