The following presentation is for use by instructors and Emergency Care Management Consultants in promoting the establishment of AED programs to Lifeguard, Aquatics Safety and Recreation, Business and Community Groups. Presented as a public service by Lifesaving Resources Inc. www.lifesaving.com Read the slide.

Automated External Defibrillators “A sudden death need not be permanent.” Of all of the marvels of medical science, one of the most remarkable is that with the use of an automated external defibrillator, a sudden death need not be permanent.

AED Instructor Foundation Developed by AED Instructor Foundation Read the slide. Helping those who help save lives

…Someday everyone will die! The Reality of Life… …Someday everyone will die! Someday all of us will cease to continue life on this planet.

"... hearts & brains too good to die." The Problem Premature Death The problem is that far too many people will die prematurely, with “hearts and brains too good to die.” "... hearts & brains too good to die." Peter Safar, MD

MEDICAL SYSTEM Serious Illness & Injury Emergency Departments Specialty Medical Centers (Cardiac, Trauma, Burn) MEDICAL SYSTEM Emergency Departments Since its creation in the early 1970’s, the EMS System made great strides in reducing mortality and morbidity… Community EMS Services Serious Illness & Injury

But despite EMS advances… 350,000 300,000 250,000 200,000 150,000 100,000 50,000 Annual Deaths (U.S.) Sudden Cardiac Arrest Lung Breast Traffic AIDS/ Cancer Cancer Accidents HIV CAUSES OF DEATH Stroke Disease or Incident Murder Advances in modern medical science (including Emergency Medical Services) have helped to prolong life and reduce the number of deaths from many “killer” health problems. But the problem of sudden cardiac death has continued to go virtually unchecked. Sudden Deaths continue to increase.

How the Heart Works Electric Event Pumping Action Blood Pressure generating Pumping Action resulting in O2 To understand Sudden Death and how to counter it, we must first of all examine how the heart works and what causes Sudden Death. (Read the slide.) producing Blood Pressure

There is a difference between Heart Attack and Sudden Death? Read the slide.

Heart Attack The “S-A” Node Blocked Coronary Heartbeat Artery The heart’s own “pacemaker” Blocked Coronary Artery Heartbeat Continues to Beat A heart attack occurs when an artery serving the heart becomes blocked or constructed resulting in damaged heart muscle. But generally, the victim’s heart – although impaired – continues to beat. Damaged Heart Muscle

Continues to Have Heartbeat & Breathing Heart Attack Signs & Symptoms (Patient may have one or more…) Chest Pain/Discomfort Radiation to Arm, Neck or Jaw Profuse Sweating Difficulty Breathing Fearful, Confused or Irritable Denial of Symptoms If someone is having a heart attack, generally the indications will be… (read the signs & symptoms.) Continues to Have Heartbeat & Breathing

“V-Fib” Sudden Death V-fib Chaotic Quivering NO Heartbeat but Although it is sometimes related to a heart attack, Sudden Death is different and far more serious. Due to an electrical malfunction known as “ventricular fibrillation” the heart quivers chaotically but is not able to produce blood flow.

Patient Symptoms when in Ventricular Fibrillation Unconscious No Effective Heart Action No Breathing Looks Terribly Sick & Discolored Resulting in… This person is what we call “suddenly dead.” (Read the slide.) No Oxygen to the Brain or Body Organs Life or Death is now a matter of TIME

Some Oxygen Sudden Death 0 Minutes At the point of Sudden Death, even though there is no heartbeat nor additional oxygen entering the lungs, the patient’s brain is still viable.

No Oxygen Brain Death 10-12 Minutes But generally, if the lack of oxygen continues for 10-12 minutes, permanent brain death will occur. 10-12 Minutes

What Really Causes Death? COMPLICATIONS PHYSICAL CHEMICAL ELECTRICAL Read the slide.

Ventricular Fibrillation Most Dangerous Complication Ventricular Fibrillation Read the slide. "Electrical Anarchy"

V-fib 80-90% R I P of sudden deaths are caused by It is estimated that 80-90% of all Sudden Deaths are a direct result of ventricular fibrillation.

The Only Correction for V-fib Although it should be started as soon as possible, CPR alone will be of little value for the victim of Sudden Death. (Read the Slide.) De-fib

Hospitals Health Care Facilities The importance of defibrillation has long bee known in health care facilities… Health Care Facilities

Police, Fire & EMS Services …and it’s been shown feasible on scene by emergency services personnel.

Chain of Survival If the person in cardiac arrest is to have a 2nd Chance at Life, a series of critical events depicted by the “Chain of Survival” needs to occur. (Refer to the Slide. Emphasize rapid defibrillation.) Early Early Early Early Access CPR Defibrillation Advanced Care Early Defibrillation © American Heart Association

Survival is reduced by 10% for each minute that defibrillation is delayed Survival Rate (percent) Time to Defibrillation (minutes) 20 40 60 80 100 5 10 15 25 30 Read the slide.

Shocking The Solution AED to Sudden Death The solution to this major public health problem is the availability and use of an Automated External Defibrillator, known as an AED.

Automated External Defibrillators Safe Simple Use High Success Rate These battery powered, computer guided technological marvels of modern medicine have been proven to be safe, simple to use and highly successful

If there is a shockable rhythm AEDs ONLY Advise Shocks If there is a shockable rhythm Read the slide.

Prompt the user in what to do AEDs Prompt the user in what to do Visual AEDs provide visual and audible prompts for users. (Refer to slide.) Readiness Audible

Electrode Placement Well Illustrated Read the slide.

Sudden Death Reversal Rates CPR (only) ……………………… 0 - 2% EMS/ER …………………… 5 - 15% CPR+AED…….. 30 - 70% The numbers speak for themselves. (Read the Slide.)

Emergency Medical Response Plan Public Access Defibrillation Part of an On-site Emergency Medical Response Plan A PAD program should be an integral component of an onsite Emergency Medical Response Program.

Planning & Implementation PAD Program Site Survey & Needs Analysis EMS Services Training Medical Control AED Acquisition & Maintenance Procedures & Protocols The plan consist of several integrated components. (Read the slide.) Medical Facilities On-site Drills & Review Incident Review Planning & Implementation

A variety of units are available There are a number of major manufacturers producing AEDs. are available

Location ? How Many ? AED Deployment AEDs need to be placed in strategic and easily accessible locations. How Many ? Location ? 32

Emergency Medical System On-site Emergency Response Emergency Specialty Medical Centers (Cardiac, Trauma, Burn) On-site Emergency Response Emergency Departments The effectiveness of the EMS System can be extended to on-site in a variety of occupational and public gathering locations. Community EMS Services

Who is or can be trained to use an AED? Lifeguards Flight Attendants Mall Workers Police Golf Pros Health Club Employees Students Office Staffs Physicians Flight Attendants Security Guards Firefighters Ushers Corporate Emergency Response Teams Cruise Ship Personnel Just about anyone can learn to use an AED.

AEDs & the Law Physician’s Prescription/Order Medical Director “Good Samaritan Law” Protection Medical Control Current Case Law ? By legal statute in most states there is immunity for the users of AEDs. To date there has never been anyone “sued” for using or having an AED. (There have been suits against corporations for NOT having an AED.) Do you have to have an AED?

(Conform to Community Standards?) Be Reasonable Read the slide. (Conform to Community Standards?)

AED Program The right thing to do The best reason to implement an AED program is because it’s the right thing to do. The right thing to do

The Benefits of an AED Program Prevent Premature Death But it also Extends Life and Productivity Enhances Employee & Client Morale Enhances Employee & Client Loyalty Promotes Personal Safety & Health Limits Liability Exposure …and if death occurs Comfort, Support & Closure for Family Read the Slide.

Sudden Death Survival Factors Prior State of Health Severity of the Event Specialty Medical Care (Quality & Availability) A number of key factors determine if the victim of a sudden death can or will have their life continued…most of which you have no control over. (Refer to the slide.) To give the victim a second chance at life, all you can do is Support Life. Immediate Life Support CPR and an AED

System Survival An On-site… of Make the Right Call Initial Early Recognition Initial Life Support ABCS CARE Effective CPR By implementing an on-site System of Survival, with rapid defibrillation as a key component, literally thousands of lives can be saved each year. Timely Definitive Care Rapid Defibrillation Continued Life Support ABCS CARE

…just about ANYONE just about ANYWHERE Public Access Defibrillation We now know that through organized Public Access Defibrillation programs (also known as PAD programs), just about anyone, anywhere can successfully utilize an AED. For use by… …just about ANYONE just about ANYWHERE

Premature Death The Problem What are you going to do about it? With community commitment, a well organized plan – and each of us playing a vital part – we can make a difference in the pain, suffering and cost of people dying “before their time”. What are you going to do about it?

Sudden Death Can Be Interrupted & When Hearts & Brains Are Too Good to Die Sudden Death Can Be Interrupted & Life Can Be Extended Read the slide. You Can Do It!

Lifesaving Resources Inc. Thank You For Your Commitment To Safety, Health & Life Lifesaving Resources Inc. www.lifesaving.com Are there any questions or comments.