™ ™ 1 Creating HeartSafe Environments Raising Survival Rates from one of the leading causes of death in Canada. * Mark Hermes, Cardiac Science Justin Pellerin, Acklands Grainger AIFPA May 28 th, 2011 *

™ ™ Agenda “Who we are and what we do” Sudden Cardiac Arrest (SCA) – Background and Prevalence AEDs and Workplace Access Survival Rates Elements required to implement a comprehensive workplace AED program Product review / Demonstration Q & A

™ ™ Our companies Opto Circuits Three leading companies in non-invasive cardiovascular care. United to serve you. CARDIAC SCIENCE Cardiac diagnostics, defibrillation and rehabilitation UNETIXS VASCULAR Vascular diagnostic systems CRITICARE SYSTEMS Vital Signs monitors, anesthesia and respiratory care

™ ™ CARDIAC SCIENCE | 4 SUDDEN CARDIAC ARREST (SCA) The #1 Cause of Death in North America* *Cardiovascular Health Branch, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. Circulation. 2001;104: ,000 deaths per year 2/3 of SCA deaths occur while at home, work or play… 1/3 occur in hospitals 375,00 out of hospital

™ ™ CARDIAC SCIENCE | 5 WHAT IS SUDDEN CARDIAC ARREST (SCA)? Often Referred to as a “Massive Heart Attack” The heart’s electrical impulses suddenly misfire. The heartbeat becomes chaotic and rapid Rapid heartbeat—ventricular tachycardia (VT) Chaotic heartbeat—ventricular fibrillation (VF) The heart is unable to pump blood effectively, blood flow to the brain abruptly stops, and victim quickly loses consciousness Death follows within minutes unless normal rhythm is restored Cardiac arrest can happen to anyone, anytime, anywhere, at any age—children, teenagers, and adults Defibrillation within minutes is the only definitive therapy for SCA

™ ™ SCA – Some Common Causes: Coronary artery disease Acute coronary syndromes Electrocution Drug toxicity and sensitivity Asphyxia Drowning Cardio Myopathy Blunt force trauma to the chest – Commotio Cordis

™ ™ Sudden Cardiac Arrest Facts Cardiovascular Disease is the world’s leading cause of death. 1 Each year SCA kills more than 495,000 people per year, including 7,000 school age children in North America. 2,3 Death from Sudden Cardiac Arrest is 96 times more likely than death from Fire. 4 Waiting for emergency medical responders results in a 5 – 7 percent survival rate. 5 Sudden cardiac death caused by stress/overexertion was the leading cause of death among both volunteers and career firefighters. 6 CARDIAC SCIENCE | 7 1. CIA World Factbook - Rank Order - HIV/AIDS - deaths. 2. Heart Rhythm Foundation website, April AHA Heart and Stroke Statistics Update. 4. National Fire Protection Association, Fire Loss in the US, Saving Sudden Cardiac Arrest Victims in the Workplace, Occupational Safety and Health Administration, OSHA

™ ™ Sudden Cardiac Arrest Over 40,000 Canadians experience cardiac arrest every year – an average of over 110 per day* *Heart and Stroke Foundation, CARDIAC SCIENCE | 8

™ ™ CARDIAC SCIENCE | 9 T HE Cardiac C HAIN O F S URVIVAL Early defibrillation is the “key link” in the chain Heart & Stroke Foundation: Once a person goes into cardiac arrest, time is of the essence; within 3-4 minutes of not receiving oxygen, the brain can suffer permanent damage. CPR keeps the blood circulating...but it takes defibrillation with an AED to resuscitate…”

™ ™ What is an AED? (AUTOMATED EXTERNAL DEFIBRILLATOR) A small, battery-operated, portable device that can deliver an electric shock to the heart to restore normal rhythm to cardiac arrest victim. Safe-will not deliver a shock unless victim is in cardiac arrest. Uses voice and text instructions to walk user through a rescue. Designed to be used by trained lay people. Uses sophisticated software to recognize the problem, analyze it, and advise treatment.

™ ™ CARDIAC SCIENCE | 11 10% decrease in survival for every minute of delay * * American Heart Association, Chapter 4: Defibrillation. In: Cummins RO, ed. Textbook of Advanced Cardiac Life Support. Dallas, TX: American Heart Association; 1994:1-2. SCA Survival: Time to Defibrillation is the Key Factor

™ ™ Common Misconceptions CPR Alone Saves Lives of Cardiac Arrest Victims. Calling 911 Will Save Your Life. Reality -- All four links in the Chain are needed to raise survival rates.

™ ™ CARDIAC SCIENCE | 13 APPROXIMATE WHEN CARDIAC ARREST OCCURS SURVIVAL RATE Where AEDs Are NOT Present Outside of the hospital5 - 7%* Where AEDs Are Present In a casino 74% † In an airplane/airport 40%-60% †† In the workplace58% ††† *Gillum RF. Sudden coronary death in the United States: Circulation. 1989;79: †American Heart Association and Emergency Cardiac Care 2000 Guidelines, JAMA ††Chicago Department of Aviation, 2002 †††Cardiac Science, Inc. Internal Data AEDS SAVE LIVES

™ ™ Alberta Promotes Workplace AED Programs

™ ™ Work Safe Alberta says the use of Automated External Defibrillors (AEDs) at the workplace should be integrated into a company’s first aid program and emergency response plan at the site. AEDs are approved for sale as medical devices by Health Canada, Medical Devices Bureau (MDB). AEDs can be effective at improving survival from sudden cardiac arrest due to ventricular fibrillation when their use is incorporated into an emergency response system that includes early recognition of emergency, early notification and access of emergency medical services, early cardiopulmonary resuscitation, early defibrillation, and early advanced cardiac life support, the Alberta agency says. (see Cardiac Chain of Survival). * - Canadian Occupational Safety Magazine

™ ™ Heart & Stroke Foundation Recommendations Regarding AED use “The Heart and Stroke Foundation is working diligently to ensure widespread access to AEDs in homes and workplaces, and in public areas such as airports, airplanes, and casinos.” (1)In considering authorizing the use of AEDs at a work site, an employer should ensure assessment of specific needs of the work site including; whether AEDs can be safely used (e.g. not to be used in a flammable environment) the population at risk - identify hazards of the workplace that increase risk of sudden cardiac arrest existing emergency response and availability of emergency medical services (2)The employer should ensure AEDs are integrated into the existing emergency response and First Aid programs. (3)Anyone using an AED must be competent therefore; the employer must ensure appropriate training in AEDs for equipment that is present at the worksite. (4)The employer should ensure there is a quality assurance program in place that includes regular maintenance and inspection of equipment, record keeping and program evaluation.

™ ™ CARDIAC SCIENCE | 17 Commitment from senior management AED technology that is reliable, easy to use, and maintenance-free Facilities adequately equipped with AEDs that are properly located Appropriate number of employees trained in CPR and AED use Management system and program to document training, manage AED deployment, provide medical direction, and ensure program compliance with regulations ELEMENTS REQUIRED TO CREATE A HEARTSAFE ENVIRONMENT

™ ™ Fire & EMS Thought Leaders & Key Stakeholders in the Community Example – San Diego, 81 Lives Saved. Partners: San Diego FF Local 145 Cardiac Science City of San Diego County of San Diego Medical Services

™ ™ AED Considerations Is it reliable? Will the AED work when I need it? Is it easy to use? Will it be easy to use for a lay responder in a stressful situation? Does it have the best technology available? Will the AED deliver the most effective treatment?

™ ™ CARDIAC SCIENCE | 20 Exclusive RESCUEREADY ® technology assures first time, every time shock delivery Simple, easy to use, one or zero-button operation Maintenance-free Intuitive and comprehensive voice and text prompts guide you through the rescue The most advanced technology available— awarded over 80 patents Industry’s first four-year, full replacement battery guarantee Expanded product line for all types of users: lay users and professionals Demonstration: Powerheart AEDs by CARDIAC SCIENCE

™ ™ Demonstration

™ ™ Questions? Thank You Mark Hermes, Cardiac Science Justin Pellerin, Acklands Grainger