1. Sudden Cardiac Arrest Disparities In Survival
Richard Lamphier, RN
Program Manager
Project S.A.V.E.
Children’s Healthcare of Atlanta

2. S A V E Project S.A.V.E. Sudden Cardiac Arrest Awareness
Vision for Prevention
Education A V E

4. Resuscitation. 2013;84:

5. When Seconds Count Public’s role is crucial in saving a life
Prepared and willing to deliver basic life support (high quality CPR)
Publicly accessible AED’s
Time between onset of arrest and provision of care is fundamental
4 reasons why people won’t do CPR.
Albany example of mouth to mouth
Grady story
Florida case in Schools
Hurt someone
Shortening Time Best Way Reduce Death and Disability From Cardiac Arrest.

6. 87/146 (60%) families completed survey
Retrospective study of PHW families with child or young adult who suffered SCD
87/146 (60%) families completed survey
72% SCA victims with > 1 CV S/S prior to SCD
Fatigue 44%, near syncope 30%
24% victims with prior syncope / seizure
CV S/S first appeared 30 months prior to SCD
26% families reported unexplained SCA < 50 years of age
Drezner, J. JABFM. January 2012

7. Key SCA Warning Signs / Symptoms
Exercise, emotion, startle seizure or syncope
Exercise chest pain or SOB
Sudden, unexpected, unexplained death before age 50 years
Family history known genetic CM, channelopathy
We talk about what warning signs look like
Seizure activity schools are familiar with seizures
We emphasize SCA until proven otherwise

8. Circulation. 2008;117:
“In places where widespread first responder CPR training has been provided (e.g. as part of community lay rescuer AED programs), survival rates from witnessed SCA associated with ventricular fibrillation have been reported to be as high as 49% to 74%%.”
N Engl J Med ;347:
N Engl J Med. 2000;343:

9. Circulation. 2008;117:
3 important concepts
High-quality CPR is an important determinant of survival from SCA
More victims of out-of-hospital SCA should receive bystander CPR
CPR must be performed effectively by bystanders and healthcare providers

10. Basic Life Support Identify the emergency
Calling 911 or Internal First Responders
Early High Quality CPR
Publicly available AED
Advance care and transport
Post arrest care
Consider reworking slide but keeping concept
Heart Attack S/S Adult female/male
SCA Child seizure like activity
Who knows where the nearest AED is?

11. Primary Focus
Schools have 20% of the Countries population during school days,
AL- coaches are usually parents who get off 3 or 4, may have little or no training
CC Boys and Girls clubs Metro Atlanta have kids/day

12. CPR

13. CPR is inherently inefficient; it provides only10% to 30% of normal blood flow to the heart and 30% to 40% of normal blood flow to the brain even when delivered according to guidelines. This inefficiency highlights the need for trained rescuers to deliver the highest quality CPR possible.
Circulation. 2013;128:

14. High Quality CPR

15. AED

16. You show the public and AED – first picture
But all they see is electricity – second picture

17. Then you open it
And all they see is the inside of a cockpit – VERY complicated

18. Early defibrillation matters

19. EAP

20. Venue Still working on design
Equipment
Do you have an AED
How many
Accessibility
Budget for replacement pads & batteries
Buildings
Building Names
Doors – keys or access codes
Elevators or stairs
EMS Access Points
Construction
Locked gates
Still working on design
County lines, cell towers full? Mention concerts/sporting events, Atlanta’s big Chicken, is their construction between venue and EMS-secondary route
Can you get a shock off in less than 3 minutes??? Closer to 1

21. 382,800 people ~ 38,000 survivors Overall Survival
Less than 6% outside the hospital
Almost ZERO if not treated in 10 minutes
A half a million people.
Equilivent to all of the attendees of the 2014 & 15 Daytona 500
An estimated 382,800 people experience sudden cardiac arrest in the United States each year.
Approximately 92% of those who experience sudden cardiac arrest do not survive.

23. ~245,005 survivors

25. How successful is Project S.A.V.E.?
Over 1200 Schools and Community Centers 72 Lives Saved 36 Children 36 Adults 2 School Nurses

26. CPR & AEDs Work
QUESTIONS?