December 20, 2004
Have you heard of AEDs (Automated External Defibrillators)? Would
you know how to use one if you needed to? Sure, the instructions
are right there, but in an emergency, very few have the time--or
the presence of mind--to open the directions for the first time.
So, what are AEDs, and why do we need to know about them?
"The automated external
defibrillator (AED) is a computerized medical device. An AED can
check a person's heart rhythm. It can recognize a rhythm that
requires a shock. And it can advise the rescuer when a shock is
needed. The AED uses voice prompts, lights, and text messages
to tell the rescuer the steps to take. AEDs are very accurate
and easy to use. Lay rescuers with a few hours of training can
operate an AED safely.... If AEDs are so easy to use, why do people
need formal training in how to use them? An AED operator must
know how to recognize the signs of a sudden cardiac arrest, when
to activate the EMS system, and how to do CPR. It's also important
for operators to receive formal training on the AED model they
will use so that they become familiar with the device and are
able to successfully operate it in an emergency. Training also
teaches the operator how to avoid potentially hazardous situations."
...And why do we need
to know about them?
"In the time it
takes you to read this page, sudden cardiac arrest will have claimed
another victim. In the past year, 250,000 Americans died of sudden
cardiac arrest: nearly one death every two minutes. Up to 50,000
of these deaths could have been prevented if someone had initiated
the Cardiac Chain of Survival, and an automated external defibrillator
(AED) had been available for immediate use at the time of the
emergency.... Many victims have no history of heart disease, or
if heart disease is present, it has not functionally impaired
them. Unlike a heart attack, which is the death of muscle tissue
from loss of blood supply, many victims of SCA have no prior symptoms.
SCA can strike anyone, at any time, anywhere."
AEDs are not just for
older people with heart disease in health clubs. As they find
their way into more public places--including schools--they are
touching the lives of teens, as well.
"January 13, 2003
A 16-year-old student with no previous history of heart problems
collapsed in class on December 16th and was resuscitated, thanks
to quick action by high school staff and students and the availability
of an on-site defibrillator. Andrea LeFleur, from Orange-Ulster
BOCES High School in New York, told another student she felt weak
and within minutes her heart had stopped beating. The school nurse,
several teachers and a student, who is a volunteer firefighter,
all helped in the rescue. The school's automated external defibrillator
(AED) had been installed a few weeks before, in response to a
new state law requirement."
AEDs are designed to
be used by those without a medical background. Training is beneficial;
and the time to learn how to use an AED--and whether or not it
is the best course of action--is not when you have someone unconscious
before you. Someone without training could read the directions
(as someone else goes to call 911), and may be able to help if
no one else is there. But then there are questions: Is it safe
in all situations? How do you know who will benefit from its use?
We have read how they have been used to help teens, and they were
designed to be used to help adults. What about children?
There are some concerns:
are much smaller than adults and therefore require a much lower
energy setting for delivery of the same defibrillation dose (J/kg)
used in an adult. AEDs designed for use in adults have energy
levels (or a single energy level) capable of delivering a substantially
higher dose (J/kg) to young children. Another concern is that
infants and small children with sinus tachycardia or supraventricular
tachycardia can have very high heart rates that might be misinterpreted
as 'shockable' rhythms by an AED with a diagnostic program developed
for analyzing adult arrhythmias."
Even with these concerns:
suggests that AEDs are capable of appropriate sensitivity and
specificity for pediatric arrhythmias and are both safe and effective
for defibrillation of children 1 to 8 years of age. Ideally pediatric
pads/cables should be used, whenever available, to deliver a child
dose.... The task force strongly encourages industry to continue
to develop pediatric rhythm diagnostic programs and investigate
appropriate pediatric AED energy doses. The task force applauds
efforts in this area and will conduct a comprehensive review of
new data as they become available."
It used to be that lifeguards
and babysitters, as well as teachers and others who are responsible
for the care of others, would be required to have CPR training.
With so many people who can be helped, and AEDs in more and more
locations, AED training has been added to what used to be classes
in first aid and CPR.
"American Red Cross
first aid, CPR and AED programs are designed to give you the confidence
to respond in an emergency situation with skills that can save
a life. Additional training in bloodborne pathogens, oxygen administration
and injury prevention can be added to CPR and first aid training
to prepare you to prevent and respond to life-threatening emergencies."
But you're not a lifeguard,
and you're not a teacher. You don't work in a hospital. So why
do you need training? Whenever you are around one of these things
at school, there's always someone else there, right? While someone
with training may not be all that easy to find at school, there
probably is someone there. What about when you are out at the
mall with your friends? Do you babysit? Some homes already have
AEDs, and the FDA has just made it easier for people to purchase
"September 16, 2004
The U.S. Food and Drug Administration (FDA) announced today that
a certain AED model, the Philips HeartStart Home Defibrillator,
may be sold without a prescription.... The device is specifically
designed for use by laypersons. 'We do not believe that the prescription
requirement provides significant efficacy or safety benefit for
personal purchase and use of AEDs, and indeed is an impediment
to more widespread availability of this life-saving therapy in
the setting where it occurs most often,' said Mary Newman, NCED
Executive Director, and Vince Mosesso, MD, NCED Medical Director
in their remarks before the panel. Sudden cardiac arrest occurs
most often in the home. According to NCED, a change enabling over-the-counter
sales of AEDs to consumers has the potential to have a strong
positiveimpact on survival nationwide without incurring risk to
future SCA victims or their rescuers."
Why would people need
AEDs in their homes?
"Between 50 and
80 percent of SCAs [sudden cardiac arrests] occur in the home,
often without warning or witnesses, thus making the use of a traditional
external defibrillator manned by trained personnel an occurrence
that is seldom an option."
Right now, it is cost
prohibitive for most families to purchase an AED, but that didn't
stop MSNBC.com from recommending them as holiday gifts this year.
"Plenty of people
will ring in the new year with a resolution of better health.
If any of them are on your shopping list, why not give them a
jump-start with a healthy holiday gift? Here are the MSNBC.com
health editors' top picks:... About the size of a hardback book
and weighing 3.3 pounds, HeartStart can be used without a prescription
on adults and children over age 8 and weighing 55 pounds or more.
The easy-to-use device analyzes a patient's heart rhythm and only
delivers a shock if needed. Voice instructions guide the user
through the process. It will also coach a user through the steps
of CPR. Price is $1,495..."
people do not plan to spend $1,500 this holiday season for an
AED to have at home. Even if you do not have one at home, chances
are you will be traveling to a place that does. Schools, airports,
stadiums, malls, and other locations where large groups come together
are getting them more and more. Even without an AED, CPR can help
a person hang on until help arrives. If you don't have a chapter
of the Red Cross nearby, check with your local fire station or
police department and see what training they offer. Above all,
if you--or anyone you are with--experiences symptoms of heart
trouble, get help right away.
"December 13, 2004--It
may be considered the most wonderful time of the year by many--but
Christmas is also the deadliest day of the year for Americans.
According to a new study by the Journal Circulation, more Americans
die from heart attacks and other natural causes on Christmas,
the day after, and on New Year's Day than on any other days of
the year. The report indicate the deaths are probably because
people are feeling too busy or too festive to go to the hospital
over the winter holidays season. Though it's time to celebrate,
it's also time to keep an eye on your health.... One of the reasons
is obvious; Shoveling snow puts a strain on the heart if you're
not used to that much exercise. The holidays contribute to heart
attacks because of higher levels of stress.... Plus, there's holiday
eating. Studies show even just one meal high in saturated fat
can increase your odds of having a heart attack. Another often
overlooked cause: the flu.... Inflammation of the vessels leading
to the heart can help cause a heart attack. Cold weather can cause
vessels to narrow, another heart attack trigger."
Questions of the Week:
Why is AED training important, even if you don't have an AED?
Why is CPR training still important if there is (or is not) an
AED nearby? What is the first thing you should do if you suspect
someone is having heart trouble? How can you know when to use
CPR, and when is it unsafe to use an AED? As a kid, a teen, or
an adult, what should you know about basic first aid, CPR, and
Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.
I look forward to reading
what you have to say.
Health Community Coordinator
Access Excellence @ the National Health Museum