DEFIBRILLATORS DEFIBRILLATORS DEFIBRILLATORS Responding to Sudden Cardiac Arrest DEFIBRILLATORS The Odds Annual Deaths from Cardiovascular Disease – U.S. Sudden Cardiac Arrest All Other Cardiovascular 250,000 695,800 American Heart Association.

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Transcript DEFIBRILLATORS DEFIBRILLATORS DEFIBRILLATORS Responding to Sudden Cardiac Arrest DEFIBRILLATORS The Odds Annual Deaths from Cardiovascular Disease – U.S. Sudden Cardiac Arrest All Other Cardiovascular 250,000 695,800 American Heart Association.

DEFIBRILLATORS
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DEFIBRILLATORS
DEFIBRILLATORS
Responding to
Sudden Cardiac
Arrest
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DEFIBRILLATORS
The Odds
Annual Deaths from Cardiovascular Disease – U.S.
Sudden
Cardiac Arrest
All Other
Cardiovascular
250,000
695,800
American Heart Association. Heart Disease and
Stroke Statistics - 2003 Update. Dallas, TX.:American Heart
Association;2002.
Total Deaths: 945,800
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DEFIBRILLATORS
Common Causes of Death in the U.S.
1
House Fires (1998 )
2,895
2
Prostate Cancer (2001 )
2
Breast Cancer (2001 )
3
Automobile Accidents (1996 )
Total
1
SCA (annual )
31,500
40,800
43,300
118,495
250,000
1 http://www.americanheart.org
2 http://www.cancer.org
3 U.S. Statistical Abstract of the United States, 1998, Table 138.
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DEFIBRILLATORS
The Stakes
Annual Sudden Cardiac Arrest (SCA) Events – U.S.
680 patients per day
(one every 2 to 3 minutes)
80% out-of-hospital
50% of men, 63% of women,
have no prior symptoms
< 5% survive
95% die without very early treatment
American Heart Association. Heart Disease and
Stroke Statistics - 2003 Update. Dallas, TX.:American Heart
Association;2002.
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DEFIBRILLATORS
SCA Fiction vs. Fact
STEREOTYPE
REALITY
Male
Male and Female
Old
Any Age
Risk
Factors
Overweight
Smoker
High cholesterol
Often No Clear
Risk Factors
Medical
History
Heart Attack
Often No
Cardiac History
Presenting
Symptoms
Chest Pain
Dizziness
Often No
Symptoms
Gender
Age
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DEFIBRILLATORS
The Benefits of Early Treatment of SCA
American Heart Association
100,000 SCA deaths prevented annually*
Recovery prospects for
survivors are high
80% alive at one year
57% alive at five years
Total SCA Events: 250,000
*estimated
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DEFIBRILLATORS
The Heart Pump: a series of events...
• An electrical event …
• stimulates a mechanical event …
• which results in a rhythmic and
coordinated pumping action of the heart
muscle
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DEFIBRILLATORS
Sudden Cardiac Arrest: A Heart in Distress
• Uncoordinated, very fast heart rhythm
– Ventricular fibrillation (VF)
– Some ventricular tachycardias (VT)
• Ineffective heart pump
• Unconscious, no breathing, no pulse
• Death certain without defibrillation
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DEFIBRILLATORS
What Is Defibrillation?
• Electric shock to the heart
• Stops uncoordinated
activity
• Allows coordinated heart
rhythm and pumping
action to resume
• Only effective treatment for
ventricular fibrillation
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DEFIBRILLATORS
Chain of Survival
Defibrillation an EARLY priority
Adapted from the American Heart Association
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DEFIBRILLATORS
Why “Early” Treatment?
100
90
Chances of success
are reduced 7% to
10% each minute
% Success
80
70
60
50
40
30
20
10
00
1
2
3
4
5
6
7
8
9
Time (minutes)
Cummins RO, et al. Guidelines 2000 for Cardiopulmonary Resuscitation
and Emergency Cardiovascular Care (ECC, Circulation (Suppl) 2001;102:8, August 22
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DEFIBRILLATORS
Survival Rates
Defibrillation
No CPR
Delayed
Defibrillation
0 - 2%
survive
CPR
Defibrillation
Early CPR
Delayed
Defibrillation
2 - 8%
survive
CPR
Defibrillation
Early CPR
Early
Defibrillation
20%
survive
CPR
Defibrillation
ALS
Early CPR
Very Early
Defibrillation
Early ACLS
?
survive
minutes
2
4
6
8
10
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DEFIBRILLATORS
Best Case Scenario
What Happens When You Call 911?
Identify emergency/ Activate emergency response plan
911 call
30 seconds
1 minute
Alert ambulance and rescue squads (dispatch)
30 seconds
Responders to their units
30 seconds
Travel time to location
5 minutes*
Unload equipment/ Distance to patient
2 minutes
Assess patient/ Apply defibrillator/ Deliver shock
1.1 minutes**
TOTAL 10.6 minutes
*Travel time varies depending on weather, traffic, distance (vertical and horizontal),
and ambulance (with defibrillator capability) availability.
**Cummins RO, et.al. Automatic external defibrillators used by emergency medical
technicians: a controlled clinical trial. JAMA. 1987; 257:1605-10
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DEFIBRILLATORS
AEDs to the Rescue
Uniquely small, lightweight and rugged
Low-maintenance
Safe, effective,
and easier than CPR
Designed for lay
rescuer
Expand lifesaving
opportunities
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DEFIBRILLATORS
HeartStart FR2+ Defibrillator
OPERATION
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DEFIBRILLATORS
Verify SCA
• Assess ABCs
unresponsive
not breathing normally
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DEFIBRILLATORS
Using the HeartStart FR2+
1
2
3
• Turn on defibrillator.
• Apply pads to patient
and plug in connector.
• Deliver the shock.
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DEFIBRILLATORS
HeartStart OnSite Defibrillator
OPERATION
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DEFIBRILLATORS
Verify SCA
• Assess the victim
unresponsive
not breathing normally
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DEFIBRILLATORS
Using the HeartStart OnSite
1
PULL
green handle
PLACE
pads on chest
PRESS
shock button
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DEFIBRILLATORS
What if the
victim has a
pulse and I
can’t feel it?
Can I hurt
someone
using the
defibrillator?
Is there legal
liability?
• Cannot make things worse
• HeartStart Defibrillators designed to shock only when
needed
• Product indemnification policy
• Good Samaritan laws, AHA standard of care
– Possible reverse liability
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DEFIBRILLATORS
What happens
if I reverse the
pads?
Can I
defibrillate on
water, snow,
ice or metal?
Can I
defibrillate
a child?
• Analysis & therapy not affected by pad reversal
• OK to defibrillate on water surfaces and metal
– Standard safety precautions
• Using HeartStart FR2 and OnSite Defibrillators is acceptable
< 8 years old with Infant/Child pads
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DEFIBRILLATORS
Sudden Cardiac Arrest DOES Happen
• On-site Early Defibrillation Programs
enhance 9-1-1 EMS systems…
resulting in more lives saved
• Rapidly becoming a
standard of care
• Early defibrillation programs
have already demonstrated
success by saving lives in a
variety of environments
Las Vegas (Clark County), Nevada
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DEFIBRILLATORS
The Ultimate Reward
Jerome Fuentes
Bob Adams
Bridgette McDonald
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DEFIBRILLATORS
Something to think about
“Public Access Defibrillation
has the potential to be the
single greatest advancement
in the treatment of
prehospital SCA death
since the development
of CPR.”
AHA Guidelines 2000 for Cardiopulmonary
Resuscitation and Emergency Cardiovascular Care Textbook.
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