Knowing where AEDs are and how they’re being used is critical to saving lives

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Using AED Registries to Increase Bystander CPR & AED Use

Saturday, December 7, 2013
Bentley J. Bobrow, MD

Bystander CPR is a critical link in the chain of survival. It has been shown to more than double a victim’s chance of surviving an out-of-hospital cardiac arrest (OHCA).1 Using an automated external defibrillator (AED) in addition to performing bystander CPR further improves the chances of survival.2 Yet, both bystander CPR and AEDs are not provided in a majority of OHCA events.1,2

 

Because time is so critical in cardiac arrest, immediate bystander action (calling 9-1-1, performing CPR, and early defibrillation) is the cornerstone of maximizing the effectiveness of subsequent EMS and hospital interventions and ultimately survival. This is especially true in rural and congested urban areas with prolonged response times. 

 

Bystander CPR lengthens the duration of ventricular fibrillation (VF) and provides critical blood flow to the heart and brain during cardiac arrest.3 This improves the likelihood of shock success, return of spontaneous circulation (ROSC), survival, and the chance of a good functional outcome.3,4 The combination of quickly calling 9-1-1, immediately doing chest compressions and applying an AED as soon as possible works synergistically to increase survival. Each of the successive links in the chain of survival depends on the preceding links—the whole is greater than the sum of the parts.

 

Because of this, EMS (in fact, our entire healthcare system) has a vested interest in the delivery of care before the arrival of professional rescuers on scene. Everything EMS does to improve the readiness of lay rescuers (training, public awareness, 9-1-1 pre-arrival instruction, assistance locating AEDs, etc.) will pay heavy dividends in an increased survival rate in our communities.

 

Measuring Interventions

There is wide and unacceptable variability in cardiac arrest outcomes between communities,5 which likely results from differences in implementation and performance of important interventions such as 9-1-1 pre-arrival CPR instructions, bystander CPR and early defibrillation. Continuously measuring these interventions and analyzing their impact is the only way to know specifically what needs improvement and whether a system is functioning as intended.

 

Current registries exist to help communities measure their cardiac arrest incidence and outcomes. The CARES (Cardiac Arrest Registry to Enhance Survival; https://mycares.net) registry is a national data collection system for OHCA. This registry includes data collection on OHCA incidence and process of care, including bystander CPR, AED use and, recently added, data for 9-1-1 pre-arrival CPR instructions.

 

The need to take this a step further and systematically track data from 9-1-1 centers has come about due to the realization that the quality of telephone CPR instructions has a significant impact on survival. Details such as whether the cardiac arrest was correctly identified, whether CPR instructions were provided, how long into the 9-1-1 call before CPR was started, and what type of CPR was given can make the difference between life and death. There is growing interest in pre-arrival CPR metrics and the need to quantify this critical intervention. To illustrate the point: If the 9-1-1 system provides pre-arrival CPR instructions at eight minutes into a call, it will obviously have much less impact on survival than if the instructions were provided one minute into the call. And yet both callers received “pre-arrival CPR instructions.”

 

The state of Arizona and King County, Wash., have  piloted a data collection tool and reporting system for suspected cardiac arrest dispatch calls, which is integrated into their OHCA registries and linked to EMS care, hospital care and patient outcomes. In Arizona, the 9-1-1 pre-arrival CPR program is part of the Save Hearts in Arizona Registry and Education (SHARE) Program, a collaboration between the Arizona Department of Health Services and the University of Arizona (see http://azdhs.gov/azshare/911/index.htm). The Arizona and King County, Wash., models have now been incorporated into CARES to help dispatch and EMS systems across the country. 

 

Why You Need an AED Registry

Like bystander CPR data, AED information is a critical component of an ongoing cardiac resuscitation system of care. When various data points along the continuum of care (bystander CPR, 9-1-1 data, AED placement/use, and outcomes) are integrated into a standardized registry, such as CARES, an entire system can be measured and improved over time.

 

AED information needs to be integrated into registries in order to know where AEDs are placed, if they are checked for maintenance (pads, batteries), if potential users are trained on-site, when they are used, and the ultimate patient outcome. Event data should include the location of the arrest, who did CPR, what kind of CPR was performed, who applied the AED, and whether a shock was delivered. Detailed data after an AED is used should be made available to other healthcare providers such as emergency physicians and cardiologists.

What follows is a closer examination of why you need an AED registry: 

 

• You can’t use them if you don’t know where they are: We know AEDs are extremely safe and effective.2 We also know they are only used by the public in approximately 4% of OHCAs.6 Knowing where AEDs are located and if they are being used is important information. For example, if AEDs are placed in a certain area of town but they aren’t being used in cardiac emergencies, likely more public education is needed. In contrast, if cardiac arrest is occurring more frequently in a certain location where few AEDs are available, then more attention should be given to acquiring and placing additional AEDs throughout that community.

• You can’t use them if they’re not maintained: Just as an AED that is not found cannot save a life, neither will an AED that is not properly maintained. Maintenance includes making sure expired pads and batteries are replaced and software upgrades are installed. A Web-based AED registry can assist in ensuring the functionality of AEDs by sending maintenance reminders. Just as fire departments check fire extinguishers in a community, it makes sense that you need to have a system to ensure that all AEDs are maintained in a ready-to-use state.

• You can’t use them if they’re not there: Another reason for having an AED registry is the fact that the information can be useful in the submission of grants for the deployment of additional AEDs. To secure and receive either private foundation or government grants, a Public Access to Defibrillation (PAD) program needs accurate data—both utilization and patient outcome information. AED grants can come from both private foundations and government. An example of a private foundation offering grants is The Ramsey Social Justice Foundation (http://ramseyjusticefoundation.org), which has donated AEDs to communities participating in the SHARE Program in Arizona. An example of a government AED grant is the one offered through the U.S. Department of Health and Human Services’ Rural Health program. 

 

Finding AEDs with Social Software

Keeping tabs on the locations of existing AEDs has been a challenge. There have been several large-scale efforts to locate AEDs within communities. One such program in Philadelphia used a crowdsourcing approach. In 2012, the MyHeartMap Challenge (www.med.upenn.edu/myheartmap) set up a competition and offered monetary awards for those submitting the most AED locations. Using a smartphone application, participants photographed and recorded GPS coordinates for AEDs they found throughout the city. 

 

Also using mobile phone technology, the PulsePoint App (http://pulsepoint.org) takes locating AEDs one step further—tying the location of the AEDs directly to nearby cardiac arrest incidents through the community’s 9-1-1 system. The mobile app (iPhone and Android) sends real-time AED location information to those within a certain radius of a suspected cardiac arrest with the goal of increasing both bystander CPR and the use of the life-saving devices. 

 

Potential lay rescuers must normally witness an arrest to take action. PulsePoint seeks to improve the efficiency of both CPR-trained citizens and publicly available AEDs by making bystander rescuers aware of cardiac events occurring nearby so they can retrieve an AED and begin CPR while paramedics are making their way to the scene. No one is in a better position to make a difference in the first few minutes of an OHCA than a nearby CPR/AED-trained individual. PulsePoint has been successfully implemented in many U.S. cities.

 

Disparity Issues: Location of Arrests

The location of a cardiac arrest has a significant influence on patient survival. Patients who arrest in public have a higher probability of having their arrest witnessed, receiving bystander CPR, and receiving defibrillation with an AED—all of which strongly increase the chance of survival.2

 

National data on bystander CPR and PAD programs have uncovered large and unacceptable disparities. For example, using the CARES registry, Sasson and colleagues found that in low-income black neighborhoods the odds of receiving bystander-initiated CPR was approximately 50% lower than in high-income non-black neighborhoods.7 Their study showed that both the racial composition and the median income of a neighborhood have a significant effect on the likelihood of receiving bystander CPR. Studies like this help identify where to concentrate public training and education efforts.

 

In Arizona, Dr. Sungwoo Moon (a visiting professor from Korea University) found OHCA victims in mainly Hispanic neighborhoods received bystander CPR less frequently and had worse neurologic outcomes than those in mainly white, non-Hispanic neighborhoods.8 

 

Using Geographic Information System (GIS) technology and SHARE Program OHCA event data, Dr. Moon was also able to identify the areas where OHCAs occurred most frequently but where AEDs were lacking. This is a great example of how important it is to have both cardiac arrest event and AED location data.9

 

A Variety of AED Registries

AED registries can take different shapes. Most states require reporting of AED locations to local EMS and/or dispatch centers. However, it varies widely as to how agencies capture and actually use this information. 

 

Arizona’s SHARE Program AED registry is voluntary; however, it fulfills the statutory requirement that AED owners enter into an agreement with a physician to oversee a PAD program. In the SHARE registry, medical direction is free of charge to those complying with the training and reporting requirements. The registry uses a Web-based data entry system.

 

AED owners must keep their units functioning and registries can play an important role in helping to ensure that AEDs are always in a ready-to-use state. A Web-based AED registry can send general reminders to registrants or targeted reminders based on expiration dates entered into the system. Several companies offer subscription services to assist with this.

 

The Future of AEDs

Tracking AEDs that are placed in static locations is one thing; however, tracking the location of AEDs that are mobile, such as those used during high school athletic events, requires a higher level of sophistication. Also, many AEDs are moved from one “permanent” location to another. In the future, AEDs will include technology (perhaps GPS, WiFi, Bluetooth, or other methods) that will allow tracking in real time, thereby allowing more efficient monitoring of the units’ placement and readiness. This technology will likely be integrated into CAD systems in the future, aiding dispatchers in locating AEDs and relaying that information to callers, in an effort to increase AED use. And of course, more AED use and more bystander CPR will translate into more lives saved.

 

References

1. Sasson C, Rogers MA, Dahl J, et al. Predictors of survival from out-of-hospital cardiac arrest: A systematic review and meta-analysis. Circ Cardiovasc Qual Outcomes. 2010;3:63–81.

2. Hallstrom AP, Ornato JP, Weisfeldt M, et al. Public-access defibrillation and survival after out-of-hospital cardiac arrest. N Engl J Med. 2004;351:637–646.

3. Eftestol T, Wik L, Sunde K, et al. Effects of cardiopulmonary resuscitation on predictors of ventricular fibrillation defibrillation success during out-of-hospital cardiac arrest. Circulation. 2004;110:10–15.

4. Bobrow BJ, Spaite DW, Berg RA, et al. Chest compression-only cpr by lay rescuers and survival from out-of-hospital cardiac arrest. JAMA. 2010;304:1447-1454.

5. Nichol G, Thomas E, Callaway CW, et al. Regional variation in out-of-hospital cardiac arrest incidence and outcome. JAMA. 2008;300:1423–1431.

6. Weisfeldt ML, Sitlani CM, Ornato JP, et al. Survival after application of automatic external defibrillators before arrival of the emergency medical system: Evaluation in the resuscitation outcomes consortium population of 21 million. J Am Coll Cardiol. 2010;55:1713-–1720.

7. Sasson C, Magid DJ, Chan P, et al. Association of neighborhood characteristics with bystander-initiated cpr. N Engl J Med. 2012;367:1607–1615.

8. Moon S, Kortuem W, Kisakye M, et al. Disparities in Bystander CPR and Neurologic Outcomes from Cardiac Arrest According to Neighborhood Ethnicity Characteristics in Arizona. Poster presentation to the American Heart Association, Resuscitation Science Symposium, Scientific Sessions in Dallas, Texas. November 2013. Circulation; in press.

9.  Moon S, Kortuem W, Kisakye M, et al. Analysis of Out-of-Hospital Cardiac Arrest Location and Public Access Defibrillator Placement in Metro Phoenix, Arizona. Poster presentation to the American Heart Association, Resuscitation Science Symposium, Scientific Sessions in Dallas, Texas. November 2013. Circulation; in press.

• Technology
• Cardiac and Circulation
• AED registry
• bystander CPR
• cardiac arrest
• chain of survival
• cpr
• defibrillation
• ED
• OHCA
• out-of-hospital cardiac arrest

Northport family raises focus on AEDs

Originally published: November 26, 2013 7:26 PM
Updated: November 26, 2013 7:31 PM
By MACKENZIE ISSLER  mackenzie.issler@newsday.com

Karen and John Acompora pulled up to an Amityville elementary school they had never visited, to meet a girl they did not know.
A few weeks earlier, 12-year-old Kiavelyn Altagracia, a seventh-grader at Edmund W. Miles Middle School in Amityville, collapsed on the sideline during her soccer practice. She was unconscious and barely had a pulse, said her coach, Isha Hamilton, who started CPR.
Within minutes, Hamilton used an automated external defibrillator, more commonly known as an AED. The machine the size of a laptop computer told her to keep doing chest compressions and rescue breathing.
"She took a deep gasp, and I felt a very faint pulse," Hamilton said. Kiavelyn slowly regained consciousness.
The AED was on the field because of the Acomporas of Northport, whose son Louis died on March 25, 2000, after a ball hit him in the chest during his first high school lacrosse game. There was no AED on hand.
The lacrosse game was in West Islip. The second quarter had just started and Louis was in the goal, wearing a chest protector, when the ball struck him and he collapsed.
Karen and John Acompora were in the stands and thought Louis had had the wind knocked out of him. But after a few minutes, Louis didn't get up, and his parents knew something was wrong. John Acompora ran to the field, while CPR was being performed. Karen Acompora remembers seeing her husband take off Louis' chin strap.
Louis, 14, died on that field.
In 2002, Louis' Law was enacted, months after the family launched the Louis J. Acompora Memorial Foundation. The law mandates that schools, including athletic events, have AEDs on-site and people trained to use them. Kiavelyn was the 75th save statewide since the law passed.
"It is amazing what they are doing and so heroic," said Hamilton, who teaches physical education at the Amityville school. The Acomporas attended an October school board meeting at Park Avenue Elementary, where they presented awards to Kiavelyn, Hamilton and Greg McCoy, another coach who assisted with the save.
The Acomporas, who also have a daughter, have spent years raising awareness about AEDs. To date, the law has saved 76 people, the family said.
"Out of those 76, there are a lot of them who have paid it forward," Karen Acompora said. One is a foundation board member, and many have helped raise money and participated in advocacy efforts, she said.
Greater New York American Red Cross spokesman Michael de Vulpillieres said Kiavelyn's save "emphasizes the continued importance of using an AED within two to three minutes of sudden cardiac arrest and having trained rescuers who recognize and act in an emergency to save a life."
"We applaud the efforts of the Acompora family over the years to make AEDs more accessible while honoring the memory of their son," de Vulpillieres said.
American Heart Association staff member Robin Vitale said the Acomporas "are a tremendous source of strength and inspiration for those of us working to improve bystander response to an emergency, meaning CPR initiation and using an AED."
"I simply cannot begin to imagine the depth of pain they experienced 13 years ago with the death of their son, Louis," Vitale said. "But what a testament to the courage of Karen and John that they have committed to building his legacy by continuing their advocacy."The foundation just held an event in Floral Park, where about 400 children were screened for heart conditions, and they are planning another for next year.
Karen Acompora says her family's work helps keep Louis' memory alive. They always talk about him, and now they have a grandson, 5-year-old Louis. "It is like Louis is still here with us," she said.

Onteora player resuscitated after collapsing on Wallkill court

By WILLIAM MONTOGMERY

Times Herald-Record

Published: 2:00 AM - 10/18/13

Heroes and life-and-death situations are clichés in the sports world, but they were quite real during Thursday's volleyball match between Onteora and Wallkill.

Onteora junior Makalia Ouellette walked over to coach Brittany Alexander during the match at Wallkill complaining that she wasn't feeling well and thought she might pass out. Alexander called timeout as Ouellette collapsed into her arms.

Alexander said she yelled for help and "people came running." After laying Ouellette flat on the court, Alexander immediately began performing CPR. Ouellette was unconscious and "turning blue and not breathing," Alexander said. Onteora assistant coach Nicole Saunders found Wallkill's automated external defibrillator and gave Ouellette a shock that caused her to regain consciousness.

"After screaming and freaking out, she did eventually calm down and was alert," Alexander said. Her teammates "were able to see her go out on the stretcher alert. I did notify them on the bus ride home that she had made it to the hospital and was OK."

An ambulance took Ouellette to St. Luke's Cornwall Hospital in Newburgh. Alexander heard from a number of team parents that followed the ambulance to the hospital that Ouellette's condition was stable. She was later transferred to a hospital in Westchester County.

Ouellette's parents were notified shortly after she collapsed and met her at the hospital.

Alexander said Ouellette had no history of medical conditions.

When Onteora's bus returned to the school in Boiceville after the match, which did not continue, the players were greeted by social workers, counselors and psychologists for trauma counseling.

"It was nice that they had that, because I was in shock," Alexander said. "She looked like she was not going to make it. It was the scariest thing I've ever experienced in my whole entire life."

Alexander credited a pair of men who came down from the stands to help administer CPR. In the chaos that ensued, she did not get their names.

For coaches around Section 9, Alexander hopes the incident can have a silver lining. If more coaches and school employees and officials are trained to use an AED in an emergency situation, they, too, may be able to save a life.

"Every person, every teacher, every administrator, every janitor and especially every bus driver, they all need to have this training," she said. "Bus drivers need to have an AED on the bus, too. You need to be able to react right then and there. There isn't any time to think. You need to just do it. I never thought I was going to have to use it, but tonight was my wake-up call."

wmontgomery@th-record.com

Coach Isha Hamilton uses CPR to save Edmund W. Miles Middle School student Kiavelyn Altagracia

A soccer coach is being hailed as a hero after making a great save.

September 18, 2013

A soccer coach is being hailed as a hero after making a great save.
Coach and educator Isha Hamilton says she used her CPR training for the first time in her 11-year career at Edmund W. Miles Middle School in Amityville to save a student.
Seventh-grader Kiavelyn Altagracia fell to the ground unconscious and stopped breathing. With the help of a defibrillator and chest compressions, Kiavelyn began breathing on her own again.

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Kiavelyn hopes to be back on the soccer field again very soon. She is waiting on approval from her doctor.

5 Keys to Success for Automated External Defibrillator (AED) Programs

• Aug 21, 2013

According to the American Heart Association, over 300,000 sudden cardiac arrests (SCA) occur annually in the United States, and, according to OSHA, about 10,000 occur at work. For many companies who set out to improve the health and safety of their workforce by implementing an Automated External Defibrillation (AED) program, it’s often easier to set up a defibrillator program than it is to maintain and keep the program as vibrant as it was when it started. While it is rare that an SCA will occur in the workplace, sudden cardiac arrest can happen to anyone, at any time, so having an AED and employees prepared to respond can make the difference if a sudden cardiac arrest occurs. While choosing a defibrillator and setting up your AED program require diligence, there are a few simple steps that will help you maximize your program’s effectiveness and ensure it will perform should the need arise.
Championing: One of the most critical elements for success with your company’s AED program is to have an internal champion. It doesn’t have to be you, the safety professional responsible for the overall program. Motivation is the key. Ask for a volunteer to help you promote and educate your co-workers. See if one of your employees has had a personal or family experience with SCA and is willing to help promote the program internally.
Elements of successful championing include:
1. Informational brochure about your AED program. It should include information on what defibrillators are, how they work, where they are located and how to sign up to join your internal emergency response team
2. Annual review of Emergency Response Plan (including AED program)
3. Showing Public Service Announcements (PSA) that create awareness of Sudden Cardiac Arrest, Compression Only CPR and AED programs Recordkeeping/Device Tracking/Maintenance: Although AEDs are easy to set up and install, making sure that they are ready for use is critical. Most devices have warning signals such as loud beeps and lights to notify personnel when the device is not ready for use. However, these methods still require an employee to notice these warning signals.
Make sure that you use an asset management tracking system to record the expiry dates of your defibrillators’ consumables such as batteries and pads, and to keep track of your units
Integrate your defibrillator maintenance schedule into your safety program schedule that would include fire alert and suppression systems, personal protective equipment (PPE), first aid station and other maintained systems.
Medical Direction and Regulatory Compliance: Most AEDs require a prescription from a physician for purchase and deployment in the workplace. In addition, many states (and even some municipalities) have legal requirements for workplace AED programs. In addition to having a prescription, some legal requirements include medical oversight and review of your maintenance and training programs. Additionally, some EMS systems require the registration of AEDs.
To minimize the legal risk to your company, make sure that you are in compliance with all regulatory and legislative requirements for your area.
Training: As a safety and health professional, you understand the importance of first aid training in the workplace but since approximately 80% of cardiac arrests occur at home, the training your employees receive will likely be used to help a family member or neighbor. Since most first aid training programs include CPR and AED elements, you’ll want to make sure that your instructor reviews how to use your company’s specific AED. In addition to reviewing how to operate the defibrillator, make sure that your trained employees can recognize when the device is in need of service.
Your employees should know these critical response elements:
1. How to recognize sudden cardiac arrest and how to activate your emergency response plan, including location of the AEDs and activation of the Emergency Medical Services (EMS) system
2. How to perform cardiopulmonary resuscitation (CPR) and if untrained, compression-only CPR
3. How to use the AED
4. How to provide on-going care until EMS arrives
Finally, as time passes since their first aid training occurred, trained employees often lose confidence in their ability to perform these life-saving skills. Many training program providers offer methods of refresher training via the use of on-line programs and should be considered. Another method of refresher training is conducting drills to respond to sudden cardiac arrest that is reviewed below.
Sudden Cardiac Arrest (SCA) Drills
The cornerstone of successful AED programs is integrating the use of AEDs into your emergency response drills. These exercises help identify weaknesses in the emergency response system that could be overlooked, plus it gives employees the opportunity to practice their emergency skills outside the classroom. Try to make the drill as realistic as possible using a team approach to maximize organizational preparedness.
Key elements of the drill should include:
1. Pre-drill preparation including notifying key communications personnel such as management and switchboard personnel; preparing emergency response equipment such as manikins and AED training devices
2. Notification of the drill for emergency response team members
3. Pre-exercise briefing
4. Simulated SCA Medical Exercise including appropriate response checklists
5. Debriefing
6. Additional exercises or CPR and AED practice for emergency response team members
Successful drills will not only provide you with insight into your AED program but should also serve as educational and motivational experiences for your emergency response team(s).
Why It Matters
Quick and appropriate response to cardiac arrest using an AED and performing CPR can significantly improve the chances for survival. In some workplace locations, success rates approach 60% versus 7-10% typically found when employees have to wait for EMS response prior to receiving early defibrillation.
While implementing and maintaining an AED program may seem daunting, there are numerous resources available to assist you in developing one for your workplace and your workplace employees.

Copyright 2010 1105 Media Inc.

Longwood HS senior uses AED to revive man

Originally published: June 1, 2013 8:08 PM
Updated: June 1, 2013 8:52 PM
By JOAN GRALLA  joan.gralla@newsday.com

Photo credit: Johnny Milano | Kayla Parmely, an 18-year-old senior at Longwood High School, administered an electric shock, reviving a grandfather who had collapsed at a school festival on Wednesday evening, school authorities said. (May 31 2013)

  Hometown heroes

An 18-year-old senior at Longwood High School administered the electric shock that revived a grandfather who had collapsed at a school festival on Wednesday evening, school authorities said.
Kayla Parmely, who is also a probationary firefighter, said she saw the commotion and raced across the Middle Island auditorium where a crowd had gathered around a man who had fallen to the floor.
"I heard someone scream to grab the AED," Parmely said, referring to the automated external defibrillator.

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"I pushed my way through and I noticed someone doing CPR on him. And no one knew how to use" the AED, said Parmely, of Coram.
"So I hooked it up and shocked him . . . eventually, he started breathing on his own," Parmely said.
Myra Vaughn, a spokeswoman for the Longwood school district, confirmed that Parmely had shocked the grandfather of a fellow student back to life.
The patient, who did not wish to have his name revealed, was doing well Saturday, Parmely said.
"Everything's fine; he's breathing on his own," she said.
"She is responsible for saving this man's life," Lt. Christopher Welga of the Middle Island Fire Department, who trained Parmely, said in a statement provided by the school district.
"She immediately recognized a true emergency and she didn't freak. She did exactly what she needed to do," Welga said.
The fire department did not respond to requests for comment.
Parmely, along with some other rescuers, gave the man CPR until the EMTs arrived, about eight to 10 minutes later, she estimates.
"When the Yaphank EMTs arrived, they were just amazed at how she handled it. She was able to give them vitals and tell them what was going on," said her mother, Jo Ann Parmely.
"This is actually her third cardiac resuscitation; this is the first one she had to juggle on her own," she said.
Kayla Parmely knows the man's grandson from a physics class. "I was just amazed that I did that," Parmely said. "I didn't think, I just acted."
The Middle Island Fire Department on Friday evening gave Parmely a medal for her CPR save and a letter of commendation, her mother said.
The teenager is a triplet, with two brothers, Eric and Kevin. She and Eric joined the fire program two years ago.
When the man collapsed, Kayla Parmely was attending the school's Music and Art Festival to hear her boyfriend, a percussionist, perform.
She will be attending SUNY Oneonta this fall, where she plans to join the on-campus EMT unit and major in psychology.

Defibrillator Used on Lancaster Student in Cardiac Arrest

1:23 PM, May 22, 2013

Posted By: Collin Bishop

LANCASTER, NY - A female student at Lancaster High School went into cardiac arrest this morning in the school.

According to a spokeswoman for the district, another student got the nurse and they called 911.

Bowmansville Fire Department responded and used a defibrillator on the student at the school.

She is now being treated at the hospital.

There is no word on her condition but the spokeswoman says she is doing well.

5 Things You Need to Know About AEDs

When the chance to save a life from cardiac arrest comes up, will you be ready?

By Jennifer Brown, Everyday Health Staff Writer

FRIDAY, May 17, 2013 — Cardiac arrest is a leading cause of death in the U.S. and in the workplace today, but with simple training, you can be ready to respond if someone needs your help. As a malfunction of the heart’s electrical system, cardiac arrest is sometimes a complication of ventricular fibrillation, and causes more than half of the deaths that result from cardiovascular disease. Survival rates jump up sharply from 5 percent to more than 80 percent when someone steps in and quickly uses an automated external defibrillator (AED) to restart the heart. To encourage people to help others without the worry of litigation, Good Samaritan laws protect those who intervene in an emergency in the U.S.

Here's what you need to know:

What is an AED?

An automated external defibrillator (AED) is a small computerized medical device that analyzes a person’s heart rhythm. The AED is programmed to detect the type of heart rhythm which requires intervention. It includes simple instructions and automated voice directions. Used by a trained operator outside of the hospital setting, the AED gives an electrical shock called defibrillation to restart a person’s heart, if needed. Using an AED within the first few minutes can reverse cardiac arrest and saves lives.

How does an AED work? 

An AED measures the unresponsive person’s heart rhythm. The computerized device then selects and delivers automated voice instructions to the rescuer, based on the heart rhythm.  The AED safely delivers an electric shock to the victim’s chest that can reset normal heart rhythm at once. “It is essential that quick defibrillation occur in order to save the patient’s life.  With each minute the patient is in ventricular fibrillation the likelihood of survival goes down,” Kevin R. Campbell, MD, FACC, a cardiologist at UNC Health Care/Rex said. The benefits to the patient are tremendous, he added, “AEDs change the survival rate from less than 5 percent to more than 80 percent with quick defibrillation.” With simple training, you can greatly change the person’s odds of survival during cardiac arrest. 

When do I use an AED?

Cardiac arrest can occur anytime and anyplace without warning. During cardiac arrest, the person’s heart beat becomes irregular and erratic — known as ventricular fibrillation — and unless a shock is delivered, the patient will die. “Every minute that a patient remains in the erratic heart rhythm, the likelihood of survival goes down exponentially,” says Dr. Campbell. In his experience, heart attacks often occur in the early morning hours when adrenaline and cortisol levels are at their highest.

The operator of an AED must be able to detect symptoms of sudden cardiac arrest. It is time to get an AED if a person:

• Becomes unresponsive suddenly
• Stops breathing
• Does not respond when you tap on the shoulders firmly
• Does not respond when you ask, “Are you OK?”
• Does not take a breath when you tilt the head up

This is the emergency situation where every minute counts, so call 911 and get an AED.

Where can I find an AED?

The American Heart Association encourages public access to AEDs which should now be available wherever a large group congregates. Laws differ by state, but many states require AEDs in public areas like schools, health clubs, and sports stadiums. All emergency response vehicles are equipped with AEDs. “I believe that every single public school in the country should have an AED readily available,” said Campbell. It may be difficult to locate an AED in an emergency, and so having these devices clearly marked at the worksite and in public areas is essential. Ask where the AED is in your worksite today.

How can I get trained on using an AED to save hearts and lives?

The American Heart Association’s Heartsaver training on performing using an AED is available online, with follow-up hands-on training with instructors. The American Red Cross provides live training and certification for AED use in many communities. Training takes only a few hours because an AED is simple to use and every device includes clear directions. According to the Red Cross, training people to use AEDs and providing ready access to them could save as many as 50,000 lives yearly. “I think that everyone should be trained,” said Campbell.

Have you taken AED training course? Please share your experiences with Everyday Health readers by adding a comment in the box below the article.

Keep Youth Sports Safety Top of Mind: Guidelines from National Athletic Trainers’ Association

 

By Staff Editor

May 15, 2013 - 10:04:15 AM

(HealthNewsDigest.com) - DALLAS, May 15, 2013 - With the spring sports season well underway and summer preseason practices and youth league games around the corner, young athletes are already enjoying warm weather activities and competition. "Every team and athlete should have sports safety as a top priority," says Larry Cooper, chair of the National Athletic Trainers' Association Secondary School Committee and head athletic trainer at Penn Trafford (Pa.) High School. "It's vital for coaches, athletic trainers, parents and the athletes themselves to maintain go od communication and follow guidelines to ensure all participants are fit for play."

NATA hosted the 4th Youth Sports Safety Summit earlier this year with the support of the Youth Sports Safety Alliance, now composed of 109 organizations committed to keeping athletes safe, and launched the first-ever National Action Plan for Sports Safety and Student Athlete Bill of Rights (www.youthsportssafetyalliance.org). "Each athlete is entitled to appropriate care, prevention and treatment of injuries should they occur," says Cooper.

NATA offers several sports safety tips to keep athletes in the game:

1. Make sure the athlete is physically and mentally in the game: Parents, with assistance from coaches, should determine whether their children are physically and psychologically conditioned for the sport/activity level they're playing. Do not push children into something they do not want to do. Additionally, if an athlete has been injured and is returning to sport, it's critical for him or her to have the right mind set and confidence to return to play and avoid repeat injury.

2. Get a pre-participation exam: All athletes should have a pre-participation exam to determine their readiness to play and uncover any condition that may limit participation.

3. Follow a team approach to care: In the case of injury, find out who will provide care and ask to review their credentials. Many schools and sports teams rely on athletic trainers or parents with medical and first aid training and certification to keep kids safe. Yet less than half of high schools have access to athletic trainers.

4. Beat the heat: Acclimatize athletes to warm weather activities over a 14-day period. The goal is to increase exercise heat tolerance and enhance the ability to exercise safely and effectively in warm and hot conditions. Should heat illness occur, cool first and transport second: immediate cold water immersion is critical to reducing the athlete's temperature rapidly. Determine core body t emperature to best assess the athlete's condition.

5. Use your head: Athletes should be encouraged to speak up if they are suffering any related symptoms (dizziness, loss of memory, fatigue). Concussions must be carefully managed using follow up assessments of symptoms, neurocognitive function and balance, prior to initiating a gradual return to play. Should a more serious brain injury occur, the medical staff should be prepared to transport the athlete to a facility, while ensuring adequate ventilation and elevating the head to decrease intracranial pressure.

6. Maintain Heart health: Recognition is vital to treatment: sudden cardiac arrest should be suspected in any athl ete who has collapsed and is unresponsive. Public access to early defibrillation is essential: a goal of less than 3-5 minutes from the time of collapse to delivery of the first shock from an automated external defibrillator (AED) is strongly recommended. Most schools now have AEDS. Ensure that the medical expert and other personnel know where they are located, how to use them and that they are placed on sidelines during competitions and games.

7. Share an athlete's medical history: Parents should complete an emergency medical authorization form, providing parent contact information and permission for emergency medical care for the student athlete. Check with your school/league to obtain the form.

8. Ensure equipment is in working order: Make sure all equipment ranging from field goals, basketball flooring, gymnastics apparatus and field turf are in safe and working order. This also includes emergency medical equipment such as spine boards, splint devices, AEDs (which should be checked once per month; batteries and pads need consistent monitoring and replacing). All it takes is a slip on a wet surface or twist of an ankle on an ungroomed field to lead to lower extremity injuries, among others.

9. Ascertain coaches' qualifications: A background check should always be performed on coaches and volunteers:

-       Coaches should have background and knowledge in the sport they are coaching. They should be credentialed if that is a requirement in the state, conference or league.

-       Coaches should have cardiopulmonary resuscitation (CPR), AED and first aid training.

-       Coaches should strictly enforce the sports rules and have a plan for dealing with emergencies.

-       Ensure appropriate credentials for coaching from the respective sport governing body.

-       Coaches can also take an online course by visiting: http://www.nata.org/Sports-safety-for-youth-coaches-course

10. Check that locker rooms, gyms and shower surfaces are clean: With the advent of MRSA and related bacterial, viral and fungal skin infections reported in recent years, it is critical to keep these surfaces routinely cleaned and checked for germs. Athletes must be discouraged from sharing towels, athletic gear, water bottles, disposable razors and hair clippers. All clothing and equipment, including bags, should be laundered and/or disinfected on a daily basis.

11. Be smart about sickle cell trait: All newborns are tested at birth for this particular inherited condition and those results should be shared during a pre-participation exam. Red blood cells can sickle during intense exertion, blocking blood vessels and posing a grave risk for athletes with the sickle cell trait. Screening and simple precautions may prevent deaths and help the athlete with sickle cell trait thrive in his or her chosen sport. Know the signs and symptoms (fatigue or shortness of breath) to differentiate this condition from other causes of collapse.

12. Ensure an emergency action plan is in place: Every team should have a written emergency action plan, reviewed by the athletic trainer or local Emergency Medical Service. Individual assignments and emergency equipment and supplies need to be included in the emergency action plan. If an athletic trainer is not employed by the school or sport league, qualified individuals need to be present to render care. Knowing that a school has prepared for emergency will give parents peace of mind.

13. Adopt a "Time Out" system: Each health care team should take a "Time Out" before athletic events to ensure emergency action plans are reviewed and in place. Determine the role of each person; communication coordination; presence of ambulance; designated hospital; test of all emergency equipment; issues that could impact the plan such as weather or other considerations.

14. Build in recovery time: Allow time for the body to rest and rejuvenate in between practices, games and even seasons. "Recovery time is essential," says Cooper. "Without rest and a change of motion and activity, we put young athletes at risk of repetitive or chronic injury."

15. Breathe easier: Athletes with asthma should be properly educated about their condition, appropriate medications, use of inhaler equipment and how to recognize "good or bad" breathing days to prevent exacerbations. A warm up protocol may decrease the risk of asthma or reliance on medications.

16. Stay smart about steroids: Use of anabolic-androgenic steroids can lead to a host of negative effects on the health and well-being of athletes and non-athletes alike. Be aware of signs and symptoms of misuse including: rapid body mass or increase in performance; extreme muscular growth; abnormal or excessive acne, unexplained hypertension, moodiness, aggression, depression or obsession with exercise and diet. Report this immediately to the athletic trainer or other school medical professionals.

"It's critical that all members of a school's athletic health care team, parents, teachers and others involved in the care of the athlete have ongoing communication to ensure a safe sports setting," says Cooper. "With those protocols in place, athletes can enjoy the great spirit, competition, and ac complishment that come from safe and fair play."

"And, if your school is following the right protocols, enter it in the NATA Safe School award program that recognizes schools implementing appropriate steps to keep athletes safe. It is a win-win for students, the athletic health care team and school at large."

For more information on the award program, visit www.athletictrainers.org.

About NATA: National Athletic Trainers' Association (NATA) - Heal th Care for Life & Sport

Athletic trainers are health care professionals who specialize in the prevention, diagnosis, treatment and rehabilitation of injuries and sport-related illnesses. They prevent and treat chronic musculoskeletal injuries from sports, physical and occupational activity, and provide immediate care for acute injuries. Athletic trainers offer a continuum of care that is unparalleled in health care. The National Athletic Trainers' Association represents and supports 35,000 members of the athletic training profession. Visit www.nata.org.