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What is Sudden Cardiac Arrest?

Cardiac arrest occurs when the heart stops beating and erratically quivers, which inhibits blood from circulating to the brain. Essentially this is caused when the heart’s electrical system malfunctions. Many times a person that suffers from cardiac arrest has an underlying heart disease that has not been diagnosed, so it occurs unexpectedly. When someone suffers from cardiac arrest they will become unconscious and collapse. This happens because when the heart no longer circulates blood the brain loses oxygen and begins to shut down.

There is a chance that cardiac arrest can be reversed if cardiopulmonary resuscitation (CPR) is performed and/or a defibrillator is used to shock the heart back to a stable rhythm. Any treatment must be done quickly because the chance of brain injury increases every minute and damage will typically be permanent after five minutes. There are around 383,000 reported cases of out-of-hospital cardiac arrest in the United States every year. The majority of victims do not survive because they do not receive CPR or defibrillation in time.

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What the difference between a cardiac arrest and a heart attack?

It is common for cardiac arrest to be mistakenly called a heart attack, but the truth is there is a big difference between the two.

A heart attack is when one of the heart’s arteries is suddenly blocked and stops the proper flow of blood to the heart. Often the blockage is from a buildup of plaque that ruptures and in turn inhibits a portion of the heart from getting its vital supply of blood. This can lead to death if the blood supply is cut off for too long because the hearts muscle cells don’t receive the necessary oxygen. Some warning signs for a heart attack include chest and arm pain, weakness, dizziness, and nausea.

On the other hand, cardiac arrest is when the heart’s electrical system malfunctions and stops the flow of blood to the brain. Unlike a heart attack, cardiac arrest usually happens without warning signs. Also, when someone has a heart attack they are usually conscious through it while during a cardiac arrest the brain loses oxygen and the victim will lose consciousness.

A heart attack is treated by returning the blood flow back to normal through treatments like medication, stenting, or surgery. Cardiac arrest is treated through defibrillation which restarts the heart to return it back to its normal rhythm. Although suffering from cardiac arrest does not mean you are more at risk for a heart attack, someone that has a heart attack can be more at risk of cardiac arrest.

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What is an AED?

The word AED is an acronym, used as an abbreviation for the Automated External Defibrillator.

AEDs are portable medical devices that automatically analyze and detect cardiac arrhythmias of Sudden Cardiac Arrest patients through electrodes, and are able to produce a shock which stops the heart and allows it to return to a normal rhythm, a process called defibrillation.

AEDs are used in the event of sudden cardiac arrest (SCA), which is a condition in which the heart suddenly stops pumping blood and quivers eratically; this typically happens without any warning signs. The chances of surviving cardiac arrest decrease by 7-10% with every minute that passes after a person's heart stops beating. About 360,000 cases occur yearly, and a person currently has about a 5% chance of surviving an incident of cardiac arrest.

Since a person's chances of surviving an incident of SCA decrease so rapidly, it is important that AEDs are readily available for when cardiac arrest occurs. Optimal AED placement allows a person to grab the AED and return to the victim within 90 seconds.

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How do I use an AED?

Since AEDs are produced by a number of manufacturers, there are slight differences to operating each AED, but all are very intuitive. In order to use an AED, begin by either opening the lid or pushing the "ON" button. From there, it's as simple as following the AED's voice and text prompts which include directions such as "Attach electrodes to patient's bare chest" and "Begin CPR."

The AED itself will determine whether a shock is necessary, and if it is, will prompt the rescuer to push the shock button, or give a clear warning before shocking the victim. Since these devices guide a person through the entire rescue process, they can be used by lay people that haven't been trained in CPR/AED usage, however, it is highly recommended that every facility have trained personnel.

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Why do I need an AED?

The American Heart Association has documented a simple but powerful 4 step “Chain of Survival” Why are there so many deaths from Sudden Cardiac Arrest when an AED can save a life when someone collapses from Sudden Cardiac Arrest (SCA). A victim of SCA will collapse often suddenly because their heart has stopped beating. There is a 5 minute window from collapse to shock that must occur in order for the victim to survive the event.

AHA - Logo


Insert “The Chain of Survival” from “Why are there so many deaths from Sudden Cardiac Arrest when an AED can save a life?
1. Early Access to get help – call 911
2. Early CPR to buy time
3. Early Defibrillation to restart the heart
4. Early ACLS (advanced care life support) to stabilize

The only successful treatment of SCA is immediate CPR with an automatic external defibrillator within the first 5 minutes of collapse.



Why can't I just call 911 and have EMS treat the victim?
EMS

Calling 911 is always the first step in a medical crisis.  EMS respond times can vary due to a number of factors ranging from the city, to confusion between dispatch and 911 caller, and the true time it takes from the time of the 911 call to the time that EMS arrives at the victim’s side with an AED.  Statistics are that “call to shock” times are too often outside of the 5 minute window that a victim has to survive without CPR and an AED.  

The most important piece of information to remember is that a person in SCA is in a race against the seconds ticking by on the clock.  They will most likely be saved if they receive the life-saving shock from an AED within 5 minutes of the sudden cardiac arrest.  

Improving and optimizing survival rates means having AED’s for EMS, Fire and Police, as well as being available for public access in settings such as football and sports fields, in rural areas, and for individuals that are high risk.  Availability, accessibility and use may save the life of someone you love. 

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How long will a victim of Sudden Cardiac Arrest survive?
Time Is Ticking

There is a 5 minute survival window for a victim of sudden cardiac arrest with the survival depending upon early CPR and having access to an AED within that 5 minute timeframe.  Sudden Cardiac Arrest is a sudden cessation of cardiac mechanical activity that causes the victim to stop breathing and have no pulse.   Annually, almost 400,000 people experience out of hospital cardiac arrest and 9 out of 10 of these victims die.  This is more than the number of people who die from AIDS, Alzheimers Disease, breast, prostate and colon cancer, fires, and motor vehicle accidents combined.  When bystanders intervene by giving CPR and using AEDs before EMS arrives, 38% survive.

The “Chain of Survival” steps must all occur within 5 minutes:
1. Early Access to get help:  Call 911
2. Early CPR to buy time: Begin CPR Compressions Immediately
3. Early Defibrillation to restart heart:  Use AED as soon as possible on victim
4. Early ACLS to stabilize:  Ambulance arrival time

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What is necessary to save the life of a victim of sudden cardiac arrest?
HeartStart AED

The simple answer – a shock from a defibrillator is the only thing that will revive a person in cardiac arrest.  Without an AED shock within 5 minutes of collapse, a victim will not survive.  

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What sorts of places have AEDs?
AED at a School

As of today’s date all 50 states have enacted defibrillator laws or adopted regulations with the vision of placement of AEDs in public buildings, schools, transportation centers, airlines, health club/fitness centers, large offices, apartment buildings, dental offices, arenas  and public gathering locations, etc.  y clicking on the link below you can find details about your state and what the current laws and regulations are:

www.ncsl.org/laws

While some industries are mandated to provide AEDs, many other organizations are voluntarily providing AEDs for their students, staff, employees, customers, etc.  In order for a victim of sudden cardiac arrest to survive they must receive early CPR and the use of an AED within 5 minutes of their collapse.  Having an AED on their premises greatly increases the survival rate of a victim of SCA.  When bystanders intervene by giving CPR and using AEDs before EMS arrives, 38% survive.

Sudden Cardiac Arrest is a treatable condition.  Many victims can survive if they are treated quickly with a combination of cardiopulmonary resuscitation (CPR) and defibrillation. If we can increase the rate of survival from 7% to 20%, 50,000 lives could be saved each year in the U.S. alone. 

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What do I need to know in order to select the right AED for me or my company?
The right AED for me

This depends on several factors, but we have put the most common AED packages together for your convenience: http://www.aed.com/aed-packages 
Please call our expert sales team (855) 233-0266 (all CPR/AED Certified Instructors) and they will be glad to help you. We are the experts. Let us assist you in selecting the right AED for you. 

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Can an AED be used on children or infants?
AED For Kids

Sudden Cardiac Arrest in youth is not a rare occurrence.  SCA is the leading cause of death on school property, which includes not only children, but also teachers, administrators, parents and visitors.

The American Red Cross says that AEDs equipped with pediatric AED pads are capable of delivering lower levels of energy appropriate for infants and children up to 8 years old or weighing less than 55 pounds. Use pediatric AED pads and/or equipment, if available.  If pediatric-specific equipment is not available, an AED designed for adultscan be used on children and infants. Always follow local protocols, medical direction and the manufacturer’s instructions. 

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What does the term “Bystander CPR” mean?

A “bystander” can literally be anyone who witnesses someone collapsing from sudden cardiac arrest and whose heartbeat has stopped.   CPR is cardiopulmonary resuscitation.

 

If  the person witnessing the sudden cardiac arrest has received formal CPR training – all the better.  However,  it is not a requirement to step up and begin basic CPR.  The first step in the Chain of Survival is to call 911, and the next immediate step is to begin CPR to keep the victim’s blood circulating to the brain and other organs, and this MUST be done in the first seconds and minutes after the victim collapses.  Enough oxygen remains in the person’s bloodstream to nourish the brain for several minutes — but a bystander has to circulate oxygenated blood to the brain and other organs by pushing down on the chest hard and fast, mimicking the heartbeat.



The Chain of Survival must be completed within 5 minutes of collapse:
1. Call 911, or have someone else do it.
2. Place both of your hands, one on top of the other, over the middle of the person’s chest.
3. Press down hard enough to make the chest move inward about 1.5 to 2 inches.
4. Relax to let the chest rebound. Repeat this press-and-relax motion quickly, almost twice a second if you can. (Keeping time to the old Bee Gee’s song, “Stayin’ Alive” is a good rhythm to stick to) Press hard. Press fast. Don’t stop.
5. Don’t stop if the person seems to gasp or move! Keep pushing until help arrives.



cpr chest compressions

 

Today, only about 5 percent of people survive a sudden cardiac arrest. Bystander CPR more than doubles an individual’s chances of surviving. Wouldn’t you want to “lend a hand” to help someone in cardiac distress? 

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Can I use the AED incorrectly?
Can I use the AED incorrectly?

When witnessing a sudden cardiac arrest, the Chain of Survival must begin immediately.  If there is a trained responder they will take over, however a bystander may be called on to start CPR and if there is an AED on the premises, use it on the victim.  Having access to an AED on the premises may well save the life of the victim because EMS call to shock times are often outside the 5 minute window that the victim has to receive CPR and the AED shock to reset the heart rhythm.   Calling 911 will get a dispatcher to walk someone through the steps over the phone until EMS arrives.  But, with a limited 5 minute window to perform CPR and use the AED to restart the heart, the bystander can be walked through the steps with the dispatcher, and most AEDs also provide very clear, audible instructions to the person using the AED.  Ninety-five percent of people who have SCA die from it—most within minutes. Rapid treatment of SCA with an AED can be lifesaving.

Not every cardiac arrest is caused by Ventrical Fibrillation (VF).  Approximately one third of the time the heart will not be in VF and therefore the AED will not deliver a shock. In this case it will advise the rescuer to check the patient and begin CPR.

The AED is designed to only shock VF.  It will not shock any other heart rhythm. Nevertheless, AEDs are not perfect and in 1% of cases it may shock a rhythm other than VF. That’s why it should only be attached to a person who is unconscious and has collapsed.

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What about Liability?
AED Liability

All 50 states have Good Samaritans laws designed to protect companies that choose to deploy AEDs. These laws reduce or eliminate the fear that people who help others could suffer legal repercussions. To receive protection under the Good Samaritan laws, a company must prove they meet all operational requirements for the deployment of an AED Program. Visit our EnPro Page  to learn about what AED program management provides. 

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What is Medical Direction and why do I need it?
What Is Medical Direction?

It is important to know what your specific state laws are to determine if Medical Direction is required in your state.  Most states require that that medical direction be part of the overall AED plan.  Medical Direction will provide a number of essential features to you including reviewing your policies and procedures and making sure adequate training is provided, consulting on AED placement, and EMS Notification.

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What if I don’t have a Medical Director?
What Is Medical Direction?

AED.com partners with En-Pro Management, Inc., an AED program management solution that will provide you with a full program to assure regulatory compliance regardless of your location. En-Pro  provides your organization with Medical Direction, Policies and Procedures, PlusTrac (AED inspection reminder Service with documentation), EMS notification, AED training programs (additional fee), regulatory tracking, upgrade/correction notifications. Click here for more information

En-Pro provides:
Annual Medical Prescription/Authorization 
EMS Registration/Notification 
Policy and Procedure Manual 
Site Analysis with an En-Pro Account Manager to Optimally Place AED Devices 
Event Review and Documentation by an En-Pro Medical Director when AED is used 
Coverage Under $1,000,000+ General Liability Policy

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Once I have an AED, what is involved in maintaining it?
AED Maintenance

This is an important question to ask and be clear on.  Providing an AED is the first step.  The maintenance of an AED is minimal but it is very important to have a system in place that tracks this maintenance.   The majority of malfunctions in AEDs are due to improper maintenance or battery failure.  

AEDs, while easy to use, require ongoing management and maintenance.  In addition to training volunteers, a well-designed AED Program includes testing and maintaining your device(s) – a critical and overlooked factor in deploying AEDs in organizations.  Whether you have 1 AED, or are a large organization with multiple AEDs deployed, you should have a Medical Oversight and Management program in place.  Taking this step ensures that your AED(s) are always maintained, in compliance, registered with local EMS, and are ready for use should they be called upon.

AEDs have accessory parts (batteries and electrodes) that have expiration dates that must be tracked and addressed prior to expiration.  At aed.com we partner with En-Pro  Management (www.enproinc.com) to provide our customers with the highest level of reputable and experienced AED Program Management.

AED Program Development through En-Pro Management occurs in three phases: design, implementation, and maintenance.

En-Pro’s PlusTrac program GUARANTEES compliance.

The most important aspect of any AED program is an active system of controls and maintenance protocols that will continually monitor overall compliance and readiness.  En-Pro has the most comprehensive AED management solution in the AED industry, PlusTrac™.

PlusTrac was designed solely for the management of AED Programs and includes innovative, valuable features exclusive to PlusTrac™. 

PlusTrac™ is an interactive, web-based AED management system that ensures the ongoing compliance of your AED Program. It monitors and tracks routine maintenance inspections, electrode pad expiration, battery expiration and volunteer responder expiration.

PlusTrac™ can be accessed anywhere there is an internet connection and a web browser. It is an innovative, comprehensive solution that is easy to manage when tracking the vital components of your AED Program. The architecture of the application enables corporate and regional or divisional Program Administrators to be notified of required actions at the local AED Program Coordinator levels. 

This hierarchy ensures proper accountability, guaranteeing compliance.

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Where should I put the AED?
AED on a desk

AED's should be visible to everyone. In the case of “bystander CPR” being required, the AED should be visible.  
AED Cabinets help deter theft and allow AED's to be visible. 
AED's should never be locked up in a drawer somewhere. Regular inspection checks probably will not get done. Regular inspections are critical to assure
   AED readiness. 
AED's should be near a phone for calling 911. 
AED's should be centrally located within the highest risk and most concentrated population area and near trained rescuers. 
AED's should be placed near high risk areas. 
AED's should be placed well within 3 minutes of anywhere within the facility. (That means 1.5 minutes to the device and 1.5 minutes back at a brisk walking pace). 

When placing AEDs in schools, think of the following:
Gyms are usually high risk areas and usually have the high concentrations of people both during school and for after school events.  Many states require that the first
   AED a school has be posted outside of the school gym.
Look at the main office area. These areas are usually staffed or supervised the most within a school. 
Look at areas that are locked in the evening time. These usually don't make very good locations because of their lack of accessibility. 
Most schools fear theft and lean toward locking AED's away. We feel this is a bad idea and other solutions can usually be found to balance security and accessibility.
Look at areas that have surveillance cameras 
Alarmed AED Cabinets help with tampering

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How much training is required and who provides the training?
AED Training

En-Pro Management offers nationally accredited CPR/AED and First Aid Training to fit your schedule and your budget.  Training courses are through The American Heart Association or The Emergency Care and Safety Institute.  AED.com also offers FREE Live Online Training with the purchase of any AED.  This training takes place online through WebEx, and you are able to watch the training, participate, and ask our certfied CPR/AED instructors any questions you have along the way.


What is the ongoing cost of having an AED?
AED Cost

 

It is important to determine your budget early and be sure to include any accessories such as: spare pads (optional), spare batteries (optional), AED cabinet or wall bracket, CPR and AED training (required), Medical Direction (required in some states), long term costs (replacement pads and batteries, refresher training).

Replacement pads (electrodes) and batteries must be replaced at the appropriate time.  AED pads are comprised of tin and an adhesive gel which allows the pads to stick on the victim’s chest.  Over time, the tin will eat away at the gel and the gel will lose its adhesive properties.  For this reason, pads have a fixed expiration date stamped on the package.  These pads should be replaced prior to expiration to ensure that they will do their job when the AED must be used. 

Batteries do not have a fixed expiration date, but they have a normal life expectancy.  A battery’s life can be shortened or prolonged by several variables, including temperature, factory self-tests and usage.    

It is of utmost importance that your AED be maintained properly to ensure that these expiration dates are managed closely.   The value of an AED management company can be worth its cost many times over as it keeps track of these details for you and ensures that your AEDs are always in compliance and ready to use if needed.

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