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Sudden Cardiac Death: Defibrillator Training Encouraged To Save Lives

Posted by Jane Akre
Friday, June 20, 2008 12:07 PM EST
Category: On The Road, Major Medical, Protecting Your Family, In The Workplace
Tags: Medical Devices, Heart Attack, Cardiac Arrest, AED, Automated External Defibrillator

Tim Russert's death invigorates the interest in training and use of automated external defibrillators.   AEDs in public places along with training are encouraged says this advocate. 

 

Jon Duffey of The Zapper Web site 
Jon Duffey, Editor -The Zapper

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IMAGE SOURCE: Wikimedia Commona/ AED Amsterdam Airport/ author: Stevenfruitsmaak

 

IMAGE SOURCE: Wikimedia Commons/ Russert in Philadelphia, Oct 2007/ author: hyku


 

Last week, Meet the Press moderator, Tim Russert died of a heart attack, a passing that has had an immense impact on citizens, newsmakers, and journalists alike.

The key to survival is timely initiation of CPR (cardiopulmonary resuscitation), including, when applicable, a jolt from the lifesaving device, an automated external defibrillator or AED.

The American Heart Association reports that with the broad deployment of AEDs by trained responders, as many as 50,000 lives could be saved from sudden cardiac arrest.

IB News speaks with Jon Duffey, editor of The Zapper, a Web site community for cardioverter-defibrillator implant recipients, families, and care givers.   These are internally placed defibrillators that deliver a jolt when an irregular heart beat is detected.

On his Web site, Duffey and The Zapper asks - Was Russert’s death avoidable?

Had the life-saving shocks from an external defibrillator been applied sooner, Duffey suggests Russert’s chance of survival might have increased.    

For more than a dozen years, The Zapper and Duffey have advocated the placement of more Automated External Defibrillators (AED) in public places, along with training so anyone can reasonably and quickly apply the necessary voltage to regain a regular heart beat and restore blood flow to the body and brain.  

As it stands now, many CPR and basic life support classes train in AED use, but how many people feel comfortable, when time is of the essence, to quickly use an AED?

Duffey was a medic during the Vietnam War and spent years in newsrooms as both a producer and writer.  He survived a major heart attack in 1994, the implant of four different internal defibrillators, and ten jolts of about 700 volts each.

Each time the heart was shocked back into a normal rhythm. Without them he would not have survived.   

*Disclaimer- IB News Editor Akre has known editor Duffey for many years and even worked with him in a Tampa newsroom where he had a first heart attack in 1994.)

Jane Akre: Duffey, the reports are that defibrillators were used on Russert?

Jon Duffey:   “Sudden Cardiac Arrest and death is NOT instantaneous.  The heart only stops when uncontrollable Ventricular Fibrillation (fluttering uncontrollably, no blood being pumped at all) follows an extended period of Ventricular Tachycardia (heart beat exceeding 200 beats per minute).

In that case, the body is telling the heart, I’m not getting enough oxygen through these tubes, so the heart speeds up. Either of those can usually be interrupted with cardioversion or defibrillation, and the heart will return to sinus rhythm. 

Granted, that's only a temporary remedy as the blockage must still be addressed quickly with either chemical (clot busting tPA) or surgical (angioplasty or bypass) intervention, and what first caused the heart to go into V-Tach and V-Fib can do so again and again.

With most airliners, airports, and arenas (and other sites with high concentrations of human traffic) equipped with portable (automatic) external defibrillators (AED)... one would think the WRC/NBC studios and offices on Nebraska Avenue NW in Washington, DC would have such rescue gear handy." 

JA: Did NBC have these devices available? And how would someone in a newsroom know how to use them?

JD:  “I called WRC (NBC- owned television station in D.C.) and NBC in Washington. I placed two different calls and asked if they had a defibrillator in the building. The first time they said it’s a privacy issue, the second time they cited corporate confidentiality."

JACNN’s Larry King talked to Russert’s doctor and he said resuscitation began almost immediately, and that NBC had the defibrillator (AED) and was “preparing” to use it when the EMS squad arrived and immediately defibrillated Russert, a total of three times.

(Dr. Newman on CNN: “His heart was beating then in a ventricular – fine ventricular fib, and then it deteriorated.” )

They reported he had no heart rhythm, but by then it had also been at least three minutes until the medics arrived. Any idea what a survival time might be?

JD: “There is no set time, it’s different for everybody. It depends how much oxygen is available to keep the brain from shutting down. Maybe two minutes, but there is not a set time.  Heart muscle dies quickly; every second the heart is not pumping blood, heart muscle dies.  

Now it could be before he hit the ground that infarction in his LAD (left anterior descending coronary artery) was so substantive that there could have never been any chance for recovery anyway, it’s a possibility, in which case no amount of defibrillation is going to keep the heart ticking.   

But if someone had training to use the device two minutes sooner, he might still be with us." 

JA:  But how would you know how to use them and why isn’t there more training?   

JD:  “Training is the smart thing to do. The important thing is to get these devices where there are concentrations of people.  Any work place or retail area, wherever you have human traffic, you should have these devices handy.  You can get them for $1,500 bucks or less, Automatic External Defibrillators.    

It’s nice if you give people training where they are placed, but you don’t need a lot of training.  It’s got a little map on it; you place one thing here on the chest, place here on the chest, then push this button. It charges up and fires. That’s all you need." 

JA: There might be a time when an AED wouldn’t work? 

JD: “Remember, if the heart is not beating at all, if you are in cardiac arrest, it won’t shock you. The AED senses if there is any heartbeat at all. Shocking somebody will do nothing if there is no heartbeat. 

JA: Why aren’t they more readily available? 

JD:  “After my decade old effort to make AED's quickly accessible to all people... I can't imagine them not in any high stress work environments with hundreds of employees and members of the public present at nearly any hour. 

Being one of the few to survive an infarction of the Left Anterior Descending Coronary artery... I point out:  NOBODY has reported Russert's death was avoidable!  Was this the case or not?  A blockage there is life threatening, but unless he slid under his desk and no one knew he was in trouble for ten minutes, he might have survived.

Russert was probably not a candidate for an internal defibrillator (because he hadn't had a heart attack). That’s the reason, if you read my website for 14 years I’ve preached that ordinary people without heart attacks deserve the same protection we do. 

Over the years, I so wished others had access to a life saving shock of life.  Never so much as in the days since the passing of Tim Russert.  I hope some of you will help give this issue some attention. "  # 

Editors note – In November 2000, President Clinton signed the federal “Cardiac Arrest Survival Act”, (Public Law 106-505, encouraging placement of AEDs in federal buildings and providing civil immunity for authorized users considered "Good Samaritans". 

State laws vary as to the requirements of persons who use an AED in a public setting without specific training. The American Heart Association offers AED training in your area.

IB News covers this topic not to point blame but to increase awareness and invite your comments. How many work near an AED. Would you know how to use one quickly?  #


1 Comment

Posted by Elliot Fisch
Tuesday, June 24, 2008 6:52 PM EST

The article states:
"Remember, if the heart is not beating at all, if you are in cardiac arrest, it won’t shock you. The AED senses if there is any heartbeat at all. Shocking somebody will do nothing if there is no heartbeat."
The fact is that the machine will only work if the heart is in ventricular fibrillation and has a shockable rhythm. Hence, it will only work if your ARE in cardiac arrest. It will NOT work if you are NOT in cardiac arrest.

Elliot R. Fisch, CEO
Atrus, Inc.
LINK

Comments for this article are closed.

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