AEDs (automated external defibrillators) have been utilized to save nearly a half million lives since first being introduced to the American public in the mid-1990s. A defibrillator introduces a shock to a heart that is in cardiac arrest, enabling it to reset to a life-sustaining heartbeat. Most often it is the non-medical layperson who witnesses someone collapse, has the compassion to want to help and jumps into action. Fortunately for the sudden cardiac arrest victim, there is an AED close by.
In the time it took to click on this link and read the introduction, another victim in the United States has collapsed from sudden cardiac arrest (SCA). The American Heart Association reports that SCA occurs nearly 1,000 times each day! Roughly every 90 seconds. Sudden cardiac arrest is the number one killer in the American workplace, with more workplace deaths caused by SCA than all other causes combined!
Is Sudden Cardiac Arrest the same thing as a heart attack?
Sudden Cardiac Arrest (SCA) and a heart attack are NOT the same thing, though a heart attack can be a precipitating cause of cardiac arrest.
Myocardial infarction (heart attack) occurs when the heart is experiencing blockage of blood flow. It is a plumbing issue. The victim may experience chest pain or tightness, shooting pain down the arm, pain or tightness in their jaw. All of which are serious symptoms that should convince one to get to a hospital right away.
SCA is not a plumbing issue; it is an electrical issue. The heart has lost its electrical pulse needed for it to pump blood through the body; a condition called ventricular fibrillation. When v-fib occurs, the muscle fibers of the heart twitch and quiver (fibrillate) without the synchronization needed to pump blood. The brain and body are instantly deprived of oxygenated blood, the victim collapses and will likely die before paramedics arrive. UNLESS a defibrillator is close by and witnesses take action! The first link of the chain-of-survival for sudden cardiac arrest is the witness. Even if unsure what to do, bystanders need to act right away, call 911, and find the AED. Within 4 to 6 minutes without oxygenated blood, the brain will experience irreversible damage and begin to die.
How does the heart go into V-Fib?
The right atrium of our hearts contains the very “gift of life” itself. In the upper, rear wall of the right atrium is a specialized bundle of neurons called the sinoatrial node (SA node; also known as the sinus node). The SA node releases an electrical signal to the atrioventricular node (AV node) which gathers the signal and relays it to the ventricles, making the heart contract and squeeze blood to the body and brain. (When you perform chest compressions, you are trying to mimic this action). This miraculous, self-contained, power plant in our heart will perform its magic over 100,000 times a day! Over 3 billion times in the average lifespan!
So, what causes the electrical signal to stop?
There are a number of identified causes for the SA node to lose its electrical rhythm:
. • A stressed heart (as in a myocardial infarction)
• Heat stroke
• Near drowning
• Choking or blocked airway
• A sudden blow to the chest
• A pre-existing heart condition
• Or for no known reason what so ever
Does SCA occur mostly among the elderly?
SCA is the most common cause of death for Americans over 40; however, sadly it is also the leading cause of death for our young athletes. Commotio cordis (Latin, “agitation of the heart), occurs when a sudden blow happens to the chest; specifically in an area just above the heart called the precordial region. The blow to the chest does not have to come from a 90MPH fastball or 100MPH slap shot to cause cardiac arrest. The impact just needs to occur during a specific point in the heart rhythm. And like thumping the filament of a light bulb, the heart stops dead.
90% of our young athletes who experience sudden cardiac arrest, do not survive.
AEDs in schools is not a new idea, but a situation which occurs all too frequently is startling:
One AED may be near the school office and perhaps another near the gymnasium, but a life-or-death situation is occurring on the ball field. AEDs must be within TWO MINUTES MAXIMUM distance (round trip) to any point on the school campus. Otherwise, the school is NOT prepared for a cardiac emergency.
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