8 Questions Answered: Automated External Defibrillators (AED)

I turn on the evening news and hear about a school-aged athlete collapsing on the football field for no apparent reason – and dying. My mind tries to establish a cause/effect relationship in this unlikely, but seemingly familiar scenario. I listen for details within the report linking this tragedy to previous injury, heat stroke, drugs, genetics –something. But there is nothing. No signs. No symptoms. No warnings. Just the vibrancy of youth succumbing to the cold reality of death. What happened?

According to a report from CBS: 

“Once every three or four days in this country, a competitive young athlete suffers sudden cardiac arrest. In as many 80 percent of those cases, there are absolutely no symptoms to warn that the cardiac arrest might occur…Sudden cardiac arrest is the leading cause of death among young athletes.”

OK, now I know it’s not just me imagining the regularity of these stories. Something widespread and scary is going on here. And if our well-exercised youth are falling prey to this stealthy killer called sudden cardiac arrest, what does it mean for those of us in the workforce whose only regular workout consists of hoofing it to the coffee pot for that all-important fourth refill and second doughnut?  What can be done to save lives? I decided to look for answers because I am a caring parent, a concerned manager, and happen to like coffee and doughnuts.

I thought sudden cardiac arrest was another term for heart attack. I was wrong. A heart attack is the dying of certain heart muscle tissues due to lack of blood flow, most often caused from plaque build-up in the coronary arteries. By contrast, sudden cardiac arrest usually happens when the heart’s electrical impulses become erratic, hindering the heart from pumping enough blood necessary for life. Nobody knows for sure the cause of sudden cardiac arrest. Unlike a heart attack, it has no direct link to heart disease. Again, what can be done to save lives?

From the Red Cross:

“More than 200,000 Americans die of sudden cardiac arrest every year. Up to 50,000 of these deaths could have been prevented if someone had initiated the Cardiac Chain of Survival, and an automated external defibrillator (AED) had been available for immediate use at the time of the emergency.”

The Cardiac Chain of Survival is just a fancy way of describing the steps necessary to help ensure survival from sudden cardiac arrest:

• Call 911 as quickly as possible
• Begin CPR
• Begin defibrillation
• Get early advanced care

I have a cell phone. Check. I am trained in CPR, although my certification is almost certainly expired. Check. But, I had questions about defibrillation, specifically automated external defibrillators (AED).  More information from the Red Cross:

What is an automated external defibrillator (AED)?
An AED is a device about the size of a laptop computer that analyzes the heart's rhythm for any abnormalities and, if necessary, directs the rescuer to deliver an electrical shock to the victim. This shock, called defibrillation, may help the heart to reestablish an effective rhythm of its own.

How does an AED work?
An AED is easy to operate. It uses voice prompts to instruct the rescuer. Once the machine is turned on, the rescuer will be prompted to apply two electrodes provided with the AED to the victim's chest. Once applied, the AED will begin to monitor the victim's heart rhythm. If a "shockable" rhythm is detected, the machine will charge itself and instruct the rescuer to stand clear of the victim and to press the shock button.

Who can use an AED?
In most cases, EMTs and first responders (police and firefighters) are required to know how to use an AED as part of their job responsibilities. Furthermore, all 50 states now have AED Good Samaritan provisions that help protect laypersons. Contact your local or state emergency medical services ("EMS") department to find out about Good Samaritan protections that your state provides for users of AEDs.

Where can I find AEDs?
AEDs can be found in corporate offices, shopping malls, airports, sports stadiums, schools, community centers, and other places where large groups of people gather    and the risk of a sudden cardiac arrest incident is very likely. The number of devices in the community will continue to grow as more and more people begin to understand the importance of AEDs and AED training.

How can I buy an AED?
A physician’s prescription is needed in order to purchase most AEDs. This means that the medical director of a facility or a physician used by such facility must prescribe and oversee the AED program at any workplace or other facility that houses an AED. Some AEDs can be purchased over the counter without a prescription.

How much does an AED cost?
The cost of an AED varies by manufacturer and model. Currently, an average price for a single AED unit is about $2,300.

If an AED is so easy to use, why do I need training?
Training is necessary in order to understand the role of defibrillation in the broader context of the cardiac chain of survival. Training in CPR and AED skills    will enable the rescuer to use all the steps in the cardiac chain of survival, thereby significantly increasing the victim's chance of survival.

How can I get trained in the use of an AED?
Contact your local American Red Cross for a listing of training classes. The Red Cross offers half-day courses that include CPR and AED skills and comprehensive, daylong sessions that also include first aid. These interactive courses are taught by certified Red Cross instructors and use hands-on practice scenarios and videos that reflect a variety of situations. Each participant receives a skills card for use during in-class practice sessions. The skills cards can also aid in retaining skills after completing the course and serves as a quick reference tool in an emergency.

As you will remember, my original concern here was to identify what is killing so many young athletes, and Americans in general. Answer: Sudden cardiac arrest (SCA). Secondly, how can lives be saved? Answer: Automated external defibrillators (AED). Thirdly, what about those of us who like doughnuts? Answer: No evidence exists that doughnut-fasting will decrease your chances of falling victim to sudden cardiac arrest, but Harvard says doughnut indulgence could be your lottery ticket to a good old fashioned heart attack.