Jolting a stopped heart back to life
You may have seen them hanging around campus, near stairwells or in lobbies. If you have, remember where they are – they might help you save someone’s life.
“They” are automatic external defibrillators, portable devices that administer a heart-starting jolt of electricity to the person in cardiac arrest.
In the time it takes you to read this story, a U.S. citizen will die from cardiac arrest. In the past year, 250,000 citizens died of sudden cardiac arrest, equating to one death about every two minutes. Up to one-fifth of cardiac arrest-related deaths could have been prevented if automated external defibrillators (AEDs) had been available for emergency use.
The portable defibrillator kits burst onto the medical scene after winning pre-market approval from the Food and Drug Administration in November 2004.
“PSU was part of a research study with OHSU – the Public Access Defibrillator program,” explained Gwyn Ashcom, community outreach coordinator for the PSU Center for Student Health and Counseling (SHAC). “[The program] placed AEDs in public locations, like airports and universities. They trained users, and followed the results. Coming out of the study, we were allowed to keep our AEDs, provided we maintained our own program.”
As a result of the Public Access Defibrillator program, over 100 PSU faculty and staff were trained in CPR and in the use of the 11 defibrillator kits placed around the PSU campus.
The AED is a portable device about the size of a laptop computer. When one of Portland State’s defibrillators is removed from its wall housing, an alarm sounds.
“That’s intentional,” Ashcom said. “Hopefully the alarm gets other people poking their heads out of their offices, and the rescuer will get some help.”
Each AED kit includes a mouth barrier device (for rescue breathing), two pairs of gloves, electrode pads and a back-up battery. Since hair must sometimes be shaved from the electrode site, the kit also includes a razor, scissors and a small hand towel.
Once the kit is turned on, voice prompts guide the rescuer in setting up the device and attaching electrodes to the victim. The defibrillator then acts as a cardiac monitor, assessing the patient’s heart rhythm and determining whether cardioversion – the jolt of electricity – is indicated.
If cardioversion is needed, the AED instructs rescuers to stand clear, and then orders them to push the button initiating the shock. Portable defibrillators are capable of delivering up to three shocks without recharging.
Together, defibrillator use and cardiopulmonary resuscitation (CPR) are the two tools that can save the lives of sudden cardiac arrest victims.
“Community training is really what this is all about,” said Diana Cave, a registered nurse and member of the Basic Life Support National Faculty. “Seventy-five to eighty percent of sudden cardiac arrests occur in the home. The average response time for 9-1-1 in Portland and surrounding communities varies from 4 to 8.5 minutes.”
“The use of skilled emergency care, including CPR and the use of an AED, can greatly increase the chance of survival after cardiac arrest,” explained Cave.
Cardiac arrest occurs when the heart either stops or exhibits a non-efficient quivering known as ventricular fibrillation. The only effective treatment for v-fib is cardioversion. Without cardioversion, the v-fib will eventually lead to cardiac standstill.
Although many cases of sudden cardiac arrest follow heart attacks, other causes are less well understood. Cardiac arrest can strike people of all ages and accounts for many of the sudden deaths that occur among trained athletes.
First responders (police, firefighters and emergency medical technicians) are trained in defibrillator use as part of their standard job responsibilities. Defibrillator training is now an integral aspect of CPR courses everywhere, where it is included as an add-on module within the class. Good Samaritan provisions in all 50 states protect laypersons using a defibrillator to rescue a victim.
Here on the Portland State campus, portable defibrillator s are located in Science Buildings I and II, the Stott Center, the Millar library, Lincoln Hall, the Public Safety building, Smith Center, the University Center building (inside the Center for Student Health and Counseling), the Urban Center and the Fourth Avenue building. Defibrillator locations have been designed to provide coverage within a series of zones.
“The idea is to have five or 10 people AED-trained in each zone area,” Ashcom said. “There are six zones on campus, and one or two AED units in each zone. If you’re on the PSU campus, you’re only a building away from an AED.”
Is defibrillator use safe for the rescuer? According to Ashcom, the devices should be kept out children’s reach. However they are safe when operated by an adult following the instructions, especially if the adult has received AED training.
“The training really helps – otherwise it can be a little overwhelming,” Ashcom said.
Many businesses and public facilities have their own defibrillators, indicated by a special decal on the front door or window. The decal shows a red heart with a white lightening bolt inside; above the heart are the initials “AED.”
Private citizens can also purchase portable defibrillators with a doctor’s prescription at a cost of $2,000 to $3,000.
Student Health and Counseling provides regular CPR-AED classes. Classes may be scheduled by calling 503-725-2800.
