1

DEFIBRILLATORS

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DEFIBRILLATORS

Responding toSudden CardiacArrest

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DEFIBRILLATORS

All Other Cardiovascular

Total Deaths: 945,800

Sudden Cardiac Arrest

The Odds

Annual Deaths from Cardiovascular Disease – U.S.

695,800

250,000

American Heart Association. Heart Disease and Stroke Statistics - 2003 Update. Dallas, TX.:American Heart Association;2002.

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Common Causes of Death in the U.S.

1 http://www.americanheart.org2 http://www.cancer.org3 U.S. Statistical Abstract of the United States, 1998, Table 138.

House Fires (19981)

Prostate Cancer (20012)

Breast Cancer (20012)

Automobile Accidents (19963)

Total

SCA (annual1)

118,495

43,300

40,800

31,500

2,895

250,000

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680 patients per day(one every 2 to 3 minutes)

80% out-of-hospital

50% of men, 63% of women, have no prior symptoms

95% die without very early treatment

< 5% survive

The StakesAnnual Sudden Cardiac Arrest (SCA) Events – U.S.

American Heart Association. Heart Disease and Stroke Statistics - 2003 Update. Dallas, TX.:American Heart Association;2002.

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STEREOTYPE REALITY

Male

Old

OverweightSmoker

High cholesterol

Chest PainDizziness

Heart Attack

Male and Female

Any Age

Often No Clear Risk Factors

Often No Cardiac History

Often No Symptoms

Gender

Age

RiskFactors

MedicalHistory

PresentingSymptoms

SCA Fiction vs. Fact

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Recovery prospects for survivors are high

80% alive at one year

57% alive at five years

SCA deaths prevented annually*

Total SCA Events: 250,000

The Benefits of Early Treatment of SCA

100,000

*estimated

American Heart Association

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The Heart Pump: a series of events...

• An electrical event …

• stimulates a mechanical event …

• which results in a rhythmic and coordinated pumping action of the heart muscle

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Sudden Cardiac Arrest: A Heart in Distress

• Uncoordinated, very fast heart rhythm – Ventricular fibrillation (VF)– Some ventricular tachycardias (VT)

• Ineffective heart pump• Unconscious, no breathing, no pulse• Death certain without defibrillation

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What Is Defibrillation?• Electric shock to the heart

• Stops uncoordinated activity

• Allows coordinated heart rhythm and pumping action to resume

• Only effective treatment for ventricular fibrillation

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Adapted from the American Heart Association

Chain of SurvivalDefibrillation an EARLY priority

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0

20

40

60

80

100

1 3 5 7 9

10

30

50

70

90

0 8642

Chances of success are reduced 7% to 10% each minute

Chances of success are reduced 7% to 10% each minute

Why “Early” Treatment?

Time (minutes)

% S

ucc

ess

Cummins RO, et al. Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care (ECC, Circulation (Suppl) 2001;102:8, August 22

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Early CPRVery Early

DefibrillationEarly ACLS

Early CPREarly

Defibrillation

No CPRDelayed

Defibrillation

minutes 2 4 6 8 10

?

survive

CPR ALSDefibrillation

20%

survive

CPR Defibrillation

0 - 2%

survive

Defibrillation

Early CPRDelayed

Defibrillation

2 - 8%

survive

CPR Defibrillation

Survival Rates

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What Happens When You Call 911?

*Travel time varies depending on weather, traffic, distance (vertical and horizontal), and ambulance (with defibrillator capability) availability.

**Cummins RO, et.al. Automatic external defibrillators used by emergency medical technicians: a controlled clinical trial. JAMA. 1987; 257:1605-10

Identify emergency/ Activate emergency response plan 30 seconds

1911 call minute

Alert ambulance and rescue squads (dispatch) 30 seconds

Responders to their units 30 seconds

5 minutes*Travel time to location

Unload equipment/ Distance to patient 2 minutes

Assess patient/ Apply defibrillator/ Deliver shock 1.1 minutes**

TOTAL 10.6 minutes

Bes

t C

ase

Sce

nario

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Low-maintenance

Uniquely small, lightweight and rugged

Safe, effective,and easier than CPR

Designed for lay rescuer

Expand lifesaving opportunities

AEDs to the Rescue

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HeartStart FR2+ Defibrillator

OPERATION

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Verify SCA

not breathing normallyunresponsive

• Assess ABCs

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Using the HeartStart FR2+

1

2

3

• Turn on defibrillator.

• Apply pads to patient and plug in connector.

• Deliver the shock.

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HeartStart OnSite Defibrillator

OPERATION

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Verify SCA

not breathing normallyunresponsive

• Assess the victim

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Using the HeartStart OnSite

1

PULLgreen handle

PLACEpads on chest

PRESSshock button

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• Cannot make things worse• HeartStart Defibrillators designed to shock only when needed• Product indemnification policy• Good Samaritan laws, AHA standard of care

– Possible reverse liability

What if the victim has a pulse and I can’t feel it?

What if the victim has a pulse and I can’t feel it?

Can I hurt someone using the

defibrillator?

Can I hurt someone using the

defibrillator?

Is there legal liability?

Is there legal liability?

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DEFIBRILLATORS

What happens if I reverse the

pads?

What happens if I reverse the

pads?

Can I defibrillate

a child?

Can I defibrillate

a child?

Can I defibrillate on water, snow, ice or metal?

Can I defibrillate on water, snow, ice or metal?

• Analysis & therapy not affected by pad reversal• OK to defibrillate on water surfaces and metal

– Standard safety precautions

• Using HeartStart FR2 and OnSite Defibrillators is acceptable < 8 years old with Infant/Child pads

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• Early defibrillation programs have already demonstrated success by saving lives in a variety of environments

Sudden Cardiac Arrest DOES Happen

Las Vegas (Clark County), Nevada

• On-site Early Defibrillation Programs enhance 9-1-1 EMS systems… resulting in more lives saved

• Rapidly becoming a standard of care

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The Ultimate Reward

Jerome Fuentes

Bob Adams

Bridgette McDonald

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AHA Guidelines 2000 for CardiopulmonaryResuscitation and Emergency Cardiovascular Care Textbook.

“Public Access Defibrillationhas the potential to be the

single greatest advancementin the treatment of

prehospital SCA deathsince the development

of CPR.”

Something to think about