The functionality of an AED (Automated External Defibrillator) is complex. It evaluates the heart rhythm and delivers an electric shock to the heart when it unexpectedly stops. It’s no wonder that an American Heart Association study revealed that only 15 percent of people feel confident they could use an AED in an emergency.
However, using an AED is not complicated. In fact, it was designed so that anyone – a stranger, a bystander, a gym-goer, a parent at a soccer game – can administer a life-saving shock to someone that has collapsed due to sudden cardiac arrest (SCA). Response time in this situation is paramount – if CPR and an AED are administered within three to five minutes of the collapse, chances of survival is 70%.
It really is simple to use, no medical degree or formal training required. The internal computer walks the user through every step. It will tell you to call 911. Apply the adhesive pads. Then the AED will assess the heartbeat. If a shock is needed, the AED will instruct you to press the shock button. If the AED determines a shock is not warranted, it will tell you to refrain from shocking the collapsed person. This is important to remember, as many bystanders are reluctant to use an AED out of fear of harming the person. AEDs are 96% accurate at delivering a shock to someone that needs it, and 100% accurate at refraining from shocking someone that doesn’t. And if you’re still uneasy, the Good Samaritan laws will protect you from liability. To see how simple it truly is, watch a video by Medtronic and the Heart Rescue Project. It’s lengthy, but worth it.
Survival of sudden cardiac arrest is dependent upon bystanders taking quick action. The safest approach is to assume that any collapsed, unresponsive individual is in cardiac arrest and apply an AED immediately. The AED’s computer will then determine the status of the heart rhythm for you. This high level of suspicion and subsequent action helps minimize potentially fatal delays in the activation of care.
As a doctor with a vested interest in this topic, I wish we had a better preventive approach, so that AEDs weren’t necessary. Currently in the United States, high school athletes are screened for life-threatening heart conditions by medical history and physical exam. This approach is imperfect at detecting the majority of student athletes at-risk for sudden cardiac arrest. Undiagnosed conditions that can lead to SCA, like cardiomyopathy and long QT syndrome, often happen in individuals who appear healthy and physically fit. At Cincinnati Children’s Heart Institute, we’re currently conducting research to find better screening options, and partnering with local organizations for outreach efforts in the community.
Until we’ve found a better methodology for screening and prevention, sudden cardiac arrest is a reality for those at-risk. Having AEDs readily available (not locked), in good working order (batteries charged), and bystanders willing to use them, is a victim’s best chance of survival.