Straight, No Chaser: Back From the Dead (aka The One Piece of Medical Equipment I Wish You Had in Your House)
Have you ever heard of an AED (automated external defibrillator)? Well, you’re about to. We’ve promoted CPR (cardiopulmonary resuscitation) a ton over the years, but recent recommendations place added emphasis on trying to literally shock patients back into consciousness. Thus, let’s start at the literal end of life, when you actually have a chance to save a life.
There are a couple of abnormal heart rhythms that suggest death is imminent. They’re called ventricular fibrillation (V-Fib) and pulseless ventricular tachycardia (V-tach). In these conditions, the heart is more or less quivering (V-Fib) or pumping too fast (V-tach) instead of giving off an optimal forceful beat. Effective beats pump blood (containing oxygen and nutrients) around the body you need to not only function, but to survive. Now, those two bad rhythms I just mentioned are unsustainable indefinitely, because without effective blood flow, vital organs such as the brain, lungs and ultimately the heart itself will give out within minutes, and that’s why you go ‘flat-line’ (aka asystole, aka dead, or soon to be). Even if you do survive, every minute these organs are starved of blood leads to damage that could be irreparable.
AEDs are designed to shock/stimulate the heart out of these deadly rhythms and back into an effective pumping state when possible (AEDs do not work for asystole, the flat-line rhythm.). The beauty of these machines is they are simple (and have been proven to be useable by untrained 6th graders), small/portable and if you pay attention, they’re all over the place. And even better: all AEDs used in the US talk to you and tell you what to do! My goal for you is simple: even if you can’t have one, know about them so you will think to use them if the opportunity presents.
Here are some frequently asked questions and answers regarding usage:
1) How do you connect it? AEDs have pads that need to be placed on the chest while staying attached to the machine. Instructions embedded on the machine will show you exactly where.
2) How does it know what to do? AEDs will detect the heart’s underlying rhythm and inform you if a shock is needed. Some machines will deliver it automatically; others will require you to press a button.
3) Are there limitations based on age? AEDs may safely be used on children and used by children. Appropriately sized pads must be used for kids.
4) Can I be sued for using this if the person dies? Users are protected by Good Samaritan Laws in case something (else) bad happens.
5) Should I own one? How expensive is it? I’d recommend one if you can easily afford it. I’d also recommend incurring the expense if you have a high-risk profile for heart disease and potentially fatal heart rhythms. This should be discussed with your physician. I paid $300 for mine, but you can pay up to $1100 for no good reason.
6) How long is it good for? You must be sure to stay up to date on the expiration dates on the components, most importantly the battery.
7) What should I do if the victim gets ‘back to normal’ after using an AED? Still call 911 and get to the Emergency Department for further investigation.
Of course the biggest question is “Do they work?” I’ll reference a study that reviewed effectiveness over two years of usage in Chicago’s Heart Start program, in which 22 individuals developed potentially fatal abnormal rhythms. 18 of these people met criteria to be treated by an AED. Of these 18, 11 survived. Of these eleven, bystanders with no prior training treated six.
I have an AED in my house and transport it in my family’s car because after all, I’m the one most likely to need it and benefit from it anyway (and I could shock myself, assuming I was still conscious). If it’s within your means, consider doing the same. It’s all about giving you the best opportunity to survive.