The University of Michigan-Flint has automated external defibrillators (AEDs) deployed in nine high-traffic areas throughout its campus. Sergeant Allen Cozart of the college's Public Safety Department is glad it does.
Cozart remembers hurrying through the door of the campus Recreation Center just in time to hear the audio prompt from an AED recommending a shock to restart the heart of a man who lay dead on the floor. The automated medical device then administered the treatment.
"I won't forget it to this day," Cozart says. "By the time I got up there, he was already reacting to the shock. That was awesome. Probably even more awesome was talking to the guy on the way out the door to the ambulance."
Every year, 365,000 people in North America die from sudden cardiac arrest, including 7,000 children and teenagers.
“The apparent increase of sudden cardiac arrest (SCA) on high school and college campuses, especially with athletes, was an important factor in our decision to deploy AEDs here,” says Koren V. Kanadanian, director of emergency management at the Office of Safety and Security at Providence College (R.I.).
Unlike a heart attack, sudden cardiac arrest gives little warning before it stops the normal heartbeat and the victim collapses on the spot. SCA strikes seemingly healthy people of all ages, even young athletes on the playing field.
The only treatment for sudden cardiac arrest is a carefully calibrated electrical shock from an automated external defibrillator to restore the normal rhythm of the heart. The battery-powered, laptop-sized device has audio prompts that can guide even an untrained adult user through a rescue. Two pads connected to the AED are placed on the victim's chest. Then, as Cozart notes, the AED determines if a shock is needed ? and administers it if appropriate.
The man who collapsed at the University of Michigan-Flint recreation center was lucky: Someone witnessed his collapse, and there was an AED close by.
Emergency medical services vehicles and many police cars carry AEDs, but all too often arrive at the scene too late to revive a sudden cardiac arrest victim. Studies show that a shock from an AED delivered in the first minute gives the victim a 90 percent change of survival but the survival rate falls by 10 percent with each minute that passes without treatment.
The availability of an AED within five minutes of a SCA incident greatly increases the survivability of a victim. Local EMS services typically can’t respond that quickly. Median response time is 6.6 minutes for emergency medical services in mid-sized urban communities. It’s even worse for the “typical” community where the average call-to-shock time is nine minutes.
Many states and municipalities are enacting legislation to require AEDs in public places and in schools similar to the requirement we now have for fire extinguishers. After all, for every one-fire death in the United States, 96 people die from sudden cardiac arrest.
More and more universities ? concerned not only about students, but about faculty, staff, and visitors at campus events ? are proactively developing AED programs.
The State University of New York, with more than 400,000 students, has placed AEDs throughout its 64 campuses. Washington and Lee University (Va.) and SUNY Albany and SUNY Buffalo have installed AEDs, as has William Penn University (Iowa) and many others.
Gary Parr, associate director of the recreation center at University of Michigan-Flint, told the campus newspaper that AED deployment could soon be the standard for campus public safety.
"The climate around the country is developing such that if you don’t have one in an institution like this, people are going to ask why not?" said Parr. "And they might drag us to court and say, ‘you should have had that. Why did you not have that?’"
Jane Horton, director of student health and counseling at Washington and Lee, emphasizes the public health aspect of AED deployment on college campuses.
“The AEDs make it possible for trained lay rescuers to provide immediate defibrillation to a victim of cardiac arrest, even before arrival of emergency medical services," Horton says. The results, she noted in a university news item, are dramatic: the survival rate following a cardiac arrest soars as much as 85 percent when an AED is applied immediately.
With improved early defibrillation efforts, 40,000 more lives could be saved each year in the United States alone ? that’s more than a cure for breast cancer.
With universities helping lead the way, it’s helpful to know what to look for in joining this movement. The best AEDs offer technology such as a “rescue ready” indicator that tells users if the device is ready to go and all of the elements are ready for a rescue. Every day, these devices self-test all of their major components. If anything is amiss, the status indicator on the AED should let you know about it.
“We looked for ease of use, good customer support, and durability when we chose our AEDs and we have counseled other universities who have asked us to look for the same qualities,” says Kanadanian. “Rescue ready technology and the ability to see if the device is set is important to us, it is one of the simplest ways to know the AED is ready to go.”
Providence College, by way of example, has 15 AEDs deployed across its campus, and similar to other schools they are in athletics areas, the fitness center, a pool, elderly housing, the student health center, in each of the school’s three security patrol vehicles, and with on-duty EMTs.
The next step will be to purchase one for each residence hall, Kanadanian says.
The device itself is only part of the solution. Experts advise finding an AED management system that will integrate with your general emergency preparedness planning and training schedule. Keep in mind some AED deployments are more complicated than others. Factors include the number of facilities on your campus, the type of classrooms and common areas available, and the turnover rate among campus staff. A web-accessible program management system can help maintain facility contacts, AED inventory, locations, serial numbers, and expiration dates.
You can also use program management services to maintain training rosters, certification dates, and employee training records. Look for a system that sends e-mail reminders to schedule training updates or order supplies.
Ultimately, while AED awareness improves, training and familiarization needs to keep pace. Set up a steady and regular program to ensure a well-trained group of employees and students who are comfortable with AED operation around the facility. These steps today may well save a member of your university community tomorrow.
Anastasia Mironova is the director of defibrillation for North America for Cardiac Science.
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