FRED does the Kokoda Track

Jason Hunter holding the FRED EasyPort on the Kokoda Trail

When Intensive Care Flight Paramedic and Staying Alive instructor Jason Hunter informed us he was going to complete the Kokoda Track, it seemed obvious we should provide a suitable Automated External Defibrillator (AED) to accompany him – the FRED® EasyPort.

The Kokoda Track saw fierce battles during World War II between the Japanese and Australian forces from July 1942 until January 1943. This was arguably the most significant of battles for Australia, for if the Japanese had captured Port Moresby, it is conceivable the Australian mainland would have been threatened. Over 625 Australians were killed and over 1000 were wounded during this campaign.

Over the past decade the Kokoda Track has become a pilgrimage for Australians of all ages. However, this is no easy stroll. The “Track” is 96km in length, and its elevation ranges from 300m to 2190m above sea level. Located in tropical jungle, the days tend to be hot and humid, and the nights can be bitterly cold.

As the number of Australians taking on this pilgrimage has increased, so has the number of deaths from Sudden Cardiac Arrest. In the past decade there have been 6 reported deaths whilst completing the Kokoda Track, with 4 in 2009. Sadly these deaths illustrate that Sudden Cardiac Arrest can strike anyone, at any age, of any fitness, at any time. The deaths include a 26 year old male, a 36 year old female and a 38 year old male.

FRED EasyPort, the world's smallest AED on the Kokoda Track

When Sudden Cardiac Arrest occurs, early CPR and defibrillation is critical. For every minute that defibrillation is delayed, there is a 7-10% reduction in the chances of survival. However most AEDs would be too large or heavy to to be considered a viable option to carry along this difficult and challenging terrain.

The FRED EasyPort is the perfect AED for this type of challenge. At a mere 490g including batteries, and 133 X 126 X 35mm it easily fitted into Jason’s pack at a time when weight and space were of the essence. It should be noted that unlike many trekkers, Jason did not use porters but rather carried his pack the entire length of the track himself.

For more information on AED programs and First Aid Training provided by Staying Alive please submit an enquiry.

Sharon Saves Mates Life

On February 1st, Sharon Neyland of JigsawFitness put into action what she had learnt during her First Aid courses with Staying Alive Paramedical Services. As a result she contributed  to saving the life of her friend David Priest when he collapsed in cardiac arrest at the Reservoir Velodrome.

The Diamond Valley Leader reports David had been feeling unwell and when he failed to respond to someone, Sharon recognised he was in cardiac arrest. Noting he was not breathing normally, was not responding or moving, she immediately commenced CPR.

Realising that early defibrillation was a key link in the chain of survival, Sharon arranged for a trainer to fetch the Automatic External Defibrillator (AED) from the neighboring Reservoir Leisure Centre. Mr Priest was shocked 3 times before Paramedics arrived.

Intensive Care Paramedic (MICA) Bradly Roberts states that without the early CPR and defibrillation that Mr Priest probably would not have survived.

Sharon and her fellow rescuers all received Ambulance Victoria Bystander Commendations last month.

Sharon and her fellow rescuers have clearly demonstrated how effective the Chain of Survival can be when used correctly.

Following instances such as this, Staying Alive offers all its individual and corporate clients a free clinical debriefing session.

Defibrillator Fails

Another AED failure has been reported in the USA.

According to the WTOP, a Hotel Executive suffered a sudden cardiac arrest in a gym in Washington. The gym had an Automated External Defibrillator (AED) but when rescuers attempted to use it they found that the batteries were dead and removed from the unit.

Despite the efforts of the victims friend and rescuers who performed CPR immediately, the victim died.

An autopsy revealed his death was caused by hypertension and atherosclerotic disease — a condition that blocks blood flow in the arteries, a spokesperson with D.C.’s Office of the Chief Medical Examiner tells WTOP. The manner of his death was natural.

Chances of Survival from Cardiac Arrest Vs Time to Defibrillation

It is unclear whether a working AED would have prevented his death. What is clear is that he did not receive the best chance of surviving due to the absence of a functioning AED. For every minute that passes before defibrillation, there is a 7-10% reduction in the chance of survival from sudden cardiac arrest.

The victims friend rightly points out that defibrillators are useless if not properly maintained.

“It is critical the batteries and pads are checked on a regular basis… your pads may be one or two years old and possibly even expired. It’s likely you never checked for an expiration date and that means those pads, once they get brittle and hard or deteriorate, may not work.”

The number of articles relating to AED failures is alarming. The majority of the time they are due to a lack of monitoring and maintenance by the owners.

Staying Alive prefers to sell AED programs rather than individual devices that include:

• an appropriate AED for your requirements
• Monitoring / maintenance
• Training
• Signage to ensure AEDs are highly visible.
• Clinical debrief in then event your AED is deployed

The FRED EasyOnline can be monitored by a central server ensuring it is monitored at all times; including battery levels, self check results, deployment, and event data download.

Werribee Districts Football Club Invest in AEDs

On May 8th 2011 a field umpire, for the under 9s match, Mr Steven Kelly 36 suffered a Sudden Cardiac Arrest. Luckily for Mr Kelly two bystanders at the match immediately administered very effective CPR until paramedics arrived with a defibrillator. According to the Whyndham Leader, Mr Kelly is due to be discharged from hospital this week.

As a result of that incident the Werribee Districts Football Club has invested in 2 Automated External Defibrillators (AED), one for each ground. Club President Mr Rod Harrington indicated that if the club didn’t act and purchase the defibrillators, then the club would have learnt nothing from the incident.

The club elected to purchase 2 FRED® Easy Online AEDs from Staying Alive Paramedical Services. Staying Alive specialises in AED programs, not just devices. The AED programs include:

• Site Assessment to advise requirement, type and appropriate location for AED
• Online monitoring to ensure the AED will always function when needed
• Accredited or Non-accredited training in Automated External Defibrillation
• Signage, pads, spare batteries, shears, CPR mask – all the items required to ensure the AED is ready when needed.

The rates of survival from Sudden Cardiac Arrest are as low as 6% in areas with no AED, and as high as 85% in areas with an available AED. As a result of their investment in AEDs, the Werribee Districts Football Club will be well armed should another person suffer a Sudden Cardiac Arrest at either of their grounds.

See the relevant media coverage at:

Football Umpire Collapses at Werribee Match

Werribee Footy Dads Lifesavers

A Heart Felt Response in Werribee

AED Donated Following Death of Football Player

SCHILLER Australia and Staying Alive Paramedical Services believe that more could be done to save lives of those impacted by cardiac arrest if public access defibrillators and appropriate training was provided to local sporting clubs and other places where crowds of people may gather.

In an effort to see this in action, representatives from SCHILLER Australia and Staying Alive Paramedical Services will travel to Silvan on March 22, to present Silvan Football Club with a much needed FRED Easy AED Online and provide the club with up to date first aid training.

“An immediate response to a cardiac arrest can be the difference between life and death.” notes SCHILLER Australia Managing Director, Harry Packer “CPR and defibrillation early triples a person’s chance of surviving.”
Sadly, 22 year old Vincent Bonanno was not given such a chance when he collapsed following a cardiac arrest during footy training at Silvan’s football ground, East of Melbourne over the weekend.

This need for immediate action action is why SCHILLER Australia and Staying Alive Paramedical Services have committed to donating their time and equipment to Silvan Football Club to ensure that if such an event occurs again the club and it’s players will be prepared and able to give their teammates the best chance of survival.

Tragically, sudden cardiac arrest among the young and fit are not uncommon during sporting events. A family in America also lost their 17 year old son whilst playing rugby near Denver in similar circumstances on the same weekend.

Staying Alive Manager and Intensive Care Paramedic, Craig Hazelwood reports that the chances of survival from sudden cardiac arrest decrease by approximately 10% for every minute that passes before defibrillation hence bystanders must take immediate action.
“The issue is that it is the first few minutes that are the key to surviving sudden cardiac arrest, before medical help arrives,” says Mr Packer.

Early defibrillation has been demonstrated to be the most effective method of saving a person’s life. New technology has made Automated External Defibrillator’s (AED’s) such as the one donated to Silvan Football Club simple and user-friendly. Clear audio and visual cues tell users what to do when using an AED and coach people through CPR. A shock is delivered only if the victim needs it.

If the Silvan football club had access to a defibrillator that can automatically deliver a precise electric shock to the heart to try to restore a normal heart rhythm, SCHILLER Australia and Staying Alive Paramedical Services believe Vincent’s chances of survival may have increased.

SCHILLER Australia and Staying Alive Paramedical Services would like to to offer their sincere condolences to the Bonanno family as well as members of Silvan Football club during this difficult time.

Changes To Basic Life Support 2011

Summary of major changes to Australian Resuscitation Council (ARC) Basic Life Support guidelines effective 1^st January 2011.

The Australian Resuscitation Council (ARC) has now published its revised resuscitation guidelines for Basic Life Support.  These changes reflect the most recent scientific evidence which was evaluated and recently published by the Australian Resuscitation Council.

The guidelines continue to emphasise the importance of commencing resuscitation and providing good quality CPR.  Resuscitation should be commenced where the person is unresponsive and not breathing normally. It is now recommended that at the commencement of resuscitation 30 chest compressions are provided before giving the initial rescue breaths. The compression / rescue breaths ratio remains at 30 compressions to 2 rescue breaths.

Key Points:

• Increase emphasis on bystander CPR as life saving intervention.
• Compression: Rescue breathing ratio remains at 30:2
• Steps in resuscitation are now DRS ABCD

–  Check for Danger

–  Check for Response

–  ‘S’ has been added for Send for help

–  ‘A’ directs rescuers to open the Airway

–  ‘B’ directs rescuers to check Breathing but no need to deliver rescue breaths

–  ‘C’ directs rescuers to perform 30 Compressions to patients who are unresponsive and not breathing normally, followed by 2 rescue breaths

–  ‘D’ directs rescuers to attach an AED as soon as it is available and follow prompts

• The major change is that in the patient who is unresponsive and not breathing normally, CPR commences with chest compressions rather than rescue breaths.
• If unwilling / unable to perform rescue breathing, then perform compression only CPR, as any attempt at resuscitation is better than no attempt and should be encouraged.

To AED or Not To AED?

Approximately 33,000 Australians die from Sudden Cardiac Arrest every year.¹ When cardiac arrest occurs, time is of the essence. It is essential that a person is defibrillated immediately following the onset of cardiac arrest. For every minute that defibrillation is delayed, chances of survival decrease by 7-10%. If defibrillated in the first minute after collapse, the victims chance of survival is approximately 90%, at 5 minutes it has dropped to 50% and by 10 minutes it is less than 5%.²

As Paramedics people often ask us if their organisation could justify the purchase of an Automated External Defibrillator (AED). They are often only looking at the financial investment (in the vicinity of $3000) and the probability that the device would ever be used. If the chances of the unit ever being used in the next five years is considered low, than often it is decided not to make the investment. Sadly this is an all too common scenario, and one that could cost lives.

It is true many units will never be used and will simply sit on a wall collecting dust. There is no sure way of calculating the risk of a sudden cardiac arrest occurring at your premises. A number of different formulas have been used and continue to be used, but they have not been validated in any robust scientific manner. Sudden Cardiac Arrests occur without warning, and can effect anyone of any age, and any fitness at anytime. So trying to calculate the probability of a sudden cardiac arrest at a particular location is a bit like predicting where lightning is going to strike next.

Whilst it is difficult to predict the chance of a Sudden Cardiac Arrest at a particular location, there is a growing body of scientific literature highlighting areas that are at higher risk. These areas include:^{3, 4}

• Mass transit areas (airports, train stations, large bus terminals)
• Large shopping centers
• Exercise Facilities (e.g. Gymnasiums)
• Sporting Clubs
• Golf Courses
• Medical Offices (GP & Outpatient facilities)
• Large industrial workplaces

So the answer is clear. If you are in any of the above industry types, there is an abundance of literature that indicates you are considered at high risk of a sudden cardiac arrest event. The literature also highlights the appropriate risk control – an AED. So the question should not be “can we justify the expense,” but rather can you justify not investing in an AED?

Organisations spend thousands of dollars on systems to protect their staff and customers (e.g. fire systems), and all types of insurance (building, public liability, worksafe etc.), so why not make an investment in what is proven life saving technology?

For an onsite assessment of your workplace contact Staying Alive Paramedical Services on 1800 789 593 or enquiries@stayalive.com.au

References

1. Cardiac Arrest Survival Foundation. http://cardiacarrest.org.au/sudden_cardiac_arrest (accessed 28 Feb 2011)

2. Resuscitation 2010; B1: e71 – e85. 2010 International Consensus on CPR

3. Rho RW & Page RL (August 2007) “The Automated External Defibrillator.” Journal of Cardiovascular Electrophysiology. 18: pp. 896 – 899.

4. Becker L, Eisenberg M, Fahrenbruch C, & Cobb L (1998) “Public Locations of Cardiac Arrest. Implications for Public Access Defibrillation.” Circulation. 97: pp. 2106 – 2109.

Why You Need an AED

Sudden Cardiac Arrest (SCA) can occur to anyone, at anytime regardless of age or physical fitness.

SCA is often confused with heart attack, but they are very different. A heart attack occurs when one or more of the hearts arteries become blocked. Sudden Cardiac Arrest occurs when the there is a problem with the electrical system of the heart that causes it to lose its normal rhythm and stop pumping. SCA usually occurs without warning and leads to death within minutes in over 95% of cases if appropriate management is not commenced immediately.

The immediate management of cardiac arrest involves the chain of survival:

• Early Access
• Early CPR
• Early Defibrillation
• Early Advanced Life Support.

Put briefly this means call an ambulance immediately, start CPR and defibrillate the patient as soon as possible. There is now overwhelming evidence that early defibrillation is critically important in the management of SCA and it is strongly recommended by all resuscitation authorities including the Australian Resuscitation Council.

Survival from out of hospital cardiac arrest within Australia remains at <10%. In areas with public access defibrillators survival from SCA has been reported as high as 70-90%. If a victim of sudden cardiac arrest receives defibrillation in the first minute following onset of SCA, they have approximately 90% chance of survival. For every minute delay to defibrillation, the chances of survival decrease by 7-10%. After 5mins the patient only has 50% chance of survival, and at 10minutes has virtually no chance of survival.

An Automated External Defibrillator (AED) is a device used to deliver electric shock (defibrillation) to patients in cardiac arrest and is designed for use by members of the community who have no medical training. They can now be found in sporting venues, schools, workplaces, and airports.

Whilst training in CPR and AED is highly recommended, AEDs can be used by anyone. Loud voice prompts coach the rescuer through the use of the device and ongoing resuscitation of the patient. As any delay to defibrillation significantly reduces chances of survival from SCA and AEDs are simple to use, AEDs should be placed in areas and appropriately signed so that any member of the public can access the machine quickly if required.

Watch the video to see an AED in action.

Contact Staying Alive Paramedical Services for all of your AED requirements on
1800 789 593.