EP Lab Digest - January 2008 - (Page 8) COVER STORY JANUARY AN AED FOR EVERY SCHOOL Continued from page 6 school that received their AED one day before a 13-year-old suffered from SCA. Now tell me you don’t believe in divine intervention! When you hear a story like that, it’s all worth it. We’ve had four children from Summit County who have died. We really don’t know why these incidents seem to be increasing. We know we’ve done a great job decreasing the number of sudden deaths in adults, but those in children seem to be increasing, though many of them are due to undiagnosed congenital heart defects. My mission in life now is to save our most precious resource: our children. There is no reason why we can’t do that. What would you say to convince people of the need for AEDs in schools? We’ve always told people that if they have an emergency to call 911. It is a very important thing to do, no doubt about it. CPR is also an important thing to do, but CPR alone doesn’t work as well as CPR combined with an early shock from a defibrillator. CPR can increase your chances up to eight percent (compared with no CPR), but with an AED anywhere from 33 to 50 percent of people will survive, and that has been well documented. A good study was done in a casino where they were monitoring people all of the time. The casino had about a 50 percent survival rate or more because these were observed events, the staff were able to get to the people right away, and they had the defibrillators on site. This is significantly important to note for schools located in rural communities; those children and individuals are at risk without an AED nearby, especially considering that many schools also double as community centers in rural communities. There was an elementary school in Ohio that decided during the first phase that they didn’t need AEDs in their elementary schools — it’s a well-known fact that more often it is in middle schools and high schools where children have cardiac arrests — but in this particular school the principal decided they didn’t need AEDs there. One of the parents gently coerced the principal into getting one, and reluctantly he did.Then on December 15 they were having a Christmas party and all 750 elementary schoolchildren were anxiously waiting for the arrival of Santa Claus, who jumped up on stage and had a cardiac arrest right in front of all these children. The paramedics arrived over 15 minutes later, and the AED that they really hadn’t wanted had in fact saved Santa. have AEDs; certainly in the state of Ohio they wouldn’t have to spend as much money! I believe the state of Texas has come up with $12 million to do the same thing, and I believe New York now has AEDs in all of their public schools. It will certainly be an arduous task but manageable, much as we’ve proven in the state of Ohio. Would each school have their choice of where to place the AED, or is there a particular location recommended for AED placement? We suggest that the AED be accessible to everyone in the school. The worst case scenario actually happened in one of our Ohio schools. A magnanimous philanthropist donated an AED to a couple schools and also to the local police vehicles. At one of the school’s basketball games, one of the players collapsed, and unfortunately the AED was locked in the principal’s office, still in its box, and no one had been trained in its use. Fortunately one of the cops who was on the scene ran out to his police car and got the AED that he had been trained on. Most AEDs are like a laptop in that when you open it, it starts talking, and when you shut it, it turns off. There were two nurses tending to this young man; the cop kept opening the AED and the nurses kept slamming it shut because it was making too much noise! Finally the cop implored the nurses to place the defibrillator patches on the kid and shock him, and save his life. Therefore, the worst thing you could do is place an AED in a school and not have it accessible or have awareness in the community that it’s there. Describe the legislation being introduced that would expand access to AEDs in schools nationwide. What does the legislation propose? How much would it cost to equip schools nationwide with AEDs? U.S. Rep. Betty Sutton (D-Copley Township) is crafting legislation as we speak; the goal is to obtain funding to place AEDs in every U.S. school (kindergarten through twelfth in all public, private, parochial, charter, and vocational schools) across the country. The legislation will be introduced in late December 2007. Of course, there are a number of schools that already than the paramedics. What this extrapolates into is that a person who is shocked by a police officer on scene has a 10 times greater chance of walking out of a hospital than if they were to wait for the paramedics. Of course this is no affront to the paramedics — we have the best paramedics in the world! The problem is that there are so few of them, so sometimes they might be on the other side of town, stuck in traffic, on another run, etc. Since there often are many more police vehicles on the streets all the time, it makes sense to put the AEDs in these vehicles. Smoke detectors, which are mandated to be in every building, save 6,000 people every year; we could save 10 times that — if not more — if we had AEDs everywhere. In addition, AEDs are so easy to use. There was a study that trained seventh graders and paramedics at the same time in the use of an AED, and I believe it took the seventh graders a whopping 29 seconds longer to figure it out. The algorithms that are in the AED are the same ones we use in the hospital, so if you don’t need a shock, the AED won’t deliver it. It’s a very safe device. How can others get involved in support of this bill? My advice is not to wait until the cardiac arrest occurs — don’t wait for a child to die and then go out and get the AED. I truly believe this program has to come from the national level. Certainly it will take a national mandate and funding, because schools cannot financially afford AEDs, nor can they afford to be without AEDs. When I first appeared before the Ohio Board of Education I told them “this will only cost 1 penny per student” and they almost laughed me out of the room, because they don’t have that penny.They are already cutting corners so much trying to give our children the best education possible with limited funds. Therefore, funding is an absolute, we must have the funding in order for this program to work on a national level. As a physician, one of the truly toughest things that I have had to do is look into the eyes of a parent who has lost a child to SCA. We must do something about these tragedies. AEDs definitely save lives, it’s that simple. As it is written in the Old Testament and the Koran, “if you can save one life, you can change the world.” We know we’ve done a great job decreasing the number of sudden deaths in adults, but those in children seem to be increasing, though many of them are due to undiagnosed congenital heart defects. My mission in life now is to save our most precious resource: our children. There is no reason why we can’t do that. What do you think will be the next step? Is there a similar program already in place to put AEDs in all public places in Ohio? There are public access to defibrillation (PAD) initiatives in place across the country. However, our goal is to get AEDs everywhere. The belief is if you can’t get to a patient and give them a shock within five minutes, then you need to have an AED on hand. That is why more schools certainly need them. In Summit County we’ve also raised money to put AEDs in every police, highway, patrol and sheriff ’s vehicles; the reason this is so important is that 80 percent of law enforcement responds to medical emergencies, and 60 percent of the time they arrive first.Therefore, they are often able to deliver the life-saving shock three and a half minutes quicker
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