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What's Better Than An AED At A Fitness Club?

by Greg Landin on 08/19/13

Fitness clubs (health studios for those here in California) have been identified as a prime place to have AEDs.  In fact, many lives have already been saved by the AEDs in those facilities.  Years ago, AEDs were required in these facilities by state law.  However, upon closer investigation we find that there are more needy venues in our communities.  

"Non-fitness-club" locations are proving to have a higher incidence of Sudden Cardiac Arrest (SCA) than in traditional gyms according to a recent study published in the Journal of the American College of Cardiology.  Dr. Richard Page, the lead author and chair of the department of medicine at the University of Wisconsin School of Medicine and Public Health cites the following:

"You've got higher site incidence at those three areas [indoor tennis facilities, ice arenas and bowling alleys in and around Seattle]. That's kind of interesting. If we're legislating AEDs to traditional fitness clubs, shouldn't they be legislated to the others?"

The Sudden Cardiac Arrest Foundation states that for the new study, Page and his colleagues used registries from King County in the state of Washington to see how many cardiac arrests occurred in public indoor locations between 1996 and 2008.

Overall, there were 865 cases during that time. Of those, 16 didn't include information about their locations. Of the remaining 849, 52 occurred at fitness or health clubs and 84 at alternative exercise facilities, including bowling alleys, ice arenas and tennis facilities. The other cardiac arrests occurred in other public indoor spaces, such as community centers.

Now, I did a GoogleMap search of the greater Seattle area looking for "fitness centers".  I saw so many red pins and dots on the map I could hardly see that it was Seattle.  My guess is no less than 350 or so. When I searched for the other non-fitness clubs mentioned I found roughly 20 ice rinks, 20 indoor tennis facilities, and over 80 bowling alleys.  

So even though the fitness centers out number the tennis/rink/alley locations by 3 to 1, these non-fitness-club locations had 32% more arrests overall during that period.  Those are pretty staggering numbers. And since California is the most bureaucratic state in the nation, I bet you we will be the first to require AEDs in all of the non-fitness-club locations around the state.  So next time you are on the dance floor or are at your local Chucky Cheese, keep your heart rate down and keep 911 on your cell phone's speed dial.  And to think one of the reasons I took up tennis was to stay healthy.

Lousy CPR Technique Saves The Day

by Greg Landin on 07/05/13

I was surfing the web this morning looking for videos that depict real-life CPRs in the pre-hospital setting.  I was looking for real rescues for our students to learn from, not the staged or simulated ones.  I think we are all tired of those.  As a result of my search I found two things, 1) There is very little out there to choose from and , 2) lousy CPR technique can still save the day...and a life.

For 30 years as a practicing paramedic, I saw many "interesting" ways of performing CPR.  Where some would most certainly never be capable of saving a life, others appeared to simply have flawed components. For instance, the person doing compressions on a patient while the patient was still trapped in the driver's seat of the vehicle.  Or the lay-rescuer doing compressions on a person with his feet uphill of the rest of his body. Or the person doing CPR so fast that I was sure that he would be our next CPR "code" to run.  Compressions or breaths too fast, too slow, too long, too short.  Even CPR on a cushy bed.  All of them seemed too flawed to save a life.

Yet after running thousands of codes, I am still in awe of what has the capacity to keep a pulseless/breathless patient in a state of readiness for a lifesaving defibrillating shock.  Even in these videos that I have been reviewing, the successful outcome catches me off guard.  

In our courses, after delivering the information and honing the skills, we have our students performing picture perfect CPR before exiting class.  But as we tell them before leaving class, should you ever be in the right spot, at the right time to begin a lifesaving rescue with CPR, don't focus on what you might have forgotten in class.  Focus on what you remember and do that as well as you can.  Because time as proven this to be true:  Even lousy CPR techniques can save the day.

What's an AED-Box-On-The-Wall Program?

by Greg Landin on 05/06/13

A friend of mine, Frank Pollafico (Emergency Training Xcellence in Philadelphia), once asked a group what was the difference between a Box-On-The-Wall AED program and a functional AED program.  I soon learned what the Box-On-The-Wall AED Program (BOTWAP) was when I was asked to see if I could help a local agency that had an employee suffer Sudden Cardiac Arrest (SCA) in their lobby.  Their underlying issue was that they had an AED just steps away from the incident, but the AED was never utilized in treating the arrest.  

Why wasn't it ever utilized?  The BOTWAP there included all of the necessary components:  An AED was purchased, some employees were trained, the AED was placed on the wall, time passed, the AED wasn't maintained, the employees were not retrained, the program was forgotten.  Sure, some safety person's checklist probably had "AED on the wall" checked off, but it served no useful function.  

Now we read in a recent study published in the journal Resuscitation that our schools are suffering BOTWAP as well.  After publishing the statistics, the article stated, "Most schools (84.2%) with AEDs reported that they had a training program, and personnel identified for its use. An AED was applied in 11 of 19 patients, of these 8 were in VF and 4 (all VF) survived to hospital discharge. Bystanders identified multiple reasons for non-use of the AED in the other eight patients." 

How do we treat BOTWAP? By having function added to our AED programs, and it starts with building AEDs into our culture, not just our checklists.  Everyone should be trained in CPR and AED, everyone should should know where the AED is located, that location should be in full view and well placarded, it should be deployed on all trainings (CPR, evacuation drills, MERT responses, etc...), and noted during the National CPR and AED Awareness week (June 2-8).   How many more lives could be saved by these simple and essential steps?

Cardiac Science Backorders

by Greg Landin on 04/16/13

I know that the current ability to obtain Cardiac Science AED's and supplies is severely hampered.  And I know that the delay in delivery can drive you mad, or maybe to another AED vendor.  However, I did speak directly with our "man on the inside" recently and I was reassured that things will soon be much better.  Cardiac Science Corporation recently sold off two of their medical device divisions which leaves just the AED portion of their business to focus on.  With this recent change, we can expect our issues to resolve themselves.  And hopefully CS can get the supply chain back into motion once again.  

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