Lisa was working through lunch to complete her monthly report on time. Her stomach growled with hunger. Craig lumbered past her. “ Pizza today, Lisa. You missed out.”
“Thanks a lot, Craig. I’m starving,” Lisa mumbled as she gathered her purse.
A loud thud came from Craig’s cubicle. Lisa froze. “Craig, what was that?” Silence. Lisa looked over the partition to see Craig on the floor. “Oh my gosh, Craig, are you OK?”
The first sign of sudden cardiac arrest is unconsciousness. The heart has an electrical malfunction and starts to quiver uncontrollably. This is called fibrillation. The heart is no longer pumping blood and oxygen to the brain, and it takes only a few seconds to pass out. For every 60 seconds without oxygen, chances of survival are reduced by ten percent. At nine minutes there is a ten percent chance of survival. After ten minutes survival is considered a miracle.
Providing CPR will circulate the blood and reduce the amount of brain damage, but the only way to stop this electrical malfunction is to shock the heart with a defibrillator. Portable automated external defibrillators (AEDs) are easy to use and available to place in offices.
Price of response
Starting an emergency response program costs some money and takes a little time. The cost of an AED in the U.S. is less than $2,000. CPR/AED training takes only a half-day. Installing a $300 wall cabinet will take less than 20 minutes. Every month someone will need to take five minutes and check the AED’s battery and complete a log. The electrodes will need replacing every two years at a cost of $100. Employees will receive emails about proper emergency response procedures. AEDs will be placed within four minutes of every employee on site.
Companies now have the ability to standardize their AED programs in all their locations. AEDs are available with instructions in all the major languages. CPR training is available in almost every country in the world.
Here are two possible endings to this story. In the first version, Lisa’s company did not have an emergency response program. No CPR training, no AED on site, no emergency procedures. Lisa called 911 from her cell, didn’t alert the receptionist, and no one provided Craig with CPR. It was seven minutes before the ambulance arrived; another two minutes before they found Craig’s cubicle. They used their manual defibrillator, shocking Craig several times before detecting a weak pulse. Craig was rushed to the nearest emergency room.
Did Craig survive?
He had only a ten percent chance of living, but without oxygen for nine minutes he would probably have moderate to severe brain damage. The current survival rate for sudden cardiac arrest in the United States is five percent. Ninety-five percent of victims die because they do not receive defibrillation in time.
In the second version, six months earlier, the safety and security department at the company sent out an email asking for volunteers for a new emergency response program. Lisa decided to sign up. She participated in a half-day CPR/AED class.
Lisa rushed over to Craig and checked for a pulse. She called to her coworkers. “Dave, call 911, let the receptionist know, and go meet the ambulance at the building entrance. Gayle, go get the AED out of the cabinet by the break room.” Employees had received an email about the company’s AED purchase and seen the device every day as they went to get coffee. Lisa started rescue breaths and chest compressions.
Gayle returned with the AED in a few moments and Lisa turned it on. The device verbally instructed her to remove all clothing from Craig’s chest and place the sticky electrodes on either side of his heart. The pictures on the electrodes were clear and she had practiced this on the mannequin in CPR class. As soon as the electrode pads were on, the AED started to analyze Craig for a heart rhythm. Lisa instructed the crowd to stand back. A voice from the AED boomed, “Shock advised. Stand Clear. Press Flashing Shock button now.” Lisa made sure no one was touching Craig and pressed the flashing button. Craig’s body moved slightly. The AED continued. “Shock delivered. Provide chest compressions and rescue breaths.” Lisa had just started to re-check Craig’s pulse when his eyes fluttered open.
“Craig, can you hear me?” Lisa asked.
“Pizza today, Lisa. You missed out,” Craig murmured. It had been less than two minutes.