The CPR Problem

Here are the facts. According to the American Heart Association:

  • CPR within the first 2 minutes of sudden cardiac arrest can double or triple a victim’s chance of survival.
  • Only 32% of the time do victims of cardiac arrest receive bystander CPR.
  • Less than 8% of out-of-hospital cardiac arrest patients survive. (today’s chance of survival)
  • There are nearly 383,000 out-of-hospital sudden cardiac arrests per year (88% occur “at home”)

Based on these statistics (and some rough math…very rough math), 30,640 people survive out-of-hospital cardiac arrest each year (8% of 383,000). If CPR is delivered promptly, we can save an additional 30,640 to 61,280 people per year (“double or triple a victim’s chance of survival”), for a total of up to 91,920 saves (8% * 3 = 24% of 383,000 = 91,920).

This is great, so what’s the problem?

In a best case scenario, we’re saving UP TO 24% of victims. This is assuming quality CPR is delivered and that bystanders act. Of course, there are likely many other factors and assumptions in play that I’m omitting for purposes of simplicity.

As we know, studies have indicated that there is a 10% decrease in survivability for every 1 minute that passes after cardiac arrest. Some studies indicate a 90% chance of survival if defibrillation is delivered within the first  minute! (note: while unrealistic to assume AEDs could be applied within 1 minute of all SCA victims, just for fun, 90% of 383,000 is 344,700, over a quarter-million more saves than CPR alone).

Additionally, the AHA states that they train 12 million people annually. While prices for CPR training services vary tremendously, from “free” training donated by a fire department to high rates charged in expensive cities like New York or San Francisco, a (very rough) rate of $50/person “feels” like a reasonable mean (see our rates for drop in training).

$50 per person * 12,000,000 people = $600,000,000 dollars spent by the market in AHA training alone. The Red Cross, NSC, and other training organizations/curriculums add to this total.

Average price of an AED? Looking at the prices found on publicly available sites and leaders like www.aedsuperstore.com, $1,300 is a solid ballpark figure.

$600,000,000 spent on CPR training divided by $1,300 per AED = 461,538 AED units (if all funds were to be spent on deploying AEDs instead of providing CPR training services).

So the question (after all of this statistically-flawed math and these incongruous assumptions), would adding 461,538 new AED units to the United States market each year save more lives than the 30,640 lives we’re saving today? Perhaps it would. Perhaps it wouldn’t. But I can’t help but think that the ratio of dollars-spent-on-CPR-to-dollars-spent-on-AEDs has to adjust if we truly want to change the save rates in the United States. After all, CPR is just buying time for an AED to arrive….

A word of caution: I’ve completely over-simplified these figures and made horrible comparisons. In no way are we advocating for less CPR training. In fact, one of the most important aspects of CPR training is that we’re able to train the public in how to recognize the signs and symptoms of SCA and when to grab an AED. The point of this exercise is merely to think out of the box and look at extreme methods of possibly saving more lives. That is, are there better, more effective, ways to use today’s dollars? Let us know your thoughts, where we’re right, where we’re wrong, and if you have better solutions.

 

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Police Add AEDs to their Tool Belt

Officer Jeff Childers spearheaded an effort to acquire AED units for the Laurel Police Department. Childers and Chief Musson recognize the need for AEDs and the critical role that officers can play in rescues given that they’re often first on scene. More on the story by the Laurel Outlook.

The Laurel Police department decided to go with the LifePak CR Plus, made by Physio Control, the same brand used by local ambulance and EMS personnel. Childers enjoyed the fact that the units are compatible with other units in the area. Therefore, when paramedics arrive, they can simply plug the electrode pads from the “police” device directly into their professional equipment, saving vitally-important time.

As we’ve written in prior posts, AEDs for police officers (and everyone else) are great tools both on and off duty. Congrats to Officer Childers and the Laurel Police Department!

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New Defibrillator on the Market

A new defibrillator from Boston Scientific hit the market, eliminating a lot of the risks associated with “implantable” units. The leads of the device do not go directly into the heart but, rather, stay outside, eliminating many surgical risks and related complications.

In 2010, 97,000 cardiac defibrillators were implanted, according to the AHA, so the market seems large. Read more here. Of course, these devices are for people with known cardiac issues. An AED is the best tool for unknown issues to maximize protection.

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Upgrading Arch Servers

Over the weekend, on June 7, Annuvia will be upgrading our Arch servers to a new Xeon E3-1240V3 (quad core 3.4GHz) with 8GB RAM and 10TB Bandwidth. What does this mean in plain English? We’re adding new speed and storage so your Arch service will be faster than ever before. 

While we don’t expect any downtime to Arch, sometimes it can take 1-2 hours for these types of changes to be propagated around the world (“servers talking to servers”), so if you’re unable to access Arch in middle of the night this Saturday, please try a little bit later. Of course, if you run into any more substantial service disruptions, let us know by emailing support@onlineoversight (dot)com.

As always, if our new lighting-fast service spurs any ideas to help you manage your AED program, please let us know. We’re always looking for new ways to help improve our customers’ programs!

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Split Over CPR Training Mandate for IL Schools

While some are pursuing accountability over AED units and CPR training in schools, others are complaining about mandates as a whole. In a recent article by Mr. Jackson Adams of the Effingham Daily News, he’s uncovered a divide in perspective and perception over CPR/AED training mandates.

Some, like Jasper County Superintendent Dan Cox, seem willing to figure out opportunities to train students in his district. Others, like Superintendent Jeff Fritchnitch, are not thrilled about the idea, even indicating students can’t respond or, confusingly, are somehow going to be “(thrown) into a situation where they potentially have to make a life or death decision for another party.”

What makes Mr. Fritchnitch’s comments particularly confounding, especially in light of the fact that he is a “former EMT,” include:

  • Victims of sudden cardiac arrest are technically dead; treatment with an AED will only help the victim. You can’t make the victim “deader” than they already are and treating cardiac arrest isn’t a decision of “life or death.” It’s assuredly “death” if you do nothing and, possibly, “life” with action.
  • Providing training services isn’t a mandate to perform or act during an emergency, so its unreasonable to state that the students would be “thrown into a situation” and imply that they’ll suddenly replace first responders.
  • As I’m sure Mr. Frichnitch would attest from personal experience, there is a lasting effect to learning CPR. Learning CPR isn’t a one-time skill in which a student would have a finite window to help the public, after which their skills expire. Learning CPR and, particularly, recognizing the signs and symptoms of medical emergencies can last a lifetime. While the students in his district who (apparently) are unqualified to act today will become adults in the near future.
  • CPR classes offer much more than teaching breaths and compressions. Possibly the most important skill, statistically speaking, is to recognize SCA and to grab an AED. Without training, few students will even know what an AED is. With training, its possible that they’ll retrieve life-saving equipment. Oh, and Mr. Fritchnitch, AEDs are located in gyms, parks, airports, community buildings and elsewhere, not just schools. To think, possibly learning something practical that can be used outside of a scholastic environment; at one time that was the point of school in the first place….

Lastly, AED units and CPR training in schools do not just help students in need, but adults such as teachers, parents and others (superintendents?) visiting school campuses.

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PulsePoint Launches Crowd-Sourcing App to Gather AED Data

At the ECCU conference in Las Vegas, NV, PulsePoint launched a new app to help gather AED unit data (see here and here). The app uses crowdsourcing to maximize exposure and impact. Users of the app simply collect data by taking a picture of an AED and the data, such as the geocoordinates/location, and other important information is added to the local database. Emergency dispatchers review the information and approve the data so that new AED locations are added and made available to the public using the PulsePoint Respond app.

The app offers a great way to gather new data and strengthen the benefits of the PulsePoint product, connecting victims of Sudden Cardiac Arrest with citizen responders.

The only gap remaining, and an item that is covered by Annuvia’s Arch product, is the ongoing maintenance and management of AED units. Its easy to locate and find an AED, then add it to a database, but we need to make sure these devices are functioning properly. Arch does just this through ongoing communication with AED owners who regularly review and “check” their devices to make sure they’re in a readiness state.

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Vancouver Police Save Life with AED & Have Outstanding Grant for More

This brief article by Craig Brown of The Columbian helps explain why AED units in police patrol cars is a must. Often police are first on-scene during medical calls and, with the proper equipment, can accomplish the job of EMTs and Medics. That equipment, of course, are AED units.

Mr. Brown indicates that the department have 60 AED units in its patrol cars and have applied for a grant to buy 50 more for their other vehicles. I’m not sure if their grant application has been submitted, but I’d say that they should make sure this story is added to help bolster their case!

Couple interesting Facts:

  • They bought the AEDs in October
  • This was the first life saved
  • Officers have responded to “dozens” of such calls since the devices were purchased and have used the AEDs several times

Interestingly, Detective Robert Givens “was leaving the police’s West Precinct office…when he saw a man in distress lying on the sidewalk.” That is, this doesn’t appear to be a 911 call that an officer responded to but, rather, an officer who recognized someone in need and was carrying life-saving equipment.

Can’t anyone with an AED in their possession respond the same way, not just a police officer? Absolutely!

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Sidewalk CPR in San Diego

San Diego’s CPR and AED programs have been very successful for many reasons. AED manufacturer-funded sponsorship and the tireless efforts of City staff have been the primary drivers of widespread AED unit adoption. Awareness from the media, like this large event, have also really helped. Way to go SD!

If your community wants to learn more about how you can make a similar impact, let us know. We’d love to help!

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Investigative Journalist Focusses on AEDs in Schools

As you can read in this article, an investigative journalist in Jacksonville, Florida is on the hunt for AED units…or lack thereof. Reporter Jennifer Waugh is asking tough questions about the availability of AED units at schools in the Duval County Public Schools. It appears some schools have AEDs and others do not, and she wants answers.

Without strict laws that include punitive consequences for not having AED programs, we find many organizations simply decide not to buy and install them. As you can see here, the AED laws in Florida are some of the most progressive in the country, yet there aren’t any specific penalties stated for failure to comply. Similarly, after an informal survey of fitness facilities in California (a state with a requirement to deploy AEDs), we’ve found that as many as 60% of clubs visited DO NOT have an AED unit available; these poor rates despite a law requiring AED units.

Why the poor adoption? Because of the perceived cost and the lack of penalties and enforcement.

Ms Waugh is doing the right thing to bring attention to this matter. If the legislature lacks the back-bone to instill penalties for failure to comply with AED mandates across the country, reporters and others have a moral duty to bring attention and, perhaps, societal pressure to this matter. After all, a parent or gym member should know if a life-saving AED is available before sending a child to school or going to the gym for a workout.

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Uneasy Feeling About Some AED “Legal” Advice

Frequently, businesses, organizations, and even individuals are interested in acquiring life-saving AED units. Prior to purchase, as any astute person would do, they ask for legal advice and recommendations. The challenge, as you can read here, is that many attorneys simply aren’t aware of technology and solutions (such as Arch) that can help organizations easily meet a given state’s Good Sam protections. They read the state statutes and they briefly learn about what an AED unit is and does, but they don’t seem to offer advice as to HOW to accomplish a client’s goals.

My frustrations can be summarized as follows:

  • Attorneys rarely tell their clients HOW to do something they want to do (in this case, purchasing a life-saving AED).
  • Attorneys offer a high-level perspective of all the considerations and legal arguments. To which we respond: “Great…so…should we get one?”
  • In my experience, we can inform a layperson of all the considerations until our voice runs dry and no progress will be made because we’re not answering their question.
  • Attorneys come up with the 99 reasons not to do something, but rarely offer the one solution that might exist. This is done to cover their own hide.

This question could be answered in a much simpler manner.

“Yes. If you do certain things, like manage your AED per the manufacturer’s guidelines and aren’t negligent, you’ll be offered immunity protection. If you need help understanding the requirements or desire additional help, like how to “manage” your unit appropriately, there are cost-effective services to help. See: www.onlineoversight.com”

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