Most Americans don’t believe they could perform cardiopulmonary resuscitation (CPR) and use an automated external defibrillator (AED) to help save a life in a cardiac emergency, according to an American Heart Association survey.

Almost 900 people per day are victims of sudden cardiac arrest, says the AHA, and studies have shown that in cases when a person receives prompt CPR, combined with the use of an AED, they stand a much better chance at survival. The AHA says, if defibrillation is received within the first few minutes of a sudden cardiac arrest, up to 74 percent of victims can be saved as the AED returns the heart to normal rhythm.

An AED is a computerized device that delivers an electrical shock to return the heart to a normal rhythm.

In an online survey of more than 1,100 adults, 89 percent said they were willing and able to do something to help if they witnessed a medical emergency. Yet only 21 percent were confident they could perform CPR, and only 15 percent believed they could use an AED in an emergency.

More than half of those surveyed didn’t recognize an AED in a typical setting. Survey respondents reported lack of confidence, concern about legal consequences and fear of hurting a victim as reasons they would not take action in a cardiac emergency.

Despite efforts by the American Heart Association to raise awareness about the effectiveness of AEDs in treating sudden cardiac arrest, only about six percent of out-of-hospital SCA victims survive.

Without immediate, effective CPR, the chance of surviving out-of-hospital SCA decreases seven to 10 percent per minute. Even if CPR is performed, defibrillation with an AED is required to stop the abnormal rhythm and restore a normal heart rhythm.

“We think it’s critical for people to get CPR training and learn how to use an AED,” said Lance Becker, M.D., professor of emergency medicine at the University of Pennsylvania in Philadelphia and spokesperson for the American Heart Association. “CPR and AED use are inextricably linked in the SCA survival chain, and it’s crucial that bystanders take rapid action. If more people are trained and respond, we can save thousands more lives.”

The American Heart Association provides classroom CPR and AED instruction, as well as a self-paced CPR Anytime Kit that includes an inflatable manikin and instructional DVD. The association’s adult Hands-Only CPR educates untrained people to call 911 and push hard and fast on the center of an adult SCA victim’s chest until help arrives.

Designed to be simple and intuitive, AEDs are available in many public places such as schools, airports and workplaces and will guide the user through the process with clear, calm voice cues. The devices should be strategically deployed and maintained to ensure that they are ready in a medical emergency, and will not deliver a shock unless a shockable rhythm is detected.

“There’s no reason for people to be afraid to act,” Becker said. “We want people to feel confident that whatever action they choose — whether using an AED or performing conventional CPR or adult Hands- Only CPR — they are doing something to help, which could be a lifesaving decision.”

As soon as a victim is encountered and it is determined that they are unresponsive, three things need to happen:

• Someone calls 911 if a phone is available;

• Someone retrieves the AED if one is available;

• Someone checks for breathing and circulation and begins CPR if needed.

 That works fine if you have at least three people on the scene. If there are only two people, one calls 911 and gets the AED while the second begins CPR.

If you are all alone, you should do them all in the order listed even if it means leaving the victim: Call 911, get the AED, and then check for breathing. If the victim is not breathing, follow these steps to perform CPR with an AED:
• Position the victim on his back;
• Tilt head back and lift chin. Check for breathing for no more than 10 seconds; • If the victim is not breathing, give two rescue breaths;
• Check for signs of circulation. If there is no circulation, then the heart is not pumping;
• Turn on the AED and follow audio commands;
• Open the victim’s shirt and wipe his chest dry of sweat or water;
• Attach one pad to the victim’s upper right chest and one to the lower left side. The pads will be labeled with a picture of where they go.
• Plug the wire from the pads into the AED if they are not already attached;
• Make sure no one is touching the victim so the AED can analyze correctly;
• Push the ‘Analyze’ button or let the AED automatically begin its analysis. Just wait for the analysis to complete.

If the AED determines a shock is required:
• Keep everyone clear of the victim;
• Press the ‘shock’ button;
• Let the AED reanalyze.

If the AED determines no shock is needed:
• Check for a pulse.
• If you can not find a pulse and the victim is not breathing, perform CPR until the AED reanalyzes.
• If there is a pulse but no breathing, then perform rescue breathing and make sure the breaths raise the chest.
• If there is a pulse and breathing, place the victim in a recover position and monitor them.
• Once you have attached the AED to a victim, do not remove it. It will continue to analyze and if the victim lapses again, the AED will recommend a shock if needed. When Emergency Medical Services personnel are on the scene, they can remove it. FSM