A ccording to the Department of Labor’s Occupational Safety and Health Administration, 13 percent of workplace fatalities are caused by sudden cardiac arrest. OSHA also receives reports that about 400 workplace deaths result from sudden cardiac arrest occur annually. Most of these deaths occurred outside of the hospital; the current out-of-hospital survival rates are between 1 percent and 5 percent. These statistics seem to point to a very real need for increased and continued training in Cardiopulmonary Resuscitation and the use of AEDs, or Automated External Defibrillators. To help explain how this affects your workplace, this article provides answers to some frequently asked questions.
What is sudden cardiac arrest?
A normal heart beat is caused by rhythmic electrical impulses. An SCA (sudden cardiac arrest) is usually caused by arrhythmias or abnormal heart rhythms. The majority of SCAs are caused by ventricular fibrillation, which is a condition where the electrical impulses of the lower heart chambers suddenly become chaotic, causing the heart to stop pumping blood. Unless the heart returns to its normal rhythm, death occurs in a matter of minutes. SCAs are not predictable, with many victims showing no history of heart problem; they strike anyone, anytime, anywhere.
Is SCA the same as a heart attack?
No, a heart attack is the death of the muscle that makes up the heart. It’s caused by a loss of the blood supply to that part of the heart. The person typically has symptoms leading to the attack. SCA is an issue involving the heart’s electrical impulses.
What is the most recent treatment for SCA?
According to the American Red Cross, there are four critical steps, the "Cardiac Chain of Survival,” that should be used to treat SCA. The steps are as follows:
• Early access to care. Call 911 or Emergency Medical Services immediately.
• Start CPR as soon as possible.
• Defibrillate as soon as possible.
• Early advanced cardiac life support.
All the links help increase a victim’s survival rate, but defibrillation is seen as the most critical step.
What is defibrillation?
Defibrillation is the treatment for irregular, sporadic or absent heart rhythms. It’s an external electrical current that "resets” and returns an irregular or absent heartbeat to the normal rhythm. Defibrillation is most successful when done within 4 minutes of the collapse. An AED is a portable device used to defibrillate.
Are AEDs needed in the workplace?
One hundred fifty million Americans spend more than half of their waking hours each day at work. It makes sense that more lives will be saved by having AEDs in workplaces of all types. The Red Cross states that wherever groups of people gather, the risk of an SCA is likely.
Who can buy an AED?
U.S. Food and Drug Administration regulations state that in order to buy an AED, a doctor’s prescription is needed. Once the AED is purchased, the majority of states have a requirement for a medical director or medical oversight, but this varies by state.
Who should be trained to use an AED?
Proper training in CPR and AED are two crucial parts of successfully helping someone survive an SCA. Having more well-trained people in the workplace can help save lives.
Why not wait for EMS?
A victim’s best chance for survival is if CPR and defibrillation occur within 4 minutes of the collapse. Many times an EMS crew’s response time is longer due to congested streets or simply distances that the crews need to travel in rural areas. Also, not all emergency medical agencies are equipped with AEDs.
Some other important AED facts are these:
• It is not possible to give an unnecessary shock while using an AED. If the need for a shock isn’t detected, no impulse can be released and the device will indicate that CPR should be started.
• It is safe to use an AED on metal surfaces as long as the defibrillator’s electrodes aren’t allowed to come in contact with the metal surface.
• AEDs can be used in the rain and snow provided that neither the victim nor rescuer is in a puddle of water.
A situation arose in late 2011 that helps to illustrate just how important AEDs are at the worksite. An employee became pinned under a trenching machine that he’d been operating. The employee got off of the machine and was caught between the machine and the ground. The vehicle came to rest on top of the employee when the blade ran into a small curb pinning him to the ground. The weight of the machine rested on top of the victim.
Coworkers witnessed the accident and sprang into action, removing the machine from the employee and administering first aid and CPR, and using an AED that was available on site. The quick action of the other workers and their first aid, CPR and AED training literally saved this individual’s life. There is no question that this type of training is expensive to a company, but when faced with a situation like this, the benefits are truly immeasurable.
Diane Kelly is a safety specialist with Intec, Waverly, Pa. Intec is AWCI’s safety consultant.