Banner Payson Medical Center’s trauma coordinator and pre-hospital manager, Michael L. Ward, RN, CEP, recently made a presentation on AEDs in a Doc Talk at Banner High Country Seniors.
His primary advice: Always check for a pulse; if no pulse, use AED. Use AED for cardiac arrest (no heart beat). If someone doesn’t have a heart beat, they also need CPR.
Ward then discussed the evolution of using electrical shock to stimulate the heart. He said one of the earliest recorded devices was demonstrated in 1899 by Swiss physiologists Jean-Louis Prevost and Frederic Batelli. They confirmed that electrical shocks could induce ventricular fibrillation (a form of arrhythmia in cases of cardiac arrest) on dogs and then even larger shocks could restart their hearts.
A Popular Mechanics article from 1933, written by Dr. Albert Hyman and his brother Charles, who was an electrical research engineer, featured a machine that they called a “Self-Starter for Dead Man’s Heart” and compared the device to the self-starter of a car. When a car engine stalls, the starter motor turns it over until the cylinders were working again and in the same way the new device gave a shock to the heart to get it started again. It worked by inserting a needle between the ribs and into the right auricle of the heart and then starting a generator and cranking it to the right frequency.
Ward said the first recorded example of shocks being used to restart a human’s heart was in 1947 by U.S. surgeon Claude S. Beck. “The story goes that during a surgery on a 14-year-old boy, his heart stopped. Beck had a theory that the heart had the ability to start again even after it had stopped and had been working on a machine capable of delivering shocks to a heart. When the boy’s heart stopped, Beck ordered that his research unit be brought up from the hospital’s basement. The first shock failed to do anything, but when Beck tried a second time, the boy’s heart started again.”
In 1956 Paul Zoll demonstrated the first closed chest (external) defibrillation, with a machine an electrical engineer, William Kouwenhoven, had been working on since the 1920s. The external defibrillation was a much less invasive procedure and clearly less time consuming.
The next big step was in 1978 when the first Automated External Defibrillator (AED) was introduced.
“This invention really changed things because it included a process with instructions that over time became simple enough where a lay person could operate it,” Ward said.
He said the heart makes its own electricity — monophasic is basically DC current, it passes in one direction from one paddle to the next; biphasic is like an AC jolt, part of the shock goes from one paddle to the next and then reverses from the opposite paddle back; less energy is required for the same effect.
AEDs in Payson
In Payson, AEDs are typically found at the Mazatzal Hotel & Casino, Payson Police and Fire Departments and most grocery stores.
Every time an AED has been used in the casino in Payson, it has saved lives. The casino has a large number of cameras, so they see immediately when someone needs help and they have quick access to an AED.
Many of the AED’s come with the following:
• Scissors — this can be used to cut a woman’s bra so the metal in it does not arc.
• Razor — if the patient has a great deal of hair on their chest, where the patches adhere, this is used to quickly remove hair as it can prevent the electrical current from passing through the body.
• Barrier device.
After using an AED, you are advised to do CPR (30 compressions to 2 breaths), checking every 2 minutes for a pulse at the carotid artery (it’s between two muscles on the side of the neck, just feel on one side so as not to block the total blood flow. The sooner you can do CPR/use AED, the more likely it is that they will live.
It takes 3-5 minutes for the Payson Police Department to respond to a medical emergency, you are the first responder.
It is highly recommended that everyone take a CPR class. To find out when the next free CPR course is scheduled, contact the MHA Foundation at 928-472-2588 to register and borrow a workbook.