New AED Sign and Poster

The British Heart Foundation and Resuscitation Council have developed a new AED location sign and supporting information poster.

New AED Sign and Poster

The new sign and poster have been created to reinforce the following key messages:

  • Anyone can use an AED – you do not need prior medical or first aid training
  • It is easy to use – just follow the instructions
  • It is for use on an unresponsive person not breathing normally

The new AED sign, supporting poster and information can be found on the Resuscitation Council website.

Training on Defibrillators to be included on the EFAW and FAW Syllabus

Changes to Resuscitation Council UK guidelines on cardiopulmonary resuscitation (CPR) in October 2015 mean that HSE will now be revising the Emergency First Aid and First Aid at Work syllabuses.  The revision will require all workplace first aiders to be trained in the use of an automated external defibrillator (AED) from the 31 December 2016, as the Resuscitation Council UK guidelines now state that the management of a casualty requiring CPR is to request an AED.

It is sensible to ensure that EFAW and FAW first aiders are trained in AED use as they are now available within many workplaces and public spaces.  There is good evidence that the early use of an AED has a far more beneficial outcome for the casualty than if that intervention is delayed.

For employers this does not mean you have to purchase a defibrillator for your workplace as the requirement for a defibrillator is still dependent on your needs assessment.  Neither do you have to retrain all your existing first aiders as they will be updated in this skill when they requalify.

For those who deliver EFAW and FAW training the change means that you should ensure that students are trained and assessed on how to use an AED from the 31 December 2016 within the existing timeframe allowed for the delivery of either EFAW or FAW training.  HSE has no objection if training providers wish to adopt this change before the 31 December.

Lifesaving Defibrillators Often Behind Locked Doors, Study Finds

Devices that shock heart rhythm back to normal were not available 25 percent of time in emergencies

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Public defibrillators can help anyone save the life of someone suffering cardiac arrest, but the devices are often kept behind locked doors, a new study finds.

At issue is the accessibility of devices called automated external defibrillators, or AEDs. They are portable, layperson-friendly versions of the devices doctors use to “shock” the heart out of cardiac arrest.

It’s now routine for paramedics to carry AEDs, and the devices are often available in large venues, such as airports and sports stadiums, as well as schools and private businesses. To live up to their full potential, though, those devices have to be readily available, said study author Timothy Chan, a researcher at the University of Toronto.

However, his team found, that’s often not the case. The researchers looked at the cases of 451 Toronto residents who went into cardiac arrest within 100 meters of an AED — about a football field’s distance. One-quarter of the time, the devices were behind locked doors. “If the AED isn’t accessible, it’s as if it’s not there at all,” Chan said.

The study found that AEDs in schools, office buildings, industrial sites and recreational facilities were most likely to be locked up, particularly at night or on weekends — which is not surprising, Chan noted, since such buildings are not open 24/7. Unfortunately, two-thirds of the cardiac arrests in this study occurred at night or over the weekend, Chan said.

He was to present the findings Sunday at the annual meeting of the American Heart Association, in Orlando, Fla. The data and conclusions should be considered preliminary until published in a peer-reviewed journal. The findings “ring true,” according to Dr. Clifton Callaway, an AHA spokesperson and a professor of emergency medicine at the University of Pittsburgh.

“One of our longstanding concerns is that AEDs are not always in locations that are clearly marked, or that people are aware of,” Callaway said. It makes sense, he added, that AEDs would also frequently be inaccessible — particularly those owned by private businesses. “A lot of businesses would buy these with their employees in mind, and not for the general public to use,” Callaway said.

He said local communities need to come up with “novel ideas” on how to make AEDs broadly available, and make sure that people know where the devices are located. There is work being done, both Callaway and Chan said. The PulsePoint Foundation, for example, has developed a smartphone app that allows users to locate local AEDs. Chan said companies are also working on ways to make AEDs available outdoors, in weatherproof, vandalism-proof containers.

But more innovation is needed, according to Chan. One possibility, he said, would be to bring banks on board and have AEDs available in ATM lobbies. In Japan, Chan noted, there are AED vending machines.

AEDs can be used to restore a normal heart rhythm in some cases of cardiac arrest. Most often, cardiac arrest occurs when the heart’s main pumping chamber stops contracting and begins to quiver chaotically — depriving the body of blood and oxygen. Without prompt treatment, it’s fatal within minutes.

Each year in the United States, about 360,000 people suffer cardiac arrest outside of a hospital, according to the AHA. Less than 10 percent of those people survive. The odds of survival do improve, however, if bystanders perform chest compressions or use an AED while waiting for paramedics to arrive.

Chan said it’s not clear how AED availability might have affected the survival of patients in his study. Callaway also pointed out that increasing AED availability is just one piece of the picture. The public also needs to know that the devices exist, and be comfortable using them.

Local CPR courses now include AED training, Chan said. But even without training, he added, anyone can use an AED: The devices automatically analyze the heart’s rhythm, then deliver a shock only if it’s appropriate.

Chan pointed to a widely reported study of “mock” cardiac arrests, where researchers found that untrained sixth-graders used AEDs almost as well as medical professionals did.

More information

The American Heart Association has more on cardiac arrest.

SOURCES: Timothy Chan, Ph.D., research chair, novel optimization and analytics in health, University of Toronto; Clifton Callaway, M.D., Ph.D., professor, emergency medicine, University of Pittsburgh Medical Center; Nov. 8, 2015, presentation, American Heart Association annual meeting, Orlando, Fla.


First Aid and Defibrillator Training for Devro plc

Mike and Duncan recently delivered a 1 day Emergency First Aid at Work (EFAW) and Automated External Defibrillator (AED) course for Devro plc in London. The feedback from the staff involved included comments of how easy it was to use the defibrillator, especially from people who had never used it before and had no previous training.

Devro have recognised the need for a defibrillator at both their London and Glasgow sites for a few years now. They have received defibrillator training from Abacus Training for a couple of years. Devro London decided that they wished to expand on this and train as many of their London based staff in basic first aid as well.

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Half of people not confident about administering CPR, survey finds

About half of people in Scotland do not feel confident administering CPR if needed in an emergency, a survey has found.

Fear of causing an injury (22%) and lack of skills (19%) were the top reasons, closely followed by being put off by visible vomit or blood (19%) and indications the person is a drug user (16%).

A fear of being sued (8%) or catching a disease (10%) were also cited in the out-of-hospital cardiac arrest (OHCA) report by the Open University for the Scottish Government.

The study was set up to explore ways of improving people’s understanding and knowledge of emergency CPR.

It states that survival rates from OHCA in Scotland currently stand at 5% and those who receive CPR from a bystander before professionals arrive are “far more likely to survive to hospital discharge than those who do not”.

The survey of more than 1,000 people found 77% think everyone should be CPR trained but just 52% are.

Of those trained, 44% did so over five years ago and just 28% within the last year.

The majority of respondents who were CPR-trained received it because it was a requirement of their employment or was offered to them through voluntary work.

The study found that the older a person is, the less likely or willing they were to be CPR-trained.

The report said: “These findings are particularly relevant considering that most OHCA happen in the homes of older people.”

Employment was also an influential factor identified among people who had CPR training.

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Resus Council Guidelines 2015

DSC_0077_smThe 15th October was the date that the 2015 Resus Council guidelines were updated. This happens every 5 years, so will be due again in 2020. There were quite a number of changes made in 2010. There appear to be very few changes in the 2015 guidelines.

The first thing to pick up appears to be that there is no emphasised shout for help as part of the response check.

There is no change to the airway section, with jaw thrust still being something that is not recommended for first aiders.

The breathing check has very little change to it, although it does go straight in to what to do if the casualty is not breathing, no mention is made of what to do with a breathing casualty.

After finding a casualty with no breathing, emphasis is placed on sending for an AED (Automated External Defibrillator) and calling for professional help (999/112). If an AED is available, it is recommended that someone should be sent to fetch the defibrillator, if it is a lone rescuer, they should start CPR. It is suggested to use the speaker-phone if calling from a mobile phone, so that the rescuer has both hands available to them.

When moving on to compressions, the wording has changed slightly, the depth of compression is still 5-6cm, but no more than 6cm. There is also emphasis placed on full recoil of the chest to allow the heart to refill with blood.

Those that are trained in CPR/BLS should perform breaths/ventilations if it is safe and they are able to do so. Compressions only CPR should be performed by those that are not trained or, if for some reason, you are unable to do the breaths/ventilations.

The full 2015 Resuscitation Guidelines and posters are available here.

The tale of the dog behind the ‘kiss of life’ discovery – BBC News


There are about 30,000 cardiac arrests every year in the UK and ten times that number in the US. It is one of the most common ways to die.

It is also one of the most common scenarios in which a bystander can save a life through CPR or cardiopulmonary resuscitation, the technique used to keep blood and oxygen pumping round the body until emergency help arrives.

This ‘kiss of life’ has an intriguing history stretching back over 100 years to when electricity was first being installed in domestic homes and, in part, it owes its discovery to the fate of an unnamed lab dog.

Throughout the early 1900s an electrical revolution hit America, and homes became populated with electrical appliances – everything from light bulbs to refrigerators.

But, on the down side, electrocution was a major risk to people working on the newly-installed power lines. Many died of cardiac arrests. As a result, external defibrillators had been invented to shock the heart back into rhythm without opening the chest – but they were too big and cumbersome to use outside of hospitals.

In the 1950s, the Edison Electric Institute in the US decided to sponsor researchers to investigate the effects of electrical currents on the heart.

Enter Guy Knickerbocker, a fastidious, 29-year-old graduate working under electrical engineer William Kouwenhoven in one of the labs at Johns Hopkins University in Maryland. They were trying to improve the external defibrillator, which Kouwenhoven had invented a few years earlier.

In 1958, before the ethical treatment of animals became a serious consideration, their experiments involved testing on laboratory dogs.

Knickerbocker, now 86 years old, remembers working with a colleague one day when, suddenly, one of the dogs went into cardiac arrest, or ventricle fibrillation (VF). Thanks to a unnamed dog, Knickerbocker and his colleagues discovered how to slow down the dying process in the 1950s. Normally when this happened, they would use a defibrillator to shock the dog’s heart back into rhythm – but that day they were in the lab on the 12th floor and the equipment was on the fifth floor. The notoriously slow lifts in the building meant they would never get the defibrillator to the dog in time.

“There is very little chance of survival after cardiac arrest that goes on longer than five minutes,” says Knickerbocker. Knickerbocker had a brainwave. Only a few weeks earlier he had observed that just the pressure of the defibrillator paddles on the dog’s chest caused a change in blood pressure. Did this change in pressure mean that the blood was moving around the body?

He took a chance: “We started to pump the dog’s chest because it seemed to be the right thing to do.”

Knickerbocker raced along the stairs to the fifth floor to get the defibrillator while his colleagues pressed the dog’s chest for 20 minutes – four times longer than any previous successful attempt. When he arrived back with the defibrillator and administered two shocks, the dog sprang back to life.

The importance of their discovery cannot be overstated; the experiment established beyond doubt that rhythmic pressing of the chest could sustain life. Knickerbocker says: “We had found a way to slow down the dying process, and give people time to receive defibrillation”. Knickerbocker excitedly shared his discovery with cardiac surgeon, Dr Jim Jude, who worked in the next-door lab.

Dr Jude immediately realised its potential, and along with Kouwenhoven, set about working out exactly where to push, how often, and how much force to apply – and found they could extend a dog’s life for more than an hour.

“I didn’t believe the chest compression technique would ever translate to humans, and neither did a lot of my colleagues,” he says today.

This included the head of surgery at Johns Hopkins at that time who wanted the team to provide a lot of evidence before he let them publish their findings. However Dr Jude was convinced the dog-saving technique could work on people.

The chest compression technique, he realised, could be used to simulate up to 40% of normal cardiac activity. The only problem was that there was no-one to test it on.

A little over a year later, a 35-year-old woman, who was admitted for a gall bladder operation at Johns Hopkins, reacted badly to the anaesthetic and went into cardiac arrest.

Dr Jude immediately began applying rhythmic, manual pressure to her chest. Within two minutes her heart started again and she went on to have the operation and make a full recovery. This led Kouwenhoven, Jude and Knickerbocker to publish their discovery in a paper in 1960. “Anyone, anywhere, can now initiate cardiac resuscitative procedures,” the authors concluded. “All that is needed are two hands.”

In collaboration with another research group who were looking at ventilation techniques, they developed modern CPR. Now it is taught across the world and in some countries it is also taught in schools. The American Heart Association estimates that CPR provided immediately after sudden cardiac arrest can double or triple a victim’s chance of survival.

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Film reconstructing how a defib saved a man’s life aims to encourage more groups to install them


A VIDEO reconstructing how a man was saved by a heart-starting defibrillator will be used to encourage more organisations to install the life-saving machines.

Ian Hough features in the video, called Pulled Through, produced by drp Video for West Midlands Ambulance Service. The film shows what happened to him when he suffered a cardiac arrest.

Mr Hough is a rower but his heart stopped during a regatta at Stourport Boat Club on August 13, 2011.

The club had no defibrillator but luckily there was medical cover on site for the event and the medics leapt into action, using their own machine to re-start his heart in the vital few minutes before paramedics arrived.

Mr Hough, 59, made a full recovery and continues to row – but he says without the defibrillator he firmly believes he would not have lived to see his daughter or granddaughter again.

He said: “I was dead for seven minutes.

“Had this happened on a normal day I would be dead.

“A cardiac arrest can happen to anyone at any time and in any place. I was lucky it happened during the regatta when a defibrillator was on site.”

Stourport Boat Club has since installed a machine, as have a number of organisations across the country, including many in Stafford, Stone and Rugeley. The public access defibrillators provide instructions on what to do in an emergency and can save lives.

Ambulance bosses hope the video will encourage even more organisations to do the same.

Cliff Medlicott, from the service, said: “I would encourage as many people as possible to see the film. It is a compelling reconstruction of what happened.”


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Study shows public access defibrillators are increasing survival but are not being used enough

New research presented at this year’s Euroanaesthesia shows that use of public access defibrillation on people suffering cardiac arrest is associated with a large increase in chances of survival. However, despite the great potential, publicly accessible Automated External Defibrillators (AEDs) are not being used enough, concludes research by Dr Marianne Agerskov and colleagues at Rigshospitalet, University of Copenhagen, Denmark.

Publicly accessible AEDs are now commonplace in many European countries, and they are often found in sport centres, transportation hubs, and other public places. In Denmark, an online network owned by the foundation TrygFonden, contains detailed information about AED location and accessibility on all AEDs voluntarily registered in the network by AED owners. The Emergency Medical Dispatch Centres (EMD) across the country are linked to the network, enabling them to refer cardiac arrest witnesses to the nearest accessible AED. The network has provided a unique opportunity to assess the use and effects of public access defibrillation in Copenhagen.

In this study, the authors determined: (1) the proportion of AEDs applied to out-of-hospital cardiac arrest (OHCA) victims before arrival of the ambulance; and (2) the proportion of AEDs referred to by the EMD. When the dispatcher at the EMD suspects a cardiac arrest, they are able, through the network, to refer the witness to/explain on the phone where the nearest accessible AED is. The research team also assessed 30-day survival and characteristics of OHCA-victims.

The researchers identified a total of 521 patients with OHCA from the Mobile Emergency Care Unit and the Danish Cardiac Arrest Registry between 2011 and 2013. They obtained Electrocardiogram-downloads from all applied AEDs. Information regarding AED-referral by the EMD was obtained from the nationwide AED Network.

An AED was applied to an OHCA-victim before ambulance arrival in 20/521 (3.8%) cases, and 13/521 (2.5%) OHCA-victims were defibrillated by an AED. To explain further: an AED was applied in 20 cases of cardiac arrest, but the AED only defibrillates (delivers one or more shocks) when it registers a “shockable rhythm”. In case of cardiac arrest, the heart either has some “electricity” left, which means the muscle is still working, but in an unsynchronised way, so that it can’t deliver blood to the rest of the body. In that case, a shock delivered by a defibrillator sort of “resets” the heart so it again beats synchronized. In other cases, the heart has an unshockable rhythm which means no electricity and it can’t be defibrillated by an AED, the only chance to get the heart beating is by performing chest compressions and hope that the heart will get some electricity so that it can be defibrillated. An AED only works when it can deliver a shock, and the data in this study showed that an AED was actually valuable in the 13 out of 20 cases where it was applied, underscoring their eligibility. Thirteen of the 20 people who had an AED applied had a shockable rhythm, and thus received one or more shocks from the AED. In six cases, the member of the public was guided to the AED by the dispatcher.

The data showed that the 30-day survival for all patients, regardless of initial rhythm, was 50% for patients with an AED applied and 19% for patients without an AED applied. For OHCA with an initial shockable rhythm (meaning they could directly benefit from the applied AED) 30-day survival was 64% with an AED applied versus 47% without.

The authors conclude: “Members of the public were only directed to the nearest AED for a minor proportion of OHCA victims, but there was a significantly higher survival in patients where an AED was applied before EMS arrival. This indicates the life-saving potential and need to further develop public access defibrillation networks.”

They add that during recent years, Denmark has seen an increased use of AEDs, which might reflect several initiatives taken to raise survival after OHCA in Denmark including; implementation of mandatory resuscitation training in elementary schools and when acquiring a driver’s licence, improving the telephone guidance to bystanders witnessing a cardiac arrest, by using health care professionals to receive calls at the EMD, as nurses or experienced ambulance rescuers trained to recognise cardiac arrests and to guide the callers to perform chest compressions and use an AED until ambulance arrives.

Discussing some changes that they would like to see in the future, the authors say: “There has been a large increase in the number of publicly accessible AEDs. Means to increase AED utilisation should target public awareness of the AED network and the location of the AEDs, CPR and AED training, and further development of the existing AED network and linkage to the emergency medical dispatch system.”


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If all school kids knew CPR we could prevent 200,000 deaths, says Bolton MP | Mancunian Matters

Bolton West MP Julie Hilling is backing the British Heart Foundation’s (BHF) push to make it compulsory for children to learn life-saving skills in school. The BHF’s Nation of Lifesavers campaign, which launched on March 16 2014, strives to ensure that all secondary school children are taught how to save a life with CPR and Public Access Defibrillator awareness.

Ms Hilling, who has been campaigning with the foundation for four years, told MM: “I can’t imagine anything worse than seeing a loved one collapse in front of me and not knowing what to do and then finding out if only I’d known I could have saved them. We could save up to 200,000 lives a year if only people knew what to do if somebody collapsed or had an accident. The vast majority of teachers and parents think that it should be compulsory to learn how to save a life. I think we’ve got to keep pressure on the government and on Labour to say that this should be a compulsory part. Just imagine if we had a world where everybody could save a life.”

According to the BHF, over 30,000 cardiac arrests happen out of hospital every year and less than one in ten people survive. They are on a mission to create a nation of lifesavers within five years and help more people survive an out of hospital cardiac arrest.

It was March 2012 during an FA cup game when ex Bolton Wanderers player Fabrice Muamba suffered a cardiac arrest on the pitch – an incident which was later used in a BHF advert. Talking after the event which ended his career, Muamba said: “When it happened, the right people were there for me… I had the right people there to help… If it happened to me in my house I don’t think we would be having this conversation.”

But it is the lifesavers who are the stars of this campaign.

A foundation spokesman said: “We haven’t used celebrity ambassadors for this campaign because we’ve been focusing on the case studies of people who have used CPR and life-saving skills to save people’s lives.”

It is those heroes who inspired Ms Hilling to fight for that life-saving training to become mandatory. She said: “The inspirational stories of people that have saved lives have made me believe that this is so essential.

“It is an option for schools. It isn’t part of the national curriculum so what we really need is for it to be part of the national curriculum so that every school leaver becomes a life saver.”

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