Nonshockable Rhythms and CPR

The benefits of cardiopulmonary resuscitation (CPR) have been well recorded in Sudden Cardiac Arrest victims

When applied early, correctly and followed up with a defibrillator, chances of survival can increase to 75 percent or more.

What about non-shockable rhythms; will CPR still increase the chances of survival?

University of Washington professor, Dr. Peter Kudenchuk and his team from Seattle analyzed thousands of patients who suffered a cardiac arrest with non-shockable rhythms and found a strong correlation between high-quality chest compressions and survival rates for people in cardiac arrest, even if they do not response to defibrillator shocks. 

Types of Rhythms

Click for a larger view

heart Rhythms

Dr. Kudenchuk discovered patients had a 50 percent better chance of regaining spontaneous circulation, a 56 percent better chance of a favorable neurological outcome, and an 85 percent better chance of living one year. 

“Why the study is important is that a huge emphasis has been placed on treating patients with shockable arrhythmias. That’s why these public-access defibrillators and rapid shock methods have evolved and been promoted and rightly so, but shockable rhythms account for only a small proportion of cardiac arrests,” says Kudenchuk.

Non-shockable cardiac arrest, including asystole and so-called pulseless electrical activity, represent a large portion of sudden cardiac-arrest cases, up to 75 percent, but this is the first study to rigorously check whether CPR could improve survival in for people with non-shockable rhymes.

All of the patients in the study were determined to have a nonshockable arrhythmia after the responders tried to defibrillate their hearts. “These patients do very poorly, because the only real therapies we have to throw at them are CPR and drugs and trying to find something reversible that may have caused the rhythm,” Kudenchuk says.

All of the patients in this study were in Washington State from 2000 to 2010, so the study was able to compare outcomes of patients before and after the release of the 2005 American Heart Association CPR guidelines that encourage uninterrupted chest compressions. Kudenchuk was then able to compare historical methods to up-to-date methods focusing on uninterrupted chest compressions. 

Kudenchuk explained that the current CPR guidelines “provide a stronger emphasis on ongoing minimally interrupted CPR and to reduce the time that a patient is in cardiac arrest and the hands are not actively pumping the chest. In simply deploying those guidelines–there is nothing magical about it–you can almost double survival from a non-survivable disease, and that is nonshockable cardiac arrest.”

Going Global! National and International Public Access to Defibrillation (PAD) Programs

Global Medical Services is a proud partner of the Heart and Stroke Foundation’s PAD program. Over the past decade and a half many countries have worked to develop programs that facilitate the public’s access to Automatic External Defibrillators (AEDs). In order to develop an innovative public access to defibrillation program for BC, the Heart and Stroke Foundation surveyed a variety of national and international PAD programs. We are excited to be part of this exceptional project that will ultimately save the lives of countless British Columbians. To celebrate BC’s PAD Program, we decided to take a look around the globe to see how different Public Access to Defibrillation programs were able to create positive impacts in their communities.

Public Access Defibrillation


Canada has a few provincial PAD programs. The Ontario PAD program has been active since 2007, and they have installed around 3000 publically accessible AEDs. Over the next few years, and with the help of additional provincial funding Ontario is planning on installing another 2500 Public AEDs. Today, over 40 lives have been saved by publically accessible AED’s in Ontario.

United States

In the United States, many cities have developed their own PAD programs. San Diego started “Project Heartbeat” in 2001. The initial goal of their program was to place 250 AEDs in public places throughout the city in time for the 2003 Superbowl. San Diego managed to exceed their goal by placing 550 publically accessible AED units in that time frame. San Diego is working to make AEDs prevalent in public places as Fire Extinguishers currently are. San Diego’s AED of choice is the Powerheart AED G3 Automatic; an AED that Global Medical Services is also proud to carry in our product line. Today, Project Heartbeat has saved 107 lives in the Greater San Diego area.

Powerheart AED G3

In Florida, the City of Miami/DADE fire-rescue department developed the “Team for Life” program in an effort to promote public access to defibrillators in the region. The fire-rescue department provides funding, training, equipment and program management for the public AED program. Miami/DADE has also worked to create one of the largest public access to Defibrillator initiatives in the world by equipping 1900 Police vehicles with Lifepak 500 AEDs.


In 2011, Spain became the first country in the European Union to start a PAD Program. The Territory of Girona, Spain intends to install 500 fixed AEDs and 150 portable AED units throughout the region. Spain has chosen to install the Powerheart G3 Plus Automatic AED on busy street corners and in public buildings. 


Meanwhile in the Southern hemisphere, Saint John’s Ambulance Australia started the community based “Heart Start” program. This program was begun in 2004 and provides guidance for public institutions seeking to incorporate an AED into their facilities. To date, this program has saved 19 lives. In 2012, Saint Johns Ambulance began offering subsidized AED’s to the public. They have received an overwhelming amount of public support for their program and they are hoping to see it grow dramatically in the future.

Hong Kong

Moving into Asia, on March 11th 2007, the Hong Kong College of Cardiology in conjunction with the Lan Kwai Fong Association installed their first AED in a public place, as part of their “Heart-Safe Place” program. In the program’s first year, over 100 AEDs were installed in places ranging from community centers and sports arenas to amusement parks.


Since 2004, Japan has been working to incorporate AED’s into their communities. When the program began there were approximately 9906 publicly accessed defibrillators in Japan. Due to a number of public and private initiatives, by 2007 the number of community based AEDs had risen to about 88,265. A study conducted on the Japanese PAD initiative found that the increase in public access to defibrillators was shown to dramatically improve an individual’s chances of surviving a cardiac event .

Global Medical Services is very proud to be part of the BC-PAD program and we are very excited to be joining these other locations in an effort to bring accessible AEDs to the public.

[1] Kitamura, T., “ nationwide Public-Access to Defibrillators in Japan” New England Journal of Medicine, (March 18, 2010)

Technology, Entertainment and Design on its Way to Vancouver

Founded in 1984 as a non-profit geared toward bringing together people form the worlds of Technology, Entertainment, and Design, TED is truly a unique experience devoted to “Ideas Worth Spreading”. Learn more about TED here.


Last year the team here at Global was ecstatic that we were able to tap into the live stream for the 2012 TED event. For four days last February, staff were invited to tune in and watch TED talks in real time, a first time for all Global employees. As part of our TED Live membership, we joined the TED Books, giving us access to even more inspiring thoughts and ideas from authors specifically chosen around last year’s TED theme.

Here’s what some of our staff had to say about the live streaming event:

  • “I thought it was great! I got to see things I normally wouldn’t have been able to.”
  • “I had never heard about TED before. Now that I have seen it, I have been missing out!”
  • “TED was a really great experience. I enjoyed learning about new subjects.”
  • “My only gripe is that I wish the talks were longer!”

It’s no wonder then that we are excited to hear that the 30-year-old conference, which has called California home since its inception, is moving to Vancouver in 2014. Yes, you heard that right. It was announced in early February that the prestigious event will be calling Vancouver home in 2014-2015.

Why move?

TED 2014 Vancouver

Here’s what TED had to say:

We’ve had five wonderful years in Long Beach, but for the anniversary conference, we want to try a new space. And we found it in Vancouver, a city that’s itself an inspiration — cosmopolitan, energetic, innovative, yet with unrivaled natural beauty, surrounded by mountains and water. The recently completed convention center is a truly spectacular meeting space offering limitless possibilities in a beautiful, peaceful corner of the city. We’re not moving to accommodate more people — in fact we’re slightly reducing audience size. We just think we’ve found a venue that can do even more to inspire creative thinking and dynamic ideas.

“We looked at a lot of cities in the U.S, especially on the west coast. In Vancouver, we found a special combination of things we didn’t find anywhere else and it got us really excited. It is a combination of an amazing city which is reflective of the values people hold. There is a feeling of looking forward, a commitment to excellence, of innovation and sustainability. Just a bustling energy, which is thrilling,” says Chris Anderson, TED curator.

The Impact

Vancouver Convention Centre

The potential deal was kept so secret that not even Mayor Gregor Robertson was told about it until a week before the announcement, when the final details were worked out.

Robertson says he can’t think of a better fit for Vancouver’s emerging image as a global city of thinkers, and he wants to take ideas that come out of the conference and put them to use here.

“I’ve been on a quest to land a premier world event in Vancouver for several years,” he said. “Our interests stem from the huge global exposure of TED and Vancouver’s brand, which is something we’ve been cultivating for some time. This is a great boost, particularly around big ideas and turning them into action.”

Learn more about the move to Vancouver

Specialist Physicians Realize the Future Lives in Surrey

Mayor Dianne Watts talks to media outside the Jim Pattison Outpatient Care and Surgery Centre in Surrey on June 8, 2011.

Mayor Dianne Watts talks to media outside the Jim Pattison Outpatient Care and Surgery Centre in Surrey on June 8, 2011.

If you talk to people who work in, or alongside, the healthcare industry, you will no doubt pick up a common theme related to physician resources — they are scarce and recruiting them is a veritable challenge. The situation is so serious that attracting specialist physicians is often identified as one of the major threats to success when opening a new hospital or adding additional beds to an existing facility.

It is precisely this contextual backdrop that makes what is happening in Surrey so intriguing.

Physicians are realizing that Surrey has the necessary ingredients to be one of the best places to practice the craft of medicine. Indeed, the historic trend that has seen Vancouver be the bigger draw when compared to communities such as Surrey is reversing as I write.

But, why Surrey? Quite simply, it is the patients. Canadians have made Surrey one of the fastest growing communities in Canada. The population growth has accelerated a healthcare infrastructure investment of over $750 million just in the last few years. Leading the way has been visionary Mayor Dianne Watts and her team, who are helping physicians, like many other Canadians, realize that, per the city slogan, “the future lives here.”

The specific appeal for physicians, in my opinion, is the combination of a unique patient population mix and the following characteristics:

1. A focus on culture

The major driving force bringing physicians to Surrey is the concerted effort to promote a new culture of healthcare innovation and excellence. A significant shift is now underway which is seeing Surrey positioning itself firmly among the traditional major players such as Vancouver General, St. Paul’s and Royal Columbian Hospitals.

This shift from its traditional role as a community hospital will see Surrey become a leading academic centre of excellence with enhanced research, academic and educational opportunities. This shift is attracting not only practicing physicians but also more and more physician learners who, once their training is completed, will plan to set up practice in Surrey.

2. The practice opportunities at the Pattison centre

jim pattison outpatient care and surgery centre

Many physicians have been afforded the unique opportunity to practice in the Jim Pattison Outpatient Care and Surgery Centre, the first stand-alone dedicated outpatient facility of its kind in Western Canada. What is making physicians so enthusiastic about the Jim Pattison centre? Well like the name implies, only outpatients are seen.

Here physicians can focus directly on the patients at hand without the constant interruptions for emergency and urgent cases that comes when clinics are located within hospitals. This allows a cardiologist, radiologist, or orthopedic surgeon to be highly efficient in the delivery of their care. The design of the Jim Pattison centre was heavily influenced by LEAN methodology, which reduces the inefficiencies in patient flow and maximizes the effectiveness of care delivery. In short more order, less chaos.

3. The Surrey redevelopment and expansion project

A major redevelopment and expansion effort is underway in Surrey including the building of an eight-storey Critical Care Tower on the Surrey Hospital campus. This state of the art facility will add 120 beds to the Surrey campus including much-needed emergency department capacity as well as both adult and neonatal critical care beds. This development is bringing some of the latest technology, equipment and care models to Surrey and the physicians are anxiously awaiting the opening of this new facility.

With the population mix that it has, and the traits outlined above, it is no wonder that Surrey has managed to attract some of the best physicians to the city.

And this certainly bodes well for the future, as in my experience, once doctors begin to practice in Surrey, they often remain committed to the region for their career. With an opportunity to raise their kids in a thriving and vibrant community and to practice great medicine, why would they move?

So while many people from within and around the healthcare industry will make commentary about the challenges associated with securing quality physicians, it is refreshing to have a story like Surrey’s to brighten the picture ever so slightly.

Dr. Allan Holmes grew up in Surrey and has spent the last 20 years working within the Fraser Health Authority in a variety of capacities. Recently he served as the hospital medical co-ordinator of the Jim Pattison Outpatient Care and Surgery Center and his current role is the physician resource planning consultant for the Surrey Memorial Hospital Redevelopment and Expansion Project. Dr. Holmes is also the founder of Global Medical Services, a continuing medical education provider and regional distributor of automated external defibrillators.

An Automated External Defibrillator (AED) Saves Another Life

With the recent launch of the province-wide Public Access Defibrillation (PAD) Program in BC, news of an AED save in Toronto couldn’t have come at a better time. Since 2006, the public defibrillator program in Ontario, funded by the Heart and Stroke Foundation has saved 48 lives.

Public Access Defibrillation

Now it is our turn here in BC. With the PAD program underway, we can expect the same impact, as articulated by Health Minister Margaret MacDiarmid, we will be to “save hundreds of lives”. Indeed, with increased access to AEDS, each of the 2000 SCA deaths reported annually in BC has the potential to be avoided.

The team here at Global Medical Services is excited to play an ongoing role with the HSFBC and PAD program, we hope to see many lives saved.

Toronto AED Save

TORONTO, Feb. 13, 2013 /CNW/ – Once again, AEDs and CPR have proven their worth as a Toronto man is alive today thanks to the quick actions of bystanders. 

On Sunday, January 13, a 51-year-old Toronto-area resident Paul Poce was playing hockey at the Malvern Recreation Centre when he collapsed to the ice after suffering a cardiac arrest. His son Ben Poce, who also works as a paramedic for Peel Regional Paramedic Services, immediately rushed to his father’s side. Recognizing the signs and symptoms of cardiac arrest, Poce called out to his teammates to dial 9-1-1, instructed his friend Shawn Nichols to start chest compressions, while he retrieved the on-site AED. 

Read the full story

CPRAbout the Heart and Stroke Foundation:

The Heart and Stroke Foundation (, a volunteer-based health charity, leads in eliminating heart disease and stroke, reducing their impact through the advancement of research and its application, the promotion of healthy living and advocacy.

Teaming Up to Teach Students to Save Lives!

February is Heart Month and what better way to raise awareness of Sudden Cardiac Arrest than by helping to bring CPR and Automated External Defibrillator (AED) training to the youth in our communities!

In a new initiative supporting our value of corporate social responsibility, Global has partnered with the Advanced Coronary Treatment (ACT) Foundation to bring such training into high schools in British Columbia.

The ACT Foundation is a national charitable organization that is establishing CPR and defibrillator training programs in all Canadian high schools as a regular part of the school curriculum. The program is built on a model of establishing community-based partnerships and support, whereby ACT finds local partners to donate equipment – such as training mannequins, AED training units and AED units – that schools need to set up the program. Training is also a key component. Teachers in secondary schools are trained in CPR and defibrillator use and they, in turn, will act as instructors for their students. The aim of the program is to ensure that all youth prior to graduation could effectively treat someone who is having a sudden cardiac arrest.

Until recently, the ACT High School CPR Program has been established in 220 public standard secondary schools throughout British Columbia. Approximately 235,000 students have already been empowered to save lives using CPR skills.

These numbers were increased on 1 February, when eight teachers from Hudson’s Hope Elementary-Secondary School and North Peace Secondary School in Fort St. John participated in the teacher-training workshop. In addition to Global’s contribution of AED training units, and funding for the AED training mannequins and program resources, Global’s CPR Instructor-Trainer, Jeff Kain, flew to Fort St. John to conduct the teacher training. As a follow-up to the workshop, and as part of the program, each school also received from Global an AED so that potential life-saving equipment is on hand in the event of an in-school cardiac arrest emergency.

The training conducted on 1 February will result in 350 students trained annually by their teachers to use these lifesaving skills.

“Since our inception, Global has been passionate about increasing community access to AEDs and CPR training within BC”, said Vern Biccum, President of Global Medical Services. “The work conducted by the ACT Foundation aligns with this passion, and we are very proud to be collaborating on such a meaningful opportunity that will equip the youth of Fort St. John with the skills and knowledge necessary to save lives.”

With eight in 10 out-of-hospital cardiac arrests occurring at home or in public places, empowering youth with CPR training as part of their high school education will help increase citizen CPR response rates over the long term.

Check out the following links for more information about the ACT Foundation and the recent workshop conducted in Fort St. John.

Act Foundation
News Story – Training Teachers Save Lives
News Story – Learning to Save a Life

Global to supply British Columbia with 450 AEDs


Michael, Julie, Vern, Allan and Tom at the PAD Program Launch presentation

In 1997, a British Columbia mill suffered a heart-wrenching loss when one of its staff members collapsed and died of Sudden Cardiac Arrest (SCA).    The only remedy for an SCA is the delivery of an electric shock that acts to reset the heart’s electrical rhythms – a shock deliverable by an Automated External Defibrillator (AED).   Unfortunately, that shock must come quickly.   For every minute that passes without shock delivery, a person’s chance of survival is reduced by 10%.   In 1997, only ambulance attendants and fire rescue personnel had access to AEDs, and on that day, neither could get to the mill in time with the life-saving AED.

This event, while tragic, led to the formation of Global Medical Services (Global), a BC-based company passionate about broader access to AEDs.  Founded by Dr. Allan Holmes, an emergency-trained physician, Global has worked in the intervening years to implement comprehensive AED programs for hundreds of workplaces across the province and throughout Canada.

And then came February 6th, 2013, a particularly special day in our company’s history.

Gathered alongside representatives of the Ministry of Health, the Heart and Stroke Foundation of BC & Yukon (HSFBCY), and the British Columbia Ambulance Service (BCAS), our team helped bring forward the announcement that a province-wide Public Access Defibrillation Program initiative was launching.

Kicked off with a highly effective Public Service Announcement and an awareness campaign, the initiative, funded by the HSFBCY and the Ministry of Health, will see 450 AED units and associated training delivered to communities throughout BC.   The expected impact, as articulated by Health Minister Margaret MacDiarmid, will be to “save hundreds of lives”.   Indeed, with increased access to AEDS, each of the 2000 SCA deaths reported annually in BC has the potential to be avoided.   This was exactly the case for Anna Shanh, an SCA survivor, who shared her survival story with those at the launch.  It was a stark reminder for us all that SCA doesn’t discriminate; even the young, fit, non-smoking and non-drinking among us are at risk.

In participating in the launch and seeing the efforts invested to bring it to life, we could not be more proud to be the PAD initiative’s exclusive AED provider.   We look forward to working with communities throughout the province as well as with the exceptional teams at both the HSFBCY and BCAS.    We share CEO Diego Marchese’s view that this has the potential to be one of the best programs in Canada, and we look forward to playing our role in ensuring that it is.

For more information and video, visit the BC Government newsroom:

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