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.

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

About the Heart and Stroke Foundation:

The Heart and Stroke Foundation (heartandstroke.ca), 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.

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 6^th, 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: http://www.newsroom.gov.bc.ca/2013/02/bc-increases-access-to-defibrillators.html

What is Heart Month?

Heart Month is the Heart and Stroke Foundations‘ key opportunity to reach millions of Canadians in February and alert them to the risks of heart disease and stroke. Today, heart disease and stroke take one life every 7 minutes and 90% of Canadians have at least one risk factor.

Here are the facts:

• Every day, heart disease and stroke lead to nearly 1,000 hospital visits.
• Heart disease and stroke rob Canadians of nearly 250,000 potential years of life.
• Heart disease and stroke kills more women than men, a fact that many women may not realize.
• Today, less than 10% of children meet recommended physical activity guidelines and less than half eat the recommended fruit and vegetables for optimum health.

History

“Heart Month was inspired by a fundraising initiative called “Heart Sunday.” The concept was adopted in British Columbia in the mid-1950s; in Ontario in 1958, and has since expanded across the country. Today Heart Month is a much broader campaign that mobilizes Canadians to rally together in raising awareness and funds that have an enormous impact on the lives of not just heart and stroke patients, but all Canadians. Through the generosity and compassion of volunteers, the Heart and Stroke Foundation has been able to fund critical life-giving research, education and advocacy programs that help save lives.”

In truth, Heart Month is integral in generating awareness for all heart diseases. Did you know Heart disease and stroke take 1 in 3 Canadians before their time and is the #1 killer of women – taking more women’s lives than all forms of cancer combined?

It is an uphill battle against heart disease, but at Global Medical Services, we believe this is a fight we can win, so help celebrate Heart Month with us and spread the word!

Learn More

 

What is an AED Program?

Issue

In Canada, 35,000 to 45,000 people die of sudden cardiac arrest (SCA) each year. Unlike a heart attack, which is caused by a blockage in an artery, SCA results from an electrical malfunction of the heart. The only effective treatment for this condition is the early delivery of an electric shock by an automated external defibrillator (AED). Response time is critical; for every minute of delay in delivering the shock, survival rates for SCA victims decrease by 7-10 percent.

Solution

Recognizing the link between increased survival rates in SCA victims and the prompt use of a defibrillator, the Heart and Stroke Foundation of Canada (HSFC) has recommended that all Canadians:

• Have widespread access to automated external defibrillators.
• Be trained and encouraged to apply cardiopulmonary resuscitation (CPR) and AED skills when needed.

When applied to the workplace, these recommendations entail implementing a program that makes AEDs readily available and ensures that staff are well prepared to use them when needed.

Process

Global Medical Services (Global) provides an AED Program that includes three indispensable components:

1) The AED device, associated accessories, and servicing

Global is British Columbia’s sole distributor of LIFEPAK AEDs and we are a regional distributor of Powerheart G3 Plus AED. Both manufacturers are renown for their use of leading-edge technology, the reliability of their units, and after purchase service provided.

2) Initial and ongoing training

Managing a cardiac arrest involves more than merely “pushing the button” on an AED. Respondents must be able to recognize an arrest, perform CPR, and use a defibrillator properly. Our AED training workshops ensure that participants are able to respond effectively when the time comes.

3) Medical direction (a WorkSafeBC recommendation)

Global provides a medical direction package, consisting of the following components:

• Emergency medical response procedures
• Emergency Health Services liaison
• Operational debriefing
• Post incident call review
• Physician consultation
• Critical incident stress referrals

Our medical direction package is designed to maximize the value of your AED, and exceeds the recommendations from WorkSafeBC, the HSFC, and Health Canada.

Our Company

Since 1998, Global has overseen the training and certification of over 10,000 lay rescuers in the use of AEDs. Dr. Allan Holmes, a fellowship-trained Emergency Physician, is an expert in pre-hospital care and has worked extensively with Occupational First Aid Attendants, fire rescue personnel and the BC Ambulance Service. We currently provide medical direction to over 300 clients including 140 fire departments throughout the province.

Don’t Take Off Your Running Shoes Just Yet

Marathon runners have been making headlines more and more in recent years. Not because of the times they put up, but rather the dramatic images of runners collapsing and in some cases, dying during or right after an event.

Should you stay out of the race? Not so fast. A study published in the New England Journal of Medicine shows that if you want to go the distance, go ahead – as long as you don’t have a pre-existing condition.

The study looked at nearly 11 million runners who took part in marathons between 2000 and 2010.

By scouring media reports and checking with medical staff of races, the researchers discovered 59 cases of cardiac arrest, where a runner became unconscious with no pulse during the race or within an hour of finishing. Unfortunately forty-two of these runners died, and 51 of the 59 cases happened in men.

The overall figures translate to 1 cardiac arrest per 184,000 participants and 1 death per 259,000 participants, the researchers said. Those numbers are low compared to other athletic activities, as shown by prior studies of deaths in college athletes, triathlon participants and previously healthy middle-aged joggers, researchers said.

“You hear about this more and more,” said Dr. Aaron Baggish, senior author of the study.

One of the reasons we have seen an increase in the number of collapses is due to an increase, overall, of runners who are trying to push themselves to stay fit, giving the illusion that cardiac arrest is on the rise amongst runners.

“More cases showed up during 2005-2010 than in the preceding five-year span, but that’s just because more people are participating in the races,” Baggish said. More worrisome was the finding that among male marathoners, the rate of cardiac arrest per 100,000 runners was higher during the latter half of the decade than in the first half.

Baggish thinks that’s because of a shift in attitudes about who can run long distances. Even a decade ago, 26.2 mile marathons were considered appropriate only for very athletic people, he said. But more recently people have come to think of it as “something anyone can do,” and even as a healthy activity for lowering the risk of heart disease, he said. So it has attracted people with a family history of early heart disease or early deaths. “These are just the people who are likely to get into trouble,” says Baggish

In the 31 cardiac arrests for which researchers could find a cause, most were due to clogged hardened arteries or hypertrophic cardiomyopathy, a sometimes inherited condition in which an unusually thick heart muscle can interfere with the pumping rhythm.

According to Baggish, most of the victims were unaware of their pre-existing conditions, so he would encourage aspiring and experienced runners to talk to their doctors about heart risks associated with distance running.

American Heart Association Dr. Gordon Tomaselli, president of the , called the study “reassuring” for finding so few cardiac arrests. “For most people, running a marathon, if you are so inclined, is a reasonably safe proposition,” he said.

Tomaselli, a heart specialist at Johns Hopkins University, also said runners should pay attention if they feel chest pain, dizziness, light-headedness or unusually short breath or rapid heartbeat while running. “You should listen to your body,” he said.

“We don’t want to alarm people about marathon running. The benefits of exercise are well established” said one of that report’s authors, Dr. Navin Kapur of Tufts Medical Center in Boston. The report shows even seasoned marathon runners can have heart disease, something paramedics should keep in mind if a runner shows suggestive signs, said Kapur.

Sudden Cardiac Arrest is a Family Matter

We have previously highlighted the factors that put you at risk of coronary artery disease (see post here). Among these factors, we identified family history as one of the leading contributors to sudden cardiac arrest.

A new Danish study released in November 2012, has provided additional details, and demonstrates a direct link between family history and SCA.

Research indicates that relatives of young sudden cardiac death victims appear to have a much greater risk of cardiovascular disease than the general population.

During 11-years of follow-up and tracking sudden cardiac death victims, there were 292 incidents of cardiovascular disease among those with relatives who suffered sudden cardiac death, compared to 219 incidents in the background population, representing a 33 percent increase.

Researchers found the risks were particularly high when the relative who suffered cardiac arrest was younger than 35. The findings suggest a large hereditary component of sudden cardiac death.

“Since the cardiovascular conditions on which we focused are treatable, early identification of at-risk persons is potentially a life-saving action,” wrote Mattis Flyvholm Ranthe, MD, of the Statens Serum Institute in Copenhagen. “Our findings are the first of their kind and support the initiation of cascade screening in families experiencing a sudden cardiac death, with customization of screening based on the underlying condition suspected to have caused the death and family member ages.”

Many of the risks linked to sudden cardiac arrest include:

• Smoking
• Hypertension
• Obesity
• Diabetes
• Sedentary lifestyle
• Alcohol (more than one to two drinks per day)
• Age (after 45 for men and 55 for women)
• Being male (2-3 times the risk)

However, previous studies have shown numerous links to sudden cardiac arrest through genetic mutations, including primary arrhythmia syndromes (electrical malfunctions), cardiomyopathies (heart muscle deterioration), familial hypercholesterolemia (elevated cholesterol levels), and ischemic heart disease (poor blood supply to the heart).

Further Details

To explore the link between family history and sudden cardiac arrest, researchers performed a prospective, population-based cohort study using Danish national registries. They identified 470 individuals ages 1 to 35 years who suffered a sudden cardiac death from 2000 to 2006, and 3,073 relatives.

• Compared with the general population, the relatives had a greater risk of developing cardiovascular disease during follow-up
• First-degree relatives — parents, children, siblings — had a greater risk of cardiovascular disease compared with second-degree relatives, such as half-siblings, grandparents, grandchildren etc…
• Risks were particularly high for first-degree relatives younger than 35
• The risks among the relatives were greater when the initial sudden cardiac death was verified by autopsy.

Not Your Regular Routine

We came across this Automated External Defibrillator save not too long ago. Thought it was a great and inspiring story that deserves to be shared!

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Haddad remembers very little of his last visit to Charter Fitness a health club in Hobart, Indiana, on October 30th. What started as a routine workout for the 22-year-old turned into a race for his life.

He remembers working in the free weight area of the club, then trying to reach for the wall right before he collapsed. 

“I couldn’t see and I couldn’t hear. I couldn’t move,” Haddad said. 

Two members quickly responded and informed the front desk that someone had passed out.

Assistant manager, Jorge Almedina, quickly began administering CPR while employee, Sarah Gacsy, brought a defibrillator that was used to get his heart started again after it had stopped. 

Almedina called 911, then went back to Haddad to begin administering CPR. 

“He started breathing, but still had no pulse and that’s when an off-duty nurse who was working out here came to help,” Almedina said. 

Once the defibrillator was administered Haddad regained a pulse. Shortly after, emergency medical services arrived and transported Haddad to the hospital for assessment. 

Haddad said doctors there couldn’t find a reason for his heart stopping, but inserted a pacemaker to keep his heart beating regularly. 

“The doctors have told me they have no answer as to why my heart stopped. … I thank those who helped me here very much,” Haddad said. 

For Almedina, who is 21, the incident was an eye-opener. “I’m just glad I was certified and able to react. You don’t expect that to happen especially to someone close to my age,” Almedina said.

Tito Garcia, regional manager for the fitness club, said it’s a requirement that there be at least one employee during all shifts who is CPR and AED certified. 

“We’re just happy a life was saved and ecstatic our employees reacted courageously to save a person’s life,” Garcia said.

Defibrillation 101 

Study Looks to Predict Sudden Cardiac Arrest Risk

A promising new way to predict sudden cardiac arrest risk has been identified by medical researchers at the University of Buffalo.

For patients who are at the highest risk of sudden cardiac arrest, this is exciting news, as this research may give cardiologists an advanced screening tool to help those in the high-risk category and those most likely to benefit from receiving an implantable cardiac defibrillator (ICD).

ICDs are mainly used to prevent sudden cardiac arrest in patients with advanced heart disease, but many patients’ devices are never triggered.

New research suggests that imaging the degradation of nerve function in the heart may identify those patients at greatest risk of developing a life-threatening heart rhythm.

Using Positron Emission Tomography (PET), in the largest PET imaging study ever done on sudden cardiac arrest, researchers were able to measure the amount of nerve damage within the muscular tissue of the heart.

PET imaging is also able to show where nerves have died or become damaged due to inadequate blood flow.

“The principal question we posed with this study was whether the amount of nerve damage in the heart could predict sudden cardiac arrest,” says James A. Fallavollita, author on the study. “We found that when at least 38 percent of the heart was showed signs of nerve damage, there was a significant increase in the risk of sudden cardiac arrest.”

At this time, to determine whether an ICD is needed, doctors take a measurement of heart function called the ejection fraction; the percentage of blood pumped by the heart with each beat. An ejection fraction of 35 percent or less is a strong indicator of sudden cardiac arrest risk; these patients usually require an ICD.

This research is a prime example of translational medicine (the emerging field which focuses on using what is learned in pre-clinical studies to do smarter things in the clinic). In this case, the pre-clinical studies demonstrated that the risk of developing ventricular fibrillation (a deadly heart rhythm) was related to regional nerve damage.

“Ultimately, we wanted to develop an approach that could tackle the problem of identifying a larger portion of the patients with coronary artery disease who are at risk of developing sudden cardiac arrest,” explains John M. Canty, a principal investigator of the research. “Since many patients who suffer a cardiac arrest do not have severely depressed heart function, PET imaging may be able to identify high risk individuals who, in the future, could be considered candidates for an ICD.”

It’s Never Too Late For AED Training

Every Tuesday night a group of ex-university basketball players get together to duke it out on the court. This may not be all that unusual, unless you factor in the fact that the players are in their 60s and 70s.

Aptly named, the “Tuesday Knights”,this group of men is still committed to being active and to sharing their love of the game. It`s no small feat to be playing a sport with that kind of intensity at their age, but as evidenced in this Greg Douglas column in the Vancouver Sun, one member of the group accomplished an amazing feat.  

John McLean, 74 last week, joined a group of young guys at the YMCA on Burrard for a spontaneous free-throw showdown. Seven straight was the number he had to beat. McLean, a Magee high school grad and UBC alumnus, nailed 61 free throws in a row as jaws dropped from the crowd that quickly gathered. “I was getting tired and although I didn’t try to miss on purpose, I was glad when I did,” he said. “I’ve never been in a groove like that before.”

Read more:  The Vancouver Sun

Having said that, there are some natural concerns about 60 and 70 year olds demonstrating that level of physical exertion every week. At their age, the risk of a cardiac event is higher than it was in their younger days. For this reason, the group decided to purchase an Automated External Defibrillator (AED) and were trained in its use by our founder, Dr. Allan Holmes.

“I was approached at a golf tournament by one of the Knights’  members who was aware that many golf courses had AEDs, but many of the indoor basketball venues such as community centers and schools, did not.” said Holmes “This was an exceptionally bright bunch of guys who quickly picked up on the training, asked tough questions and were soon very confident in using the AED, should the need arise.”

This means that if one of the players were to have a sudden cardiac arrest, any of the Tuesday Knights would be there, immediately able to assist, and increase the chances of survival.

Global is thrilled to have provided the Knights with their AED and training, and applauds their proactive measures. By staying active they are reducing one of the risk factors for cardiac issues, and by having an AED on hand, they are ensuring they’ll continue to play together for many more years. 

Sudden Cardiac Arrest – Know the Risks

Recent studies have shed light on many risk factors related to Sudden Cardiac Arrest (SCA); often a quick and silent killer.

Up to ninety percent of those who die from SCA have evidence of plaque (fat and cholesterol) in two or more major arteries. Plaque buildup leads to one common underlying cause: coronary artery disease.

The Mayo Clinic (a medical research group) reports that because the link between coronary artery disease and SCA is so strong, the same factors that put you at risk of coronary artery disease also may put you at risk of SCA.

These include:

• Family history of coronary artery disease
• Smoking
• Hypertension
• High blood cholesterol
• Obesity
• Diabetes
• Sedentary lifestyle
• Alcohol (more than one to two drinks per day)
• Age (after 45 for men and 55 for women)
• Being male (2-3 times the risk)

The American Heart Association reports that SCA can be caused by almost any known heart condition, they list the following specific factors that further increase the odds:

Scarring or enlargement of the heart from a previous heart attack or other causes can make someone more prone to developing life-threatening ventricular arrhythmias.

Cardiomyopathy is a deterioration of the heart muscle; typically a root cause of SCA in athletes.

Heart medications, under certain conditions, can set the stage for arrhythmias that cause SCA. Antiarrhythmic drugs sometimes can produce lethal ventricular arrhythmias, even at normal doses.

Electrical abnormalities, such as Wolff-Parkinson-White syndrome (a condition with an extra electrical pathway in the heart) and long QT syndrome (a disorder of the heart’s electrical activity) may cause SCA in children and young people.

Blood vessel abnormalities, particularly in the coronary arteries and aorta, may be present in young SCD victims. Adrenaline released during intense physical or athletic activity often acts as a trigger for SCA when these abnormalities are present.

Recreational drug use, even in people without organic heart disease, is a cause of SCA.

There are numerous risk factors related to SCA, but there are also ways to reduce the risk. Next week we will highlight some SCA prevention methods that you can incorporate into your everyday life. Don’t forget to check back!