Home Gesundheit Automatisierte externe Defibrillatoren retten Leben, wenn Sie sie verwenden

Automatisierte externe Defibrillatoren retten Leben, wenn Sie sie verwenden

von NFI Redaktion

On February 20, 2024, fate was on the side of 63-year-old Billy Frolick when he collapsed at Charlotte Douglas International Airport in North Carolina. It just so happened that Lauren Westafer, DO, an emergency physician, was catching a connecting flight at a nearby gate.

It was Friday, May 13, 2022. Westafer, who works at Baystate Medical Center in Springfield, MA, had just come out of the restroom when she heard what sounded like snoring nearby and saw a flight attendant rushing away from her gate. She followed the sound and found a man lying on the ground with agonal breathing – a gasping for breath usually caused by cardiac arrest or stroke. In the midst of the commotion, some onlookers checked his pulse while the flight attendant ran back with an oxygen mask.

Westafer knew she had to start resuscitation quickly. She turned to the flight attendant and asked for the nearest AED – an automated external defibrillator designed for situations like this.

The flight attendant said the airport didn’t have one.

„I was pretty blunt and said, ‚This is an airport.‘ There is an AED. I don’t know where the nearest one is. ‚Ask someone, check the walls, run down the corridors until you find one,‘ Westafer said.

All airports in the USA – and other public places where large groups usually gather – are legally required to have AEDs. They are often red and stored in a white metal box affixed to the wall. Westafer said the flight attendant quickly returned with an AED in hand.

Automated external defibrillators are different from the defibrillators used in hospitals; Westafer calls them „essentially foolproof.“ There are clear instructions that guide you step by step on where to place the pads and what to do next.

In the event of cardiac arrest, there are four different types of EKG rhythms (electrocardiography) that can occur. Only two of them are shockable, and part of the AED’s task is to determine whether the patient should receive a shock.

For Frolick, fate once again aligned when the AED indicated „shock advised.“ That’s what you want to see in this situation, said Westafer. „Then you have the best chance of bringing someone back.“

Chest compressions were also a crucial part of Frolick’s resuscitation. Seven of his ribs were broken – not uncommon during CPR – one that even lacerated his liver. Technically, Frolick was dead during those ten minutes, but every 30 to 45 seconds during CPR, he started moving his hands or bending his knees.

Ultimately, obtaining access to an AED is often a matter of life and death.

“My goal was to get a shock as quickly as possible because the longer your heart is in that irregular rhythm and you can’t provide a shock, the more it’s going to transition to a rhythm you can’t shock. Then your options are extremely limited,” Westafer said. „That’s why access is so important.“

When the doctors arrived and hooked him up to a heart monitor, they could see that Frolick’s heart was now in a normal rhythm. After loading him onto a gurney, he was able to tell the paramedics and Westafer his name.

As an emergency physician, Westafer doesn’t often witness patients coming back to life. Studies have shown that the survival rate of out-of-hospital cardiac arrests account for only about 10%, costing around 350,000 lives per year in the USA.

Before the ordeal, Frolick said he had been admitted to the hospital three times for chest tightness. His doctors inserted a stent, gave him a prescription for nitroglycerin, and sent him on his way.

„I was popping nitroglycerin like Tic Tacs,“ Frolick said. „At Charlotte Airport, I felt tightness between flights, took the nitro, and it was the last thing I remember until I was staring up at three doctors from a hospital bed.“

Cardiologist Paul Chan, MD, has been studying AED usage trends and survival rates in out-of-hospital cardiac arrests for years.

“In states that have laws requiring AEDs, especially in fitness centers, we see a higher rate of bystanders applying the AED even in cases of cardiac arrest,” Chan said. “But we would like to see that percentage higher. Ideally, we would expect mandatory training of the staff to know where the nearest AED is in these states.”

Both Chan and Westafer said that some bystanders may freeze when someone collapses due to sudden cardiac arrest. There might be chaos. However, as long as someone provides an AED to the patient, there is a higher likelihood of someone intervening and administering the shock when prompted.

“He was lucky to die in an airport,” Westafer said about Frolick because all 50 states require AEDs at airports. Even if the staff is not adequately trained to know where they are or when they should be used, as in Frolick’s case, someone will likely be able to find one fairly quickly.

After a week in the hospital, Frolick – truly one of the luckiest unlucky people – had recovered from his cardiac arrest. And almost two years later, he and Westafer remain friends.

Still, the use of AEDs in public facilities remains low (2-5%), according to a CDC studyThis is mainly attributed to lack of knowledge, bystander reluctance to use AEDs, and limited access to AEDs in general.

You don’t have to be a physician to save a life, you just need to know what to look for.

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