The best day of Dr. Ralla Shrit’s life turned into her worst nightmare in a matter of seconds.
As she was cutting the cake at her wedding reception, her 60-year-old father collapsed and went into cardiac arrest in a Cincinnati hotel ballroom. For 10 excruciating minutes, nobody could find the hotel’s automated external defibrillator, or AED.
Thanks to physicians at the wedding who performed CPR until an AED was located and used, Shrit’s father survived and is expected to make a full recovery. But she’s upset that hotel staff couldn’t immediately find the lifesaving device – and she wants to make sure others don’t die because of similar delays during cardiac emergencies in public places.
“We are lucky we had a room full of medical professionals who started CPR within seconds, but most people don’t have that at their disposal,” said Shrit, a surgical resident at Good Samaritan Hospital in Cincinnati.
“Hotels and public places need to have more AEDs, they need to be more accessible, and every staff member needs to know where to locate them,” she said. “Nobody’s asking public places to make clinical decisions about people’s lives. All we’re asking is that they have the tools necessary to give someone a chance to make it to a hospital.”
Shrit’s story underscores the dire need to improve access to AEDs and to educate the public in how to save lives, said Clifton Callaway, M.D., Ph.D., chair of American Heart Association’s Emergency Cardiovascular Care Committee.
“We want to create a culture of action where every citizen is able to rescue another citizen,” said Callaway, a professor of emergency medicine at the University of Pittsburgh. “We can’t just hope for faster and faster emergency medical services because there will not be a paramedic over your shoulder every moment of your life.”
The AHA is helping to spread that message June 1-7 with the annual National CPR and AED Awareness Week. More than 350,000 people have cardiac arrests out-of-hospital every year in the U.S., but only 46 percent get the immediate help from a bystander they need before professional help arrives. CPR can double or triple chances of survival, especially in the first few minutes of cardiac arrest.
Just as anyone can perform CPR, anybody can save a life by using an automated defibrillator, said Michael Kurz, M.D., an associate professor of emergency medicine at the University of Alabama at Birmingham and a volunteer with the AHA’s ECC committee.
“The big misconception is that AED use requires training when, in fact, any member of the public can use it in an emergency,” Kurz said. "The AED walks a lay responder through the steps using spoken audio cues. I taught my daughter’s fourth-grade class CPR and how to use an AED. If a 10-year-old can use it, any member of the lay public can.”
Still, AEDs can’t save lives if they go unused.
“It’s a tragedy that a cardiac arrest occurs within yards of an AED and it isn’t applied. Perhaps bystanders or 911 dispatchers aren’t aware it’s available,” Kurz said.
Most AEDs cost $1,200 to $1,500, according to Kurz. The AHA encourages anyone who buys an AED to inform the local EMS office so 911 dispatchers will know it’s there.
“The first barrier with AEDs is a lack of awareness,” Callaway said. “One of our initiatives is to advocate for communities to develop good registries of AEDs in their area. If you’re at a hotel or a convention center and you call 911, they should be able to quickly pull up a map of your location and say, ‘There’s an AED 100 feet behind you – go get it.’ ”
The AHA also is helping to improve CPR instructions for 911 call-takers.
“If someone calls 911 and says, ‘This person is in cardiac arrest,’ dispatchers now have a set of guidelines by which they can provide CPR instructions,” said Kurz, a past chair of the AHA’s Telephone-CPR task force.
“Everyone who experiences cardiac arrest should get bystander CPR and telephone CPR instructions. When they don’t, that is a preventable death,” he said. “We’ve come a long way in CPR education, but we still have some distance to go.”