Backpack on a bench can save lives

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Automated external defibrillators, or AEDs, are now required at schools and athletic events in 14 states.

The devices are designed to bring a heart back into rhythm after sudden cardiac arrest, a condition where the heart is just quivering, not pumping blood.

A quick-thinking coach and just such a device, a backpack on her bench, helped save the life of a New Jersey teen.

Lynette Messina is head soccer coach of the Garfield High School Boilermakers. Her job is getting players of all abilities to work as one unit.

Freshman Gabriela Koziol had just joined the squad. But on the first day of after-school practices last fall, there was a problem.

"They were doing a run, and when they got to the other side, Gabby collapsed," Messina recalled.

"I just remember hearing the goalie scream after I fell," Koziol said.

Messina and her assistant coach were on the other end of the field.

"I had him run back to grab the AED, I started CPR, and he called 911," Messina said.

In all her years of coaching, Messina always had the AED within quick reach, as mandated by New Jersey law. But she had never had to pull it out in a life-or-death situation.

The device "talks" users through the delivery of a shock to the heart. The AED applied only one shock to Gabby's heart.

"With the application of the shock, it put the heart back into normal rhythm, which restored normal output of the heart and normal perfusion, and Gabby woke up almost immediately," Dr. Barry Love said.

Love implanted a tiny defibrillator inside the teen to help start her heart if it arrested again.

"I would say it's like her having her own guardian angel," he said.

"If I could get back on the field, I would really love to. I'd just want to play goalie again," Koziol said.

With one seldom used backup ever present on the bench, she may just have the chance to do that.

In addition to the 14 states that mandate the AEDs at schools, there are now 38 states requiring students to learn how to perform CPR.

Love says they will have to evaluate Koziol to determine if she will be cleared to play soccer again next season.

RESEARCH SUMMARY
BACKPACK ON A BENCH CAN SAVE LIVES! REPORT #2623

BACKGROUND: Sudden cardiac arrest is a leading cause of death among adults over the age of 40, and it's a healthcare crisis affecting more than 300,000 people every year, according to the SCA Foundation. Even the fastest paramedics could take eight to 12 minutes to get to a patient after he or she collapses. Quick access to an automatic external defibrillator, or AED, by an engaged bystander could increase the odds of survival from about 5 to 40 percent and higher. A defibrillator is a small, lightweight device that allows quick-thinking citizens and co-workers to treat sudden cardiac arrest by delivering a shock to the victim's chest, ideally re-starting his or her heart. There is no danger of harming a patient who might not need defibrillation because an AED diagnoses dangerous heart rhythms and responds accordingly. AEDs are user friendly and even "talk" the user through the process. National Safety Council provides a variety of superior courses to train laypeople to respond to breathing and cardiac emergencies, including how to use an AED and perform CPR. (Source: https://www.nsc.org/safety-training/first-aid/supplies/aeds)

THE MODERN DEFIBRILLATOR: Until the 1990s, AEDs delivered what are termed monophasic shocks, or jolts so energetic they could damage heart tissue and inflict burns. Modern AEDs take a leaf out of the alternating-current playbook by employing a biphasic waveform. The pulse travels in alternate directions between the paddles, allowing for lower energy levels and providing higher survival rates. In hospitals, biphasic defibrillators can now restore a regular pulse in up to 99 percent of patients. Today, however, the majority of these machines are situated not in hospitals but in public places. In 2017, an article in the Journal of the American College of Cardiology stated, "AED purchase costs range from $1,250 to $1,500, and costs $250/year for maintenance, with an expected useful life of 8 to 10 years. Initial training of local personnel is estimated at $300." "It was a really daunting technical challenge," says Carl Morgan, who developed some of the first public AEDs at Heartstream. "We helped pioneer the concept of self-test, where the device wakes up every day and performs extremely comprehensive tests on itself. These are supplemented by other tests done weekly and monthly to conserve the battery," continued Morgan. (Source: https://spectrum.ieee.org/biomedical/devices/the-shocking-truth-about-defibrillators)

RESEARCH SUPPORTS REQUIREMENTS: As of February 2016, 17 states had some legislation requiring AED installation in schools, but the remaining 33 states had no legislation. Researchers calculated that nearly 35 million public elementary and secondary students attend school in U.S. states with no legislative requirement for a school AED. "Installing AEDs in schools should include a plan for implementation in which all staff are trained in the use of the AED, integrated with cardiopulmonary resuscitation training" says Mark Sherrid, program director for the hypertrophic cardiomyopathy program and professor of medicine at NYU Langone Medical Center in New York City. A questionnaire study of sudden cardiac arrest in U.S. high schools determined that two in 50 high schools can expect a sudden cardiac arrest event each year. Several observational studies show an association between AED installation in schools and colleges with increased survival. Collapse to defibrillation time was shorter when administered by bystanders than by emergency medical services. Many states, with no requirements for school AEDs, have placed a higher legislative priority for required AEDs in other locations, such as state office buildings, health clubs, gambling facilities, racetracks, and jails. (Source: https://cardiacrhythmnews.com/research-argues-requirements-for-aeds-in-us-schools-need-improvement/)