Heart Hero Program

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Heart Hero Program

• The objective of this City of Kawartha Lakes EMS
  led program is to provide awareness in Public
  Access Defibrillation (PAD) and Hands Only Cardio
  Pulmonary Resuscitation (CPR) for the sudden
  collapse of an adult.

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Disclaimer

• You should be reasonably fit to participate in
  this course and that is why we have a disclaimer
  for you to sign. If you feel you can not perform
  the physical aspects of this program, but want to
  observe the course, you may do so. We will still
  require a disclaimer be completed.

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Acts To Protect Citizens

• Since 2001, Ontario has had a Good Samaritan Law
  that protects all citizens who help someone in
  need. This includes health professionals when
  they are not at work. The Chase McEachern Act was
  signed by the Premier of Ontario in June of 2007,
  protecting citizens who use an AED/PAD in an
  emergency. Again, this includes health
  professionals when they are not working.

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Hands Only CPR
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• Hands Only CPR is now recommended by the Heart
  and Stroke Foundation of Ontario for bystanders
  to perform on the witnessed collapse of an adult.
  This individual does not require mouth to mouth
  resuscitation because there is still oxygen in
  their blood. By circulating the oxygen rich blood
  with compressions, you will help to keep the
  brain viable to resuscitation. The rescuer needs
  to
• 1. Establish unresponsiveness of the victim
• 2. Call for help (911) and a Public Access
  Defibrillator (PAD) if it is available
• 3. Begin chest compressions at a rate of 100 per
  min and ensure that the chest is depressed ½ of
  its diameter (push hard push fast)
• 4. Hands Only CPR should be continued until the
  arrival of a PAD or emergency services.

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Traditional CPR

• Traditional CPR (ventilations and
  compressions) is required for
• Unwitnessed collapse of adults
• All children cardiac arrests

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What is an AED?
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• The automated external defibrillator (AED) is a
  computerized medical device that can check a
  persons heart rhythm. It can recognize a rhythm
  that requires a defibrillation shock and advise
  the rescuer to deliver the shock if needed. The
  AED uses voice prompts, lights and text messages
  to inform the rescuer of the steps they need to
  take. AEDs are very accurate and easy to
  use. With a few hours of education, anyone can
  learn to operate an AED safely. There are many
  different brands of AEDs, but the same basic
  steps apply to all of them. We do not recommend a
  specific model.

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PAD Concept
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• What is public access to defibrillation?
• Public access to defibrillation (PAD) means
  making Automated External Defibrillators (AEDs)
  available in public and/or private places where
  large numbers of people gather.
• Why is PAD Essential to Our Community?
• Every year in Canada about 30,000 citizens
  die from sudden cardiac arrest (SCA) before they
  reach a hospital. SCA strikes people of all ages
  and various degrees of fitness. It usually
  happens without warning. Many of these victims
  can be saved if citizens are prepared to quickly
  phone 911, begin CPR and provide defibrillation
  within three minutes of collapse. The goal of an
  organized PAD program is to better prepare the
  public to deal with SCA prior to the arrival of
  Emergency Medical Services (EMS). This is
  essential in improving the Chain of Survival
  within our community.

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PAD Symbol
The universal symbol of an automated external
defibrillator (AED) is a heart with a lightening
bolt through it. In our community you will find
door identifiers if the building has an AED.
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Ventricular Fibrillation (VF)
Most common initial lethal arrhythmia, also the
easiest to treat through. Early Defibrillation
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• 70 of all SCAs are caused by an abnormal
  heart rhythm known as ventricular fibrillation
  (VF). In laymans terms, VF causes the heart to
  quiver like a bowl of jelly and, therefore,
  prevents the heart from pumping blood. As a
  result, the victim suddenly collapses and becomes
  lifeless. The treatment for VF is defibrillation.
  Defibrillation is the delivery of an electric
  shock to the heart that stops VF and allows a
  normal heart rhythm to resume. Providing early
  defibrillation drastically improves survival
  rates for VF cardiac arrest. In communities with
  an organized PAD program, survival rates from VF
  cardiac arrest have risen to 70. Currently, only
  about 5 of all SCA victims survive in places
  where no PAD programs have been established to
  provide prompt CPR and defibrillation by
  citizens.

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Choking
If the victim can speak and breath encourage them
to cough and only intervene if the victim can no
longer talk. For obese or pregnant victims use
chest thrusts instead to relief the obstruction.
The landmark position is the same as that for CPR
compressions.
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• The universal sign of choking is the victim
  clutching their throat. If you witness an adult
  or child victim who is choking and unable to
  speak or breath call 911 and then immediately
  perform abdominal thrusts. This should be
  repeated until the obstruction is removed. If the
  victim collapses, you should perform CPR as the
  chest thrusts will assist in removing the
  obstruction and maintain blood flow to the brain
  should the heart stop. After 30 compressions, the
  rescuer should open the airway/mouth (using the
  head tilt chin lift) and look to see if there is
  any debris to remove. Attempt to ventilate.

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• .if no air enters, reposition the head tilt chin
  lift once and then attempt the ventilation again.
  If still no air enters the lungs, you should
  continue with 30 compressions. Repeat the airway
  / compression process until the object is
  removed. It is important to consider hooking up
  the PAD to this patient because the obstruction
  may not be the real cause, and in an adult, they
  will eventually go into the heart rhythm that
  will require a shock. The defibrillation shock
  will be a powerful jolt that may dislodge the
  blockage.

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Choking Causes
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• Older children/Teens and Adults Food is the
  number one cause of choking due to talking while
  eating. Always cut food into small pieces and
  chew several times before swallowing. Festive
  seasons are predicable times for a choking to
  occur due to talking, standing, eating and
  drinking simultaneously. Many adult choking
  victims will get into trouble and disappear to a
  washroom because they dont want to cough and
  struggle in a public setting. Always be
  suspicious of someone who suddenly leaves for the
  washroom without verbally excusing themselves.

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• Small children (toddlers) explore their world
  by putting things in their mouth. Objects like
  small toys, marbles, buttons and food like hot
  dogs or peanuts are dangerous for toddlers.
  Running with food in there mouth or putting to
  much food in at once are other situations that
  can lead to a choking scenario. Make your home
  safe by setting an example and removing potential
  problems.

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Be a Link!!

• Healthy Choices reduce your risk factors for
  heart disease and stroke (watch your diet,
  maintain a good body weight, exercise, reduce
  stress, ensure regular physicals with your doctor
  and follow his/her advice)

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Early Recognition

• Heart attack (chest pressure, tightness,
  indigestion - chest, neck, jaw, teeth, shoulder
  pain weak, tired, unwell, impending sense of
  doom, denial pale or blue skin colour and
  shortness of breath are all signs of heart
  attack. In fact 25 of all heart attacks have no
  pain. If someone does not look well suddenly,
  seek help and call 911).

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Early Recognition (cont)

• Stroke (weakness on one side, slurred speech,
  head ache, unable to swallow, unable to stand or
  walk or grasp your hand) seek help immediately
  call 911.

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Early Access
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Early CPR

• everyone needs to learn this lifesaving skill.
  Dont worry if you are not currently certified or
  have never taken a course just do what you know
  is best. You should tell and teach as many people
  as possible about Hands Only CPR.they could be
  saving you!

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Early Defibrillation

• that is why we are developing PAD programs for
  high risk buildings and events. If you have an
  event that should be covered with a PAD device
  call EMS to see if you can get one to keep your
  event safe. Remember that Fire and EMS carry
  defibrillators into the community but their
  response time needs to be thought about when
  planning events.

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Early Rehabilitation

• this link is the support groups that help a
  survivor return to an active life in the
  community.

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Managing Sudden Cardiac Arrest

• Can you help!!!

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Establish Unresponsiveness
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• When responding to a possible SCA, the first
  determination is to establish unresponsiveness.
  This is done by loud verbal stimulus (shouting)
  as you approach the victim. Shout into both
  ears and then tap the victim on both shoulders.
  If the victim is not easily aroused call for help
  immediately. Send a bystander to retrieve the
  PAD and have a second bystander call 9-1-1. If a
  second bystander is not available, you will need
  to place the 9-1-1 call and get the PAD.

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Call 911

• When placing the call to 911, inform the operator
  that you believe the victim is suffering from
  sudden cardiac arrest . Give 911 your address
  (include street, name, number and region/county)
  and return phone number. Tell them you need to
  perform CPR (use a cell phone if it is
  available).

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Compressions
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• If the victim is unresponsive, turning blue with
  no breathing (or if they have gasping breaths)
  you should begin chest compressions (100 per min.
  compress ½ the chest diameter.) and make sure
  someone is looking for an on site PAD. If you
  know where the PAD is located get someone else to
  do the Hands Only CPR while you locate the PAD.
  If you are by yourself GET THE PAD and return to
  the victim. Turn the PAD on and follow the
  prompts from the machine. You may need to
  forcefully and tell others to remain quite so you
  can easily hear the PAD. Continue to do as
  prompted by the PAD.
• NOTE the PAD has a pocket mask stored with it
  and you can use that with traditional CPR at a
  ratio of 302.

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Turn On AED!

• Turn the AED on by pulling on the PULL handle
  and follow the verbal prompts and/or text
  messages.

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Early Defibrillation
Remove clothes and prepare chest quickly
Open pre packaged defibrillation pads and peel
the backing to stick the pad to the victims chest
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• To attach the defibrillation electrodes
• 1.Completelty bare the chest.
• 2.Remov all clothing, shaving excess hair,
  drying skin with towel and removing medical
  patches (with a gloved hand).
• 3.Peel off the backing of electrode pads
  exposing sticky gel and metal surface. Be
  careful not to disturb gel when handling
  electrodes.
• 4.Fimly place the electrodes on the skin of the
  victims chest.

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Defibrillating Man

• If male victim has a hairy chest then firmly
  attach the electrodes and hold them with pressure
  against the chest wall. The AED will prompt you
  to stand clear but you will ignore this prompt
  and continue to press the electrodes to the chest
  wall. The AED will be searching for the heart
  rhythm and when it arms to shock it will advise
  you to stand clear as it begins to charge for the
  defibrillation shock. Remember, the AED will not
  shock until you press the shock button. You
  should then let go of the electrodes and ensure
  everyone is clear of the victim and deliver the
  defibrillation shock as directed by the AED only
  when it is safe and no one is touching the
  victim. The time spent holding the electrodes to
  the chest will assist the adhesive in sticking to
  the victims chest.

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Defibrillating Women

• When placing the electrodes on a women the chest
  must be barred. This includes removing the bra
  using the scissors supplied in the fast pack
  attached to the AED. The right electrode will be
  placed below the right collar bone and above the
  right breast. The left electrode will require
  pushing the left breast up with the back of a
  gloved hand so that that electrode can positioned
  in the appropriate place.

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Victim Dignity

• Have other rescuers hold up a blanket to
  provide a privacy screen to maintain the victims
  dignity. Another method would be to have a line
  of bystander face away from the victim an block
  the view of on lookers.

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Early Defibrillation
Place one electrode pad just below the left
breast and slightly off to the side Place the
other electrode pad directly above the patients
right breast, below the collarbone and beside the
breastbone.
Press pads firmly onto skin.
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Alternate electrode placement

• One electrode is placed anterior (on the lower
  half of the sternum) and the other posterior
  (between the shoulder blades).

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D is the priority

• Defibrillation is the priority in adult SCA.
  Remember that the AED is designed for victims
  over 8 years of age. However, dont be afraid to
  attach it to a child less then 8 and over 1 year
  of age. It is very rare (less then 10) for a
  child to require a defibrillation shock but the
  CPR coach in the AED will be beneficial in
  assisting you with a child in cardiac arrest.
• Note Defibrillation is the definitive treatment
  for ventricular fibrillation which is found in
  70 of adult SCA victims.

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Continue CPR unless signs of Life

• After defibrillation is achieved, continue CPR as
  prompted by the PAD device. If the patient starts
  to show signs of life, such as
• Movement
• Improving skin colour with normal breathing (not
  gasping)
• Moaning
• If signs of life are noted, stop CPR but don't
  remove the PAD or turn it off. If the patient
  slips back into cardiac arrest, the PAD will
  sense it and prompt you to shock the victim. Make
  sure to follow shocking prompts.

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You are a vital Link

• Early CPR and defibrillation is a vital link to
  the survival of a future SCA victim.

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Transfer of Care

• The rescuer operating the PAD shall give a verbal
  report to EMS paramedics and to Fire service if
  they were first on scene, which shall include the
  following information
• 1. If the cardiac arrest was witnessed or
  unwitnessed.
• 2. The number of shocks delivered via AED, if
  any.
• 3. Whether or not there has been a return of
  signs of life.

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Safety Issues

• How safe is this procedure?...
• How do I learn and how do I know I am
• doing it correctly? ...

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• This procedure is very safe as long as no one
  touches the patient while the defibrillation
  shock is being applied. This is why we recommend
  that citizens take a program outlined by EMS.
• NOTE dry up puddles of water i.e. pool decks
  use towels to sop water. A damp deck or bathing
  suit will not compromise safe defibrillation. If
  a puddle of water exists on an ice rink due to
  the ice cleaning machine, have a few people drag
  the victim to a dry area on the ice. The AED
  should be placed on some improvised barrier (i.e.
  backboard, blanket etc.). This will ensure the
  AED battery does not fail due to contact with the
  cold surface.

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Heart Hero Leader

• We need you to teach what you learned to your
  family and friends. If you agree to be a Heart
  Hero Leader, we will need to
• Register your name and phone number (this will
  commit you to teaching at least ten other people)
  
• We will give you a Heart Hero Kit
• You teach as many people as you can and fax,
  email or mail us the completed roster within 30
  days
• This is how we train the masses in a lifesaving
  skill.

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Contact Information

• Kawartha Lakes Emergency Medical Services
• 9 Cambridge St. N., Lindsay ON. K9V4C4
• Phone - 705-328-1976
• Email padprogram_at_city.kawarthalakes.on.ca