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 (photo: BOC Healthcare)
19.10.2015, 17:49

Is your Centre Prepared for Sudden Cardiac Arrest?

Health, Safety & Environment

Chery Toole, product manager for BOC Healthcare's Lifeline Range, considers the risks of sudden cardiac arrest (SCA), and solutions that are available for operators and managers of leisure centres and other facilities.

Chery Toole, product manager for BOC Healthcare's Lifeline Range, considers the risks of sudden cardiac arrest (SCA), and solutions that are available for operators and managers of leisure centres and other facilities.

 

 

Sudden cardiac arrest (SCA) is a condition in which the heart suddenly and unexpectedly stops beating. If this happens, blood stops flowing to the brain and other vital organs. SCA is not the same as a heart attack – during a heart attack, the heart usually doesn't suddenly stop beating and a person can be conscious and aware. In contrast, during a SCA a person is unconscious and may stop breathing – SCA usually causes death if it's not treated within minutes.

 

SCA can occur anywhere; at any time. Out of hospital episodes have an incidence of approximately 66 per 100,000 Europeans every year and in the UK, SCA counts for almost 1/5 of all deaths recorded. People who have heart disease are at higher risk for SCA. However, SCA can happen in people who appear healthy and have no known heart disease or other risk factors.

 

WHAT IS REQUIRED OF YOU?

The Health and Safety (First-Aid) Regulations 1981 require employers to provide adequate and appropriate equipment, facilities and personnel to ensure their employees receive immediate attention if they are injured or taken ill at work. The Regulations do not place a legal duty on employers to make first-aid provision for non-employees such as the public users of a premises or children in schools. However, the Health and Safety Executive (HSE) strongly recommends that non-employees are included in an assessment of first-aid needs and that provision is made for them. This means that as a facilities manager, your duty of care covers not only your team but all users of your premises.

 

It is a legal requirement for every UK business to carry out a fire risk and first aid needs assessment. This order applies to premises such as offices and shops; premises that provide care, including care homes and hospitals; community halls, places of worship and other community premises. It also covers pubs, clubs and restaurants; schools and sports centres; hotels and hostels as well as factories and warehouses. What is ‘adequate and appropriate’ will depend on the circumstances in the facility. This involves consideration of workplace hazards and risks, the size of the organisation and other relevant factors, to determine what equipment, facilities and personnel should be provided.

 

THE ROLE OF DEFIBRILLATION

It is estimated that there are around 100,000 deaths caused by SCA in the UK and Ireland each year compared to approximately 364 fire fatalities. Given this, if almost all risk assessments conclude that a fire extinguisher is a must-have provision then surely equipment that accounts for SCA should also be considered. In fact, the chance of death by SCA is approximately 300 times greater than that by fire; bearing this in mind, why is access to a portable Automated External Defibrillator (AED), a rare possibility yet a fire extinguisher is almost always only at an arm’s distance away?

 

An AED is a portable device that checks the heart rhythm and sends an electric shock to the heart to restore a normal rhythm when it is interrupted or has stopped. Most deaths caused as a result of SCA are potentially avoidable by using AEDs. In the event of SCA, every minute that defibrillation is delayed the chance of survival decreases by around 7 to 10%. Most deaths caused as a result of SCA are potentially avoidable by using defibrillation, but the success rate is high only if treatment can be given within four to five minutes of the event - easy access to on-site devices and prompt defibrillation has the potential to save lives.

 

CASE STUDY: SCA IN THE YOUNG

Although SCA can hit at any age, the risk of SCA in young athletes is increased 2.8-fold compared with non-athletes of similar age. Sudden death from cardiovascular disease is also the principal cause of death in young athletes during exercise and represents 75% of all fatalities during sport. If your facility is one frequented by active children, the case for a defibrillator is even stronger.

 

Tara Bonnett, Duty Manager at Lea Manor Recreation Centre, part of the Active Luton sport and leisure trust, has direct experience of the importance of having an AED on-site. The sports centre is regularly used by local schools for PE and other sports activities. 16-year old Rahul Patel was in a regular PE lesson on the premises when he suddenly collapsed, lost consciousness and stopped breathing. Having received an AED from BOC Healthcare at her centre the week before, Tara had the ‘adequate and appropriate’ equipment as recommended by the HSE at her centre. She performed CPR and applied the AED pads to Rahul. The device analysed the heart rhythm and prompted Tara to administer the defibrillation shock. Tara and her colleague continued with CPR and deployed the AED as advised by the unit.

 

Tara Bonnett of Active Luton.
Tara Bonnett of Active Luton. © Active Luton
Allowing time to make an emergency call, the ambulance journey time and the time taken to administer a shock, the delay from collapse to paramedic treatment is usually 13 to 14 minutes at best. After this length of time there is virtually no chance of survival. By having awareness of SCA and easy access to the AED, Tara saved Rahul’s life. He has since made a full recovery, been fitted with a pacemaker and is living a normal life, which doctors have put down to Tara and her colleague’s fast and effective action. The team has also since been honored at Luton Sports Network Awards.

 

Tara is proof of the value in having an on-site AED: “We had evaluated the arguments for buying an AED and had concluded there was a clear benefit to be gained from adding one to our inventory of medical support equipment. It was a surprise to everyone, though, just how quickly that decision would be justified in practice. It was of course an unexpected experience for us but knowing we had the right equipment and had been fully trained in its use meant we were able to handle it effectively”.

 

Active Luton’s Chief Executive Helen Barnett believes it is important to be prepared: “While incidents like this are very rare, it does demonstrate the importance of ensuring our staff are equipped to deal with situations like this…It is one thing to learn something in training; but applying it in a real life emergency situation shows real courage.”

 

NOT JUST THE EQUIPMENT

European Resuscitation Council (ERC) guidelines place great emphasis on the importance of effective CPR in the event of sudden cardiac arrest. 70% of all CPR is carried out inadequately; when using an AED it is best to minimise interruptions in chest compression and performing chest-compression-only CPR is better than giving no CPR at all. It is therefore advantageous to use an AED which provides feedback on the pace and pressure of compressions during CPR. Training courses in emergency CPR are strongly recommended to ensure ‘good compressions’ are always deployed. Where an employer decides to provide a defibrillator in the workplace, those who may need to use it should also be trained to provide additional knowledge and skills and to promote greater confidence in its use. Although these units can be operated by anyone, it is always recommended that staff undertake a short training course in their correct use. In Active Luton’s case, Tara had completed her training just a week before the incident.

 

Most people who have SCA die from it – often within minutes. Every week in the UK, 12 apparently fit and healthy young people aged 35 and under die from undiagnosed cardiac conditions. AEDs are designed not just for use by medical professionals but also by appropriately trained first aid personnel in commercial and community premises – enabling these bystanders to save the lives of people who encounter SCA.

 

As part of a complete resuscitation solution BOC Healthcare supplies a range of AEDs. Visit www.bochealthcare.co.uk for more information.




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Chery Toole, product manager for BOC Healthcare's Lifeline Range, considers the risks of sudden cardiac arrest (SCA), and solutions that are available for operators and managers of leisure centres...