Life-Point AED Trainer
An automated external defibrillator for training purposes – With the publication of the new FIRST AID REGULATION in the Official Gazette on July 20, 2015, the legal basis for AED (automated external defibrillator) use has been defined. In accordance with this Regulation, Automated External Defibrillators required for training may be purchased from our company, which manufactures defibrillators, at reasonable prices and conditions.
In terms of their appearance, automated external defibrillators for training purposes are exactly the same with actual automated defibrillators, but they do not have charging/discharging energy function. The aim of these devices is to familiarize trainees visually with automated defibrillators, enabling them to use AEDs effortlessly when they intervene in a real case.
Interview with Assoc. Prof. Dr. Mutlu Vural published in Akşam daily on July 13, 2014
Unless a person suffering sudden cardiac arrest is treated, cerebral death starts after 3 minutes, a period that we call the “golden minutes”. Around 10 minutes later, the victim’s brain is completely dead. In other words, a person who suffers sudden cardiac arrest is already dead when the ambulance arrives. Even so, Turkish society still does not have the skill to perform cardiopulmonary resuscitation or to apply electroshock. Nevertheless, in the last 10 to 15 years, many societies have achieved the skill to perform both cardiopulmonary resuscitation and electroshock. Our main target is to strengthen the basic rescue chain in our society for emergency situations that occur outside hospital, particularly in relation to sudden cardiac arrest.
THE BASIC RESCUE CHAIN
The basic rescue chain consists of 5 links. The first one is to call emergency 112. A healthcare professional must come to the scene. This is the first thing we should do. If there is someone with us, we get him or her make the call in order to save time. If we are alone, we should make the call. After that, we perform basic life support. If the victim is in cardiac arrest, we perform CPR. If we know how to give artificial respiration, we give it, if not, we continue only with CPR. The third link is to use the AED or intervention with an electroshock device in ordinary language. These three links must become public knowledge. The fourth link is the ambulance, and the fifth is the place where the ambulance goes, the hospital. In Turkey, the rescue chain comprises 4 instead of 5 links. The first link is to call emergency 112, something with which we also have problems. The second link is basic life support, where we have only a few first responders. Intervention before the arrival of the ambulance is almost nil. The third link is the ambulance and the fourth is the hospital. Why do foreign countries have a higher level of first aid? Because it is mandatory. Let’s say you had a heart attack at a shopping mall abroad and died. If there is no electroshock device in that shopping mall, this is perceived directly as involuntary manslaughter, as it is compulsory for malls to have AEDs. This is also true for schools and public transport, the personnel of which must also be trained.
FIRST AID TRAINING
The intervention made by healthcare professionals is called medical intervention. In turn, the intervention of those who are not healthcare professionals is called first aid. In fact, in relation to situations that do not require an emergency response, we resort to the healthcare system. First aid training takes 2 days and 16 hours, and you take an exam once the course is completed. Having all adults receive first aid certificates should be our target, because we do not recommend intervention by people who do not have a first aid certificate. Certified first responders must obey the laws too. When we go out, we may witness someone we do not know or a colleague suffering sudden cardiac arrest, and we may find ourselves in a situation where we must intervene. This is a social responsibility, a duty to the society in which we live; yet, even healthcare professionals hesitate before intervening. In order to intervene, he or she should not have negative thoughts such as, “If I intervene now, I will have to give a statement to the police, then they will summon me to the court; the victim may even sue me for damages and I may be charged.” And this is only possible by granting immunity from prosecution to certified first responders.
WHY DO WE NEED THE PUBLIC?
For instance, with sudden cardiac arrest, cerebral death kicks in starting from the fourth minute. When we look at the average time for an ambulance to arrive, we see that it is 10 minutes in urban areas and 30 minutes in the countryside. So, by the time the ambulance arrives, the damage is already done. If no-one intervenes to help a sudden cardiac arrest victim, the patient is considered dead after 12 minutes. In most cases, the ambulance arrives later than 12 minutes. Therefore, there must be solidarity regarding first aid between society and healthcare professionals.
HOW CAN WE RECOGNIZE CARDIAC ARREST?
A healthy person loses consciousness and collapses immediately after the complaints begin. If the person is breathing as if they are sighing and short of breath, they are experiencing a cardiac arrest. This is how we define sudden cardiac arrest. When the heart stops beating, the brain cannot get oxygen, and you collapse on the spot in only 10 seconds, as if you have been unplugged. Unfortunately, in our country 99 percent of those suffering cardiac arrest die before arriving at the hospital. Our aim should be to reduce these deaths. If we intervene within 2 minutes, and perform electroshock, if a device is available, the victim’s heart will start beating again, they will start breathing and regain consciousness. But, if the process takes longer, the person will start breathing again, but it could take several hours for the brain to regain consciousness. Even worse, brain damage may occur if the intervention is too late.
HOW DO YOU PERFORM CPR?
If there is no electroshock device around, we perform CPR. We call this hands-only CPR. And in this practice, when we apply pressure on the victim’s chest, keeping our elbows straight, the victim’s heart is compressed between the chest and vertebra, and starts to pump blood. When we compress again, the victim exhales, and when we release the pressure, the chest rises on its own. With each compression, the victim exhales, the heart pumps blood, and when released, the heart refills with blood and the lungs refill with air. So, you are maintaining blood circulation, as well as providing respiration and this, to a certain extent, is enough. That is why the importance of respiration has declined, and nowadays CPR has come to the fore. Of course, what I have been talking about so far related to people who are 13 years of age, or older. The situation for children is somewhat different. Respiration is slightly more pronounced in children.
WHAT KIND OF PROBLEMS DO WE HAVE?
For instance, the first link of the chain is to call 112. The number of calls received by emergency service is excessive. Yet, regrettably, 90 percent of these calls have nothing to do with medicine. And this may delay the 112 answering service responding to an actual patient by up to one minute. A emergency operations center receives 90,000 calls per day in Istanbul alone, and more than 90 percent of these are not related to medicine. People call 112 for anything other than emergencies. Above all, we need to prevent this from happening.
The number of those who are trained in first aid should be increased, and first responders should be encouraged, as well as legally protected. For instance, there is no obligation to have automated defibrillators available. Consequently, the basic rescue chain in our country has only 4 links.
If automated external defibrillators are included in the chain, it will have 5 links. Operating these devices is so simple that even a 10-year-old child can do it. It guides you with commands in Turkish. Commands already should be in the native language.
We are completely falling behind in this respect. In America, they have one device per 10 people.
IS IT POSSIBLE TO GET ONLINE TRAINING?
Online training is quite common overseas, because in this way you can reach more people. You can reach people very easily and create awareness in a very short time. In addition to online training, training is also provided using public service advertisements, and certificates are issued after these too. We want to pave the way for this approach to be used in our country. And we are willing to provide such training free of change. Our target is to teach 10 million people CPR in 10 years and 30 million people in 20 years.
AT 103 BEATS PER MINUTE
The Bee Gees’ song, “Stayin’ Alive”, has been used around the world in first aid training since 1972. Our first responders have been using that song as well. So we decided to compose a national song. And we called it “Hayatta Kal” (“Stay Alive”) in Turkish. The song has a beat of 103 bpm. This is because we don’t want to have CPR of less than 100 beats per minute. It should be between 100 and 110 per minute. This beat of 103 bpm is also used globally for training. As a result, we composed a song called “stay alive” with a beat of 103 bpm. Vural Şahin wrote the lyrics of the song. It was composed by Tuncay Yalın, a composer endorsed by the Ministry of Culture. And Ali Avni performed the song. People will be able to learn CPR according to the beat of this song. We will also shoot a video clip for the song. We will also try to reach to more people through television as well. The beat of the awareness song is faster, 120 bpm. We are thinking about filming a video clip for that song also. We applied to “ttmuzik” to get them on air. For training though, the song was composed at 103 bpm.
WHAT IS THE SITUATION ABROAD?
In the US, they have 1 minute videos explaining how to intervene in cases of sudden cardiac arrest. We translated the hands-only CPR video of the American Heart Association into Turkish. It is only 1 minute long but explains the subject very well. Moreover, there is a website called cprtoday.com supported by CNN International. They teach CPR on that website as well.
They also suggest that CPR can be learned in 30 minutes to an hour, depending on the trainee’s level. They have reached 500,000 people so far and granted them online certificates. Since the law supporting the society in sudden cardiac arrest intervention was ratified in 2000, the survival rate has increased by 5 percent (15,000 people per year). Moreover, in many European countries, the answering service personnel at emergency health services operation centers encourage intervention over the phone to those around the patient, until the ambulance arrives.