Four Critical Minutes

Sudden cardiac arrest (SCA) causes 13 percent of workplace fatalities, according to the Occupational Safety and Health Administration (OSHA). OSHA receives about 400 reports of workplace deaths from cardiac arrest annually. Most of these deaths occur outside of a hospital; the current out-of-hospital survival rates are between 1 and 5 percent, pointing to a need for training in cardiopulmonary resuscitation (CPR) and the use of automated external defibrillators (AEDs). Below, you’ll find answers to some frequently asked questions about cardiac arrest.

What is SCA?
A normal heartbeat is caused by rhythmic electrical impulses. SCA is usually caused by arrhythmias or abnormal heart rhythms. The majority of SCAs are caused by ventricular fibrillation, which is a condition where the electrical impulses of the lower heart chambers suddenly become chaotic, causing the heart to stop pumping blood. Unless the heart returns to its normal rhythm, death occurs in a matter of minutes. SCAs are not predictable and can strike victims with no history of heart problems.

Is SCA the same as a heart attack?
No, a heart attack is the death of the muscle that makes up the heart. It is caused by a loss of the blood supply to that part of the heart. The person typically has symptoms leading to the attack. SCA is an issue involving the heart’s electrical impulses.

What is the treatment for SCA?
According to the American Red Cross, four critical steps, the “Cardiac Chain of Survival,” should be used to treat SCA. The steps are as follows:

• Early access to care: Call 911 or emergency medical services (EMS) immediately.
• Start CPR as soon as possible.
• Defibrillate as soon as possible (AED).
• Use early advanced cardiac life support.

All steps help increase a victim’s survival rate, but performing defibrillation is the most critical step.

What is defibrillation?
Defibrillation is the treatment for irregular, sporadic or absent heart rhythms. It is an external electrical current that “resets” and returns an irregular or absent heartbeat to the normal rhythm. Defibrillation is most successful when performed within four minutes of the collapse. An AED is a portable device used to defibrillate.

Why not wait for EMS?
A victim’s best chance for survival is if CPR and defibrillation begin within four minutes of the collapse. Many times, an EMS crew’s response time is longer due to traffic or distance the crews need to travel. Also, not all emergency medical agencies are equipped with AEDs.

The following are some other important AED facts:

• It is not possible to give an unnecessary shock while using an AED. If the need for a shock isn’t detected, the device will not release an impulse and will indicate that CPR should be started.
• It is safe to use an AED on metal surfaces as long as the defibrillator’s electrodes are not allowed to come in contact with the metal surface.
• AEDs can be used in the rain and snow provided that neither the victim nor rescuer is in a puddle of water.

Because of the vital time frame, employees should know CPR and should have an AED on-site. For example, late in 2011, an employee became pinned under a trenching machine that he had been operating. Coworkers sprang into action, removing the machine from the employee and administering first aid, CPR and using an AED on-site. The quick action of the other workers and their training saved this individual’s life. There is no question that training is expensive, but when faced with a situation like this, the benefits are immeasurable.

Are AEDs needed in the workplace?
The average American spends a considerable amount of his or her waking hours each day at work. It makes sense that more lives will be saved by having AEDs in workplaces of all types. The Red Cross states that, wherever groups of people gather, the risk of an SCA is likely.

Who can buy an AED?
FDA regulations state that a doctor’s prescription is needed to buy an AED. Once the AED is purchased, the majority of states have a requirement for a medical director or medical oversight, but this requirement varies by state.

Who should be trained to use an AED?
Proper training in CPR and AED use are two crucial elements of helping someone survive sudden cardiac arrest. Having well-trained people in the workplace can help save lives.

KELLY is a safety and health specialist with Intec, a safety consulting, training and publishing firm that offers on-site assistance and produces manuals, training videos and software for contractors. She can be reached at 800.745.4818 and Joe O’Connor edited this article.

About the Author

Diane Kelly

Safety Columnist
Diane Kelly is a safety and health specialist with Intec, a safety consulting, training and publishing firm that offers on-site assistance and produces manuals, training videos and software for contractors. She can be reached at 800.745.4818 or dkell...

Stay Informed Join our Newsletter

Having trouble finding time to sit down with the latest issue of
ELECTRICAL CONTRACTOR? Don't worry, we'll come to you.