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The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

After AED may have saved football player Damar Hamlin, here are five things to know about the device

With the cameras running and millions of football fans watching, Buffalo Bills player Damar Hamlin collapsed on the field after a tackle and went into cardiac arrest.

The cameras also captured moments of medical wizardry as medical teams rushed to his aid to use an AED and start CPR.

Those efforts during the crucial first minutes and seconds saved the professional athlete’s life.

Today, Hamlin is recovering while the rest of us are getting a refresher course on the advances in medical technology and how to save a life.

AEDs, or automated external defibrillators, have become seemingly ubiquitous. They’re in offices, gyms, schools, shopping malls and just about anywhere crowds gather. And there’s good reason: AEDs are easy to use, and they work fast in the most crucial of moments to restore a normal heart rhythm.

“I want to make clear that in terms of somebody who does collapse, anybody should be doing CPR whether you’ve taken a CPR class or not,” said Daniel Ingalls, a paramedic and CPR instructor. He works for Pend Oreille Paramedics, a private Newport paramedics station, and he teaches first aid-CPR classes in Spokane for Providence.

“Ideally, someone is putting the AED pads on while you’re doing CPR,” he said. “The AED is very easy to use; it has pictures on it to help with the location of the pads, it has voice prompts to help you know what to do.”

AED voice prompts will include steps such as moving back and staying clear, if and when the AED shock is necessary. Or the machine might announce, “No shock advised.”

“The AED is analyzing the heart rhythm for an abnormality that could potentially get fixed with a shock, and that’s why it is so important that early defibrillation occurs,” Ingalls said.

In Spokane, bystanders do need to know the location of the nearest AED and what to do, but the machine and often a 911 dispatcher provide the steps, he said.

An app called PulsePoint, designed for people with some CPR training, offers a crowdsourced map of AED locations in the Spokane region. It tells users if a cardiac event is nearby, so they can provide aid. The app has a good mapping of local AEDs, based on voluntary uploads, he said.

Call 911 and start CPR first

“You can do a tap and shout, and say, ‘Can you hear me?’ just to see if there is any normal response,” Ingalls said. “Call 911 right away and start good quality compressions. It’s at least 2 inches of depth at a rate of 100 to 120 compressions per minute.

Allow for a chest recoil, he said, which means to push in with compression that moves blood through the body and provides oxygen and nutrients to the brain, and then to let the chest rise, for blood flow back to the heart.

With compressions, “The best songs to think about are ‘Staying Alive,’ by the Bee Gees or if you have kids, ‘Baby Shark,’ ” Ingalls said.

He said anybody can start the CPR process, even if they don’t have a lot of strength. “Doing something is better than nothing, so just acting and starting that CPR is going to be ultimately better than not doing anything at all.”

Know why AEDs are important

Although AEDs are stationed in multiple public spaces, one misconception is that only medical professionals can use one if a person collapses.

But anyone can use an AED, said Valerie Koch, a regional heart association spokeswoman.

Receiving immediate CPR and an electric shock from a defibrillator are the key drivers of survival for the roughly 350,000 U.S. adults who go into cardiac arrest outside of a hospital each year, says the AHA.

Bystanders administer CPR about 40% of the time and AEDs even less so, it says. About 1 in 10 people who have cardiac arrests in public get this type of help.

Spokane Public Schools has at least one AED located at all 56 SPS school sites, and a response team in each facility, said spokesman Ryan Lancaster. The schools conduct AED drills at least once a year. Many school employees train in CPR and AED use through the year.

It’s the same for Central Valley School District, said Brian Asmus, director of safety and security. The large high schools have more AEDs. The district’s campus resource officers carry them, and in the community, many police officers and first responders carry them, he said.

“They’re more affordable now,” Asmus said. “You see AEDs more. In the city of Liberty Lake, they have them in their city parks. It’s good to have an awareness if you’re in public settings to know where they are, know how to use one and to know they’re not complicated to use.”

It’s also good to have a maintenance schedule. CVSD resource officers every year check the AED batteries and that the machine’s electrode pads haven’t expired, he said.

Be aware of AED basics

First, take the AED out of the cabinet or bag, open the kit and power on the machine, Ingalls said.

Other basics are as follows:

  • Attach sticky pads on the patient’s skin as directed in pictures, following images for where they go on a chest. “An important point for a lay person is to make sure you’re putting those pads on bare skin, so you want to make sure the chest is exposed,” Ingalls said.
  • Wait as the device reads the heart and charges up if a shock is required. Once ready, and if it finds an abnormal heart rhythm, the voice will prompt to push the button for a shock.
  • Know when to briefly stop chest compressions – when the device is reading the patient’s heart and when it is delivering a shock.

The AED prompts go through the motions quickly, such as “Apply pads, plug in connector,” “Analyzing heart rhythm,” “Shock is advised,” or “Shock not advised.” If shock is recommended, tell everyone to get back from the patient and press the button, he said, and the machine will announce when the shock is delivered.

“Now after the shock is delivered, we’re going to go back to good-quality chest compressions.”

Don’t worry that you’ll make things worse

“Definitely with the Damar Hamlin tragedy – and I’m glad he’s doing better – but it opened a lot of people’s eyes,” Ingalls said. “Now, it’s really about getting the community involved and trying to crowdsource as many people as we can get to step in and start doing CPR on cardiac arrests.”

EMS professionals get to scenes quickly, but those seconds and minutes matter, he said.

“The quicker any of this gets started, you improve the potential for a person to live and have a good quality of life,” he said. “There’s a reason there are so many of these stories of people starting CPR and getting an AED, and then you have these good patient outcomes.”

You can’t get in trouble

Washington state has Good Samaritan laws, he said. If a bystanders stops to render aid, they’re protected from liability. However, taking a basic first aid-CPR class will help people gain confidence, he said. AHA, Providence and many other organizations offer regular classes.