Automated External Defibrillator: A Self-Help Weapon for Sudden Cardiac Arrest

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  Not long ago, at the half marathon in Zhuhai, Guangdong, a 30-year-old contestant died suddenly due to cardiac arrest, which attracted public attention. The incidence of cardiovascular disease in my country is increasing, and cardiac arrest is not far away from us. If you or someone close to you belongs to the following two groups, you should pay special attention.
  High-risk groups
  Cardiovascular disease groups with a history of myocardial infarction, or middle-aged and elderly people with coronary heart disease are high-risk groups for cardiac arrest. In addition, patients with high blood pressure and diabetes have a long medical history and many underlying diseases, and the risk of cardiac arrest is also greatly increased.
  The first manifestation of coronary heart disease attack in many sub-healthy groups is sudden death, that is, there is no symptom before the onset, and even no risk factors such as high blood pressure and high blood fat are found at ordinary times. This situation directly points to the sub-healthy people who have been in a tense working state and under huge psychological pressure for a long time. Sudden stress, exercise, excitement, etc., may induce cardiac arrest and cause sudden death.
  Ventricular fibrillation
  The vast majority of cardiac arrests are caused by fatal cardiac arrhythmias, and 80% of them are ventricular fibrillation (referred to as ventricular fibrillation). After a patient suffers from ventricular fibrillation, the best rescue time is the first 3 to 5 minutes. For every 1 minute delay in cardiopulmonary resuscitation and defibrillation, the survival rate of sudden cardiac death will decrease by 10%. Therefore, if the patient’s ventricular fibrillation can be resolved in the first place (ie defibrillation), the vast majority of patients with cardiac arrest can save their lives.
  However, less than 1% of patients are lucky enough to be rescued. The reason is that most people don’t know the basics of CPR and don’t have an automated external defibrillator around until the paramedics arrive.
  Before the ambulance arrives,
  the first aid for “self-help” cardiac arrest is divided into four steps, namely, early access (call for help), early cardiopulmonary resuscitation, early electrical defibrillation, and early advanced life support. The combination of these four steps is the “chain of survival” proposed by the American Heart Association for cardiac arrest.
  Step 1: Early access (call for help). Immediately notify the nearest rescue agency, and accurately report the basic situation and location of the patient; at the same time, take the second step before the ambulance arrives: “self-help” on-the-spot rescue.
  Step Two: Early CPR. It includes chest compressions and artificial respiration. Correct operation of chest compressions: Let the patient lie on his back, the rescuer clasps his fingers tightly on the middle and lower part of the patient’s sternum, and presses down vertically. Chest compressions should be strong and fast. Adult recovery compressions are 100 times per minute, and the compression range is 4 to 5 cm. After each compression, the chest completely rebounds. Ensure that the release and compression time are basically the same, and the compression should not be interrupted as much as possible. . The correct operation of artificial respiration is: let the patient lie on his back, tilt his head back, the rescuer pinches and closes the patient’s nostrils, and after taking a deep breath, forcefully blow air into the patient’s mouth. It is effective if the chest rises and falls. About 12 times per minute.
  Step Three: Early Defibrillation. Early use of automatic external defibrillator (AED) or manual defibrillator for electric shock defibrillation is of key significance to improve the success rate of resuscitation. The combination of early cardiopulmonary resuscitation and early electrical defibrillation can make the success rate of resuscitation more than 50%. Therefore, in dealing with patients with cardiac arrest, defibrillators must be applied as soon as possible. The operation of the AED is not complicated, and the user does not need to have the ability to interpret the ECG at a high level. As long as the power is turned on and the discharge button is pressed, the automatic analysis of the ECG and defibrillation can be completed. Therefore, if there are people with cardiovascular diseases such as coronary heart disease at home, it is very necessary for family members to master primary CPR and equip an AED (the price is similar to a high-end laptop) at home.
  Step Four: Early Advanced Life Support. After the first three steps of “self-help” rescue, the patient finally waited for the arrival of the ambulance. At the scene, if necessary, endotracheal intubation can be implemented, and a breathing bag or a simple ventilator can be connected to ensure that sufficient oxygen enters the lungs. If the condition permits, send the patient to the emergency department of the hospital as soon as possible for advanced life support after resuscitation. The first three steps play a decisive role in the success of advanced life support, which buys time for doctors to save patients and prolongs the lives of patients.

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