Civilian AED Ownership. A Story of Why.

By Jonathan Willis

Update:

 

            It has been a while since this article was originally published, but due to recent events, I felt a need to revisit this important topic. I recently attended the Rangemaster Tactical Conference in Dallas Texas. The evening prior to this event a meet and greet is held, allowing old and new friends alike to come together to kick off what is the biggest weekend of the year in the firearms training world. A short time into the evening’s festivities things “went sideways” so to speak when a friend of mine abruptly said “Jon, we need you NOW!” Two other friends of mine were attending to a close friend of theirs at a table and I approached to assist. As soon as I made contact, the gentleman lost consciousness and went into cardiac arrest. Immediately we took the man to the floor and initiated aggressive CPR. Calls immediately went out to call 911 and for the AED to be delivered. The call was made, but much to our shock, the hotel/convention center in a major metropolitan city, did not have an AED present for us to utilize. In 2024, this is unconscionable!

 

            Realizing the mess we were in without an AED, and that I was committed to providing compressions, Scotty Cronin, who knows what equipment I keep, went through my pockets, retrieved my car keys and sprinted to my vehicle to retrieve my AED. Upon his return, compressions had been assumed by my friend Greg Ellifritz. I moved to the head to apply the AED. Prior to pulling and applying the pads, a fellow rescuer advised that pulses had been restored, and that the patient had began breathing again. ROSC, or return of spontaneous circulation, from CPR alone is quite rare, but here we were. Although we ended up not needing it, the only reason the AED was brought into the equation in this event was because WE brought it. We can be mad about the facility not having one, I think that a fair emotion to have. But knowing that this happened to us in such an improbably location. Maybe we should all take a much more serious look at empowering ourselves with this important tool. As for our patient, his condition took an unforeseen turn with the Medics and Hospital staff, and he unfortunately did not survive. My deepest condolences to all friends and family of this much-loved man.

 

Original Article:

 

            It should go without saying that EVERY physically capable person should learn CPR. Cardiopulmonary Resuscitation is affordable, if not free, easy to learn, and has been simplified to a point where it’s almost impossible to forget. Given that 350,000 times a year people experience sudden cardiac arrest events outside of hospital environments, a capable and willing citizen may be the literal difference between life and death. All this being true, the harsh reality is that cardiac arrest survival, when only receiving CPR, is at best, bleak. Studies show a range of between 7% and 12% survival. 

 

            Let’s reflect on what the actual goal of CPR is, and why quickly initiated, aggressive CPR matters. The real purpose of CPR is to circulate remaining oxygenated blood to the brain while we await the most crucial components of cardiac arrest treatment; shocks and drugs. All the CPR in the world by its best practitioners will mean little if we don’t progress in the “chain of survival.” The chain of survival, per the American Heart Association, is as follows; Call 911, Start CPR, Use AED, EMS advanced resuscitation, Hospital post arrest care, Recovery. Most folks in their non-professional contexts rarely consider anything beyond the first or second links in this chain. Some however are realizing and taking action to impact patient outcomes up to that vital third link, “Use AED.” 

 

Automated External Defibrillators Save Lives.

 

            According to research from the National Institute of Health, a good mix of cardiopulmonary resuscitation AND early defibrillation can boost survival rates to 70%. There is a 7-10% drop in cardiac arrest survival for every minute a patient waits for defibrillation. These are a couple of good statistics to remind you that time is of the essence. Parallel to my work within the firearms community, also teach civilian trauma management, CPR/BLS, and technical rescue in the industrial safety realm. In every one of these teaching environments students are always shocked to know exactly how far away Fire/EMS really is. The same applies to your home. If you imagine EMS walking through your front door to save the day in 4 to 6 minutes, you are going to be incredibly disappointed. Statistically speaking, nothing like that is going to happen. Many of us have loved ones or visitors on a regular basis of varying medical background and complexities. Now visualize yourself in a remote location, perhaps participating in a strenuous activity in mixed company. Firearms trainers, most of us have a strong trauma kit game, but how far from your firing line is an AED in those Summer training weeks between 90 and 100 degrees? Let’s all agree that reducing this timeline of intervention is an important consideration in every context possible.

 

            This Spring, I was traveling home from a safety convention for a large Ohio based company where we were providing CPR/BLS and Confined Space Rescue trainings. We were discussing or day of instruction and I was speaking of my enjoyment in teaching something as seemingly simple as CPR. It’s fun, meaningful, and we can teach nowadays offering more of our realistic perspective from experiences on the street. It dawned on me that I was teaching CPR and espousing the benefits of the AED and the real possibilities of witnessing a cardiac arrest at some point. I was talking that game, but not really living it. Me, a dude who spends most of my time in a VERY low crime middle to higher income area and carries a gun every place I’m legally authorized to. Me, a certified Paramedic with and large amount of medical knowledge, skills, and abilities. I would still be the guy yelling “where the hell are they” as I awaited the government to hopefully solve a problem that I’m capable of making a dent in. That is not acceptable to me. I asked my friend who owns the company I teach for about AED costs and civilian AED ownership. The short answer, every one of us are $1300 to $2400 away from having this vital option, and not that many people even know then can. I could close my eyes and picture my gun safe, knowing that something in there could represent that cost immediately. How could I reconcile that being the truth, while not putting something in my home that could save someone I love? Or even myself?

 

            This week I took receipt of two HeartSine Samaritan 450 P AEDs from Firefighter Safe near Dayton Ohio. This AED is so advance that it talks ANY person through every step of its use. It also coaches the user in the quality of compressions being delivered, whether to speed up or slow down, and counts out all compression to ventilation ratios. Another bonus with this model is that it is extremely small and light. Lower end offerings will tend to be much larger and heavier which obviously affects portability. The modern AED is absolutely a tool most anyone can use. There are many options out there that may meet your needs. Price, patient use potential, weight/size, ease of use and supportive technologies vary greatly, but most importantly, potentially lifesaving defibrillation is not too expensive to be practically available in your home. 

 

Because of my lifestyle, we determined I would acquire two of these tools. The first would be staged in a central location in my home and my family is receiving updated training on CPR and AED use. The second would travel with me. I spend a great deal of time teaching a training remotely and I’m not going to expect this to have been done by someone else. At Gunset Training Group courses, AED location and retrievers are stated and assigned in every safety brief. As instructors, often operating in less than comfortable environmental conditions, we must be prepared for these potentials and convey to our trusting students that we’ve considered this aspect of their safety. 

 

            Whatever AED you chose or have assigned, you need to be aware of its operating condition. Often there will be some obvious indicator of function by a green light or in some models the word “OK” with a checkmark. A red light of any sort if often an indicator of a battery issue or some other function in need of evaluation. If in doubt open it up and check it out. I was in a gym the other day walk by an AED with a big bright red service light flashing. In a GYM!! 

 

One of the reasons I went with the HeartSine 450 is that it’s battery pack and pads are on a linked 4-year replacement cycle. Some AEDs will have the battery and pad cycles at differing intervals. This can cause confusion and lead to the device potential failing in the hour of need. Not a good thing. This is one reason I recommend working with a professional company who puts the device into a reminder cycle to alert you when due. Firefighter Safe does this and I appreciate that.

 

            Every Automated External Defibrillator must be stored with a few critical items, never to be separated. At minimum the kit should include; storage container appropriate for area of operation, AED, Pocket Mask w/ one way valve, trauma shears for cutting all clothing of upper body including bras, Razor capable of dry shaving any hairy chest. This foundational kit can be expanded upon based on the training level of its potential users. My mobile AED kit with have a bit more advanced lean to it as I would be working with less support and greater response times. That will include items like bag valve mask (BVM), Oropharyngeal Airways (OPA), extra gloves, etc.…

 

 

               The idea of owning and Automated External Defibrillator will be new to most. For me, it was always something I would say, or think about, but never act upon. Because of the 20 years I spent being a guy on the other end of a 911 call, I can recall hundreds of scenes where family members would have given a million dollars for a real chance to change the results. They cannot. Because of the work I do now, I regularly here stories of companies or people we’ve taught, saving or being saved by these amazing tools. Me and mine will not suffer the torment of “What if?” or “If I’d only.” The question remaining is how much is a good chance worth to you?