Watching her co-worker that morning, Nancy Myers remembered thinking, "Man, she's quiet."
"And then she just said my name and slumped over," said Myers, who works for the Kenai Peninsula Borough's finance department. "I rolled my chair around and grabbed her and she was out. She had a pulse and was breathing, but she didn't come to."
Her co-worker's plight and the actions of Myers and other borough employees in the moments following that incident had an effect that rippled through the Borough Building. The result was a request from Borough Mayor Dale Bagley to Central Emergency Services for cardiopulmonary resuscitation -- CPR -- and first aid training.
Tim Cooper, captain with Central Emergency Services, who has been teaching CPR and first aid classes since 1980, immediately saw the request as an opportunity to train borough employees in the use of an automated external defibrillator -- AED -- used to revive victims of cardiac arrest.
Cooper's involvement with the American Heart Association and his travels as chairman of the Emergency Cardiac Care Committee recently brought him into contact with a Seattle doctor who had been given an AED by the manufacturer, Physio-Control. The doctor, in turn, redirected the donation to CES to be used for training purposes.
Slightly larger than a lunch box, smaller than a briefcase and costing between $3,500 and $5,000, the AED is a computerized piece of equipment that carries enough electrical power to light up a football field. It analyzes the heart rhythm of a person in cardiac arrest, recognizes a shockable heart rhythm and advises the operator through voice prompts and lighted indicators whether the rhythm should be shocked. The whole point is to use electricity to stop abnormal electric activity in the heart and allow it to resume normal functions.
On Wednesday, Thursday and Friday, 18 borough employees learned how the puzzle pieces of CPR, the AED and first aid fit together. According to information supplied by the National Safety Council and the American Heart Association, 1.1 million heart attacks occur every year in the United States. Coronary heart disease accounts for 480,000 deaths annually. Prehospital cardiac arrests result in 250,000 deaths on a yearly basis.
"You're going to have a co-worker, a family friend, a person you go to church with, someone having an emergency," Cooper said. "It could be simple or it could be life-threatening. The decisions you make could have a bearing on the outcome."
During training, the employees were familiarized with a four-link chain of survival for situations involving cardiac arrest:
n Call 911;
n Begin CPR;
n Use the AED; and
n Transfer of the victim to advanced care.
Why put an AED at the Borough Building with CES only two blocks away? Cooper said survival for cardiac arrest victims is reduced by seven to 10 percent each minute. Within five minutes, survival rate has dropped to 50 percent. A training video pointed out that CPR will extend the survival time by keeping a flow of oxygen going to the body, but rapid defibrillation is the key.
Cooper and his students walked through response activities, beginning with finding the victim to calling and relaying the information to CES, getting response personnel into the ambulance, driving to the scene and locating the emergency situation.
"By the time we get (to the Borough Building) and intercede, we're about five minutes into it," Cooper said. "The chance of survival is at 50 percent. That's why it's important, even two blocks away. The earlier we do something, the greater the chance to bring someone back.
"Time is the whole purpose of this program."
In order to be certified as capable of operating the AED, borough employees responded to a variety of challenging scenarios. Nervous laughter eased the adrenaline flow as teams trouble-shot situations that placed victims in a variety of imagined settings, from crowded banks and casinos to swimming pools. Working in groups of three, they assessed the severity of the situations, determined when and if CPR and AED were required and administered the appropriate response.
Myers' experience with her co-worker underscored the need to consider a variety of settings.
"It was really bad because the area we were in, we couldn't lay her down," Myers said. "There was no room."
Cooper and Sam Evanoff, a CES firefighter and EMT, added unexpected twists of reality with shouts of imaginary pain and role-playing as nosy bystanders or worried family members.
"That class was really good," said Mayor Dale Bagley. "I have been EMT certified before and CPR certified before, but this is the first time I've had AED certification. That thing is incredible."
Today, the AED will be installed at the Borough Building, where it will remain until a replacement is purchased.
"We're going to have it downstairs outside the assembly chambers," Bagley said. "That way, it can be used by anyone from the borough or during evening meetings.
"I think this is a very, very good thing."
The purchase of defibrillators for other borough facilities is being considered. But, as with emergency response, there is a chain of events that has to take place.
"First we had to get people trained in its use," Bagley said.
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