On March 25, 2000, Louis Acompora of Long Island played his first game for Northport High School’s freshman lacrosse team.
Acompora, the team’s goaltender, wore the requisite extra padding for his shoulders, arms and chest. Lacrosse balls are smaller than baseballs, but they’re just as heavy; getting hit with one hurts.
A goalie’s job is to ignore pain and keep the ball out of the net. That’s what Acompora did when he stopped a seemingly routine shot with his chest early in the second quarter. Then he staggered a few steps, went down and didn’t get up. Coaches and trainers who rushed to his side found him in cardiac arrest. They started CPR and called 911.
When EMS arrived 15 minutes later, Acompora was in ventricular fibrillation (VF) due to commotio cordis, a lethal blow directly over the heart during a brief-but-vulnerable phase of repolarization.
VF often responds to prompt defibrillation; for each minute of delay, though, the odds of survival diminish by about 10 percent.
It was too late for Louis. He was 14.
Improving the odds
Lightweight, user-friendly automated external defibrillators (AEDs), devices that sense and correct dangerous arrhythmias like VF with minimal operator involvement, have been marketed to the public since the mid-1990s.[1] Organizations and even individuals can help prevent deaths from sudden cardiac arrest (SCA) by making AEDs available to the public. Here’s how:
1. Partner with a foundation
Karen Acompora – Louis’s mother – is co-founder of the Louis J. Acompora Memorial Foundation, an organization dedicated to placing AEDs where they can best help victims of SCA.
“I just don’t understand why defibrillators aren’t more available,” Acompora says. “AEDs are a standard of care. Fifteen years ago when we started this they weren’t, but with education and ease of use, they’ve become a tool for the average bystander to save someone’s life.”
Acompora is talking about public-access defibrillation (PAD), a 1994 American Heart Association initiative to broaden awareness and use of AEDs in the setting of SCA.[1]
“The average response for EMS in most of the U.S. isn’t fast enough to solve that problem by itself,” says Acompora. “Ninety percent of SCA victims are still dying.”
The Acompora Foundation offers free, practical advice to communities of any size wishing to implement PAD. So do these organizations:
2. Raise funds
PAD organizers who can’t afford AEDs should consider fundraisers. Online crowd sourcing programs like Kickstarter are popular; so are these conventional alternatives suggested by the Sudden Cardiac Arrest Foundation:
- Walkathons
- Car washes
- Golf tournaments
- Bake sales
- Pancake breakfasts
- Bingo
- Telethons
3. Apply for grants
Grants may be available from federal, state or local government agencies, community and hospital foundations, corporate foundations and community service organizations.
Be prepared to make a presentation about the cost and effectiveness of AEDs. Purchases dedicated to public welfare often can’t be justified in dollar terms, but PAD proponents still have to satisfy grant requirements that funds will be spent wisely.
4. Make lifesaving everyone’s business
An often overlooked environment for AEDs is the corporate world, where stress alone can lead to cardiac arrest unrelated to heart disease.[2] EMS agencies can help major employers and other population clusters in their communities purchase and place AEDs, then train potential users.
“We have 3,500 employees and 22 easily accessible AEDs,” says paramedic Danny Burton of Marriott’s Opryland Hotel in Nashville, Tennessee. “The key is teaching everyone how they work so there’s no fear of using them.
“In the eight years I’ve been here, we’ve had six cases where AEDs were involved. All of those patients were in cardiac arrest. Four survived [neurologically] intact.”
5. Enable private citizens
Part of EMS’s role is to teach civilians to recognize cardiac arrest, perform CPR and use available AEDs. EMS can also help citizens – especially those at risk for SCA – purchase defibrillators for home use through companies like AED Superstore that bundle prescriptions and medical direction with their hardware.
“The technology is here,” says Acompora. “Now education is the key. People need to know why they should have AEDs; that the only way to save an SCA patient is with early defibrillation.
“EMS isn’t always going to be there first.”
References
1. Weisfeldt ML, Kerber RE, McGoldrick RP, et al. American Heart Association report on the public-access defibrillation conference December 8-10, 1994. Circulation. 1995;92:2740-2747.
2. Modi S, Kruhn AD. Sudden cardiac arrest without overt heart disease. Circulation. 2011;123:2994-3008.
