An emergency involving a cardiac arrest or stroke may require a team with advanced life support providers and equipment or may need to be directed to a hospital that is specially equipped for that particular emergency.

Emphasize Calling 911 When an Emergency Occurs

Many people fail to recognize the seriousness of their condition and delay calling for help.

Most of the time when an emergency strikes, it isn't in a hospital, where medical professionals can jump into action within moments. It happens at home, in a public shopping center, inside an airport, or at work.

A bystander who jumps in to immediately call 911 and give first aid, CPR, or use an automated external defibrillator plays a crucial role in improving the chance of survival and or recovery. In the workplace those preparations include several components, including employee training and having key tools available. First response training, including first aid, CPR, and use of an AED, is critical to developing the skills to provide help and the confidence to take action when an emergency occurs.

Quick, effective action can be the difference between life and death when an emergency occurs. While having all employees undergo training may not be possible, there are still important roles for them to play in recognizing when something is wrong.

Create a Culture of Awareness
Having all employees prepared to recognize symptoms of an emergency in a co-worker or themselves is a crucial first step and is just as important as having a team of employees trained to act.

Most would know that it's an emergency if someone has stopped breathing. But what if they’re simply having trouble breathing. Being out of breath, gasping, breathing rapidly, or even too slowly can all be signs of an emergency. If a person struggling to breathe has asthma or severe allergies, assisting him or her with an inhaler or epinephrine pen could help avoid a bigger emergency.

Seconds matter, especially when it comes to cardiac arrest. The sooner a person in cardiac arrest receives CPR and the AED is used, the better the chances for survival and a strong recovery.

Raising awareness about heart disease and cardiac arrest is important not only for encouraging prevention through lifestyle changes, but also recognition when an emergency occurs.

Cardiovascular disease is the No. 1 cause of death for all Americans, and more than 1 in 3 are affected by at least one type of heart disease. An awareness campaign that helps employees recognize the symptoms of cardiac arrest is important to activating medical help quickly.

Cardiac arrest is not the same as a heart attack, which occurs when the blood supply to part of the heart muscle is blocked. Cardiac arrest, which may be caused by a heart attack, occurs when the heart’s normal rhythm is disrupted and cannot generate blood flow. It can also be a result of other medical emergencies, for example a severe asthma attack or allergic reaction, a hemorrhage, or choking. 

In a cardiac arrest, chest compressions administered through CPR can generate blood flow to vital organs. Defibrillation by an automated external defibrillator can shock the heart back into normal rhythm, restoring an effective rhythm.

If the cardiac arrest is caused by a heart attack, it's important that employees understand that it may not happen like they've seen in the movies: dramatic scenes of a man clutching his chest or grab his left arm. Especially for women, heart attack symptoms can be much more nuanced, such as nausea, a feeling of anxiousness, unusual fatigue or shortness of breath, or pain in their backs, rather than their chests.

If a cardiac arrest does occur, time is critical. The earlier a shock is delivered, the greater the chance the neurological damage can be prevented. Every minute of delay for defibrillator decreases the success of restarting the heart.

Emphasize Calling 911
About 10 percent of people who experience an out-of-hospital cardiac arrest survive, but death from cardiac arrest can be preventable if a bystander quickly recognizes that the patient is unresponsive, calls 911 following the dispatcher's instructions, and starts CPR without delay. Getting someone to retrieve the AED and using it when it's available adds to the victim’s chances of survival.

Bystanders play an in important role in improving the chances of survival because it can often take several minutes for EMS to arrive after 911 has been called. The longer the delay in starting lifesaving resuscitation, the less chance the victim will have to survive.

Having an AED program in place and having bystanders act quickly can reduce the response time to a cardiac arrest victim and thus increase his or her chance of survival.

A workplace program should emphasize calling 911 when an emergency occurs. It seems basic, but many people fail to recognize the seriousness of their condition and delay calling for help. Sometimes, they're embarrassed and don't want to seem as though they're over-reacting, not realizing that it's better to be told it's nothing than to not get vital treatment. Once they realize they need to go to the hospital, many ask someone to give them a ride to the hospital or drive themselves, rather than call for an ambulance.

Failing to call for help is dangerous because it can create an unnecessary delay in getting care from trained professionals. Delaying treatment can make successful treatment more difficult and also limit the potential recovery.

Calling 911 also can provide an important link that can lead to a better outcome for the person experiencing the emergency. Dispatchers may be able to help callers who have no CPR training by giving them instructions to do chest compressions until additional help arrives. CPR performed immediately can improve the chances of survival by two to three times, so it's important that employees are aware that they shouldn't wait until an ambulance arrives.

A dispatcher also can collect information that can ensure the right type of medical response arrives or that the hospital can be alerted so delays in care can be minimized. For example, an emergency involving a cardiac arrest or stroke may require a team with advanced life support providers and equipment or may need to be directed to a hospital that is specially equipped for that particular emergency, and the advanced life support providers or paramedics can alert the hospital to activate its cardiac catheterization lab or other specialty departments. These early alerts could shave important seconds in the response and lead to a better patient outcome.

AED & CPR Training
Having a team of employees undergo a robust first aid/CPR/AED training course adds an important layer of support to your workplace safety program.

Program components typically include:

  • First aid basics
  • Medical emergencies
  • Injury emergencies
  • Environmental emergencies
  • Adult CPR and AED use

A comprehensive program trains employees to recognize different emergencies—a crucial component that goes hand in hand with knowing what action is needed. Helping the person in need is just one part of the training programs. Today’s first aid/CPR/AED programs also teach how to make sure the scene is safe, preventing injuries to rescuers and others.

Provide Tools and Eliminate Fears
It may seem mundane, but having basic tools such as a well-stocked first aid kit is important to being able to act when an emergency strikes. Be sure the kit is monitored regularly to ensure everything is available and nothing has expired. It's also important to display informational posters depicting basic signs of choking, cardiac arrest, or a stroke in frequently visited areas, such as lunchrooms or near elevators. Also, it's good to practice and do team simulated training in the workplace to keep up with key resuscitation skills and first aid knowledge.

Make tools easy to find. First aid kits and AED equipment should be easily identified and located strategically throughout your building so that it can be accessed quickly in an emergency.  

Most Americans feel helpless to act during a cardiac emergency because either they don’t know how to perform CPR or are afraid to hurt the victim. While no one wants to hurt anyone, the bigger risk is failing to provide early CPR when it’s needed.

Many of us recall the phrase "mouth-to-mouth" resuscitation. Providing breaths during CPR, either using your own mouth or with a device, is still used by medical professionals and trained rescuers, but it's not the only option. When a rescuer is not trained or cannot give breaths, delivering chest compressions only (as shown with the Hands-Only™ CPR campaign) is effective in delivering much-needed oxygen to the heart and brain for the first few minutes after a cardiac arrest. Research has shown that hands-only CPR can just as effective at keeping blood pumping to vital organs until help can arrive and is easy to learn.

AEDs are also becoming more common and, when used with CPR, can improve the chances of survival. Training employees to use the device plays an important role in building confidence to deploy them in an emergency. But it's also important for employees to understand that AEDs are safe and designed to be used by a layperson. The equipment includes easy-to-follow written and audio directions and won't deploy a shock if it isn’t safe to do so.

Review and Practice
Training for first aid/CPR/AEDs is most effective when it's reviewed on a regular basis, enabling participants to refresh information and practice skills. The more you repeat something, the better it's retained.

While most programs recommend retraining every two years, research shows that most people forget much of what they learned after about three months if it isn't used. Providing memory aids is an easy way to make information available and top of mind. Resources such as online videos or mobile apps also can provide an easy way to regularly review information.

We can all make a difference when it comes to saving a life.

This article originally appeared in the September 2015 issue of Occupational Health & Safety.

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