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When We're Willing To Help But Don't Know How

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By IRENE MAHER

News Channel 8 Medical Editor

Published: June 6, 2008

If you have a sudden heart attack, it's not very likely a bystander will attempt CPR or use an automated external defibrillator to save your life.

A new survey from the American Heart Association found that although the vast majority of Americans want to help in an emergency, only a small percentage feel confident that they could deliver life-saving assistance by doing cardio pulmonary resuscitation or using an AED. Fortunately, 57-year-old Marsha Moulder of Zephyrhills is one of the few who can - and did.

In November, a passenger on the Pasco County Public Transportation bus Moulder was driving reported that another rider was having what appeared to be a seizure. Moulder pulled over, parked her bus, reported the emergency to dispatch and rushed to the back of the bus to see what was happening. When Moulder noticed that the woman had stopped breathing, she grabbed the AED perched on the dashboard, attached the sticky pads to the woman's chest, pressed the start button and waited for the machine to tell her what to do.

The device evaluated the patient's heart rhythm and determined it was irregular. A voice on the machine instructed Moulder to press a button to deliver a shock and then to perform CPR. Moments later, paramedics arrived and took over.

Moulder never doubted she could take the necessary steps in an emergency.

"It kicks in. You get all the confidence from the AED. The AED does all the real work," she says.

Part of that confidence comes from the instruction all Pasco County bus drivers receive in first aid, CPR and AED use. The other part comes from having watched her husband die in 1982 when he had a heart attack at home and she didn't know what to do. By the time paramedics arrived at Moulder's Ohio home, her husband was gone. "I stood there helplessly and watched and couldn't do a thing. I promised myself that would never happen again," she says.

The Heart Association survey of more than 1,100 adults found that only 21 percent felt they could perform CPR and just 15 percent believed they could use an AED in a cardiac emergency. Yet 89 percent of respondents said they were willing to help in a medical crisis. The survey was released to draw attention to the inaugural National CPR/AED Awareness Week, June 1-7.

Laurie Romig, medical director of Pinellas County Emergency Medical Services, says it doesn't surprise her that people are afraid to attempt these life-saving steps, but they shouldn't worry. "CPR has been greatly simplified," she says. "And the AED is simple as long as you can follow directions."

It's widely known that performing rescue breaths on an unknown victim has been a major barrier to bystander CPR. But the latest updated guidelines, released just this year, have eliminated rescue breaths. Now called Hands-Only CPR, it requires only hard, continuous compressions in the center of the chest until paramedics arrive.

"People don't realize this is a person who is dying," Romig says. "This may be their one chance to live. Dying is the worst thing that can happen; you really can't make it any worse."

Pasco put AEDs on 30 of its county buses at a cost of about $1,200 each. Christine McGuire-Wolfe with Pasco County Fire and Rescue oversees the program, which was funded by the "Penny for Pasco" tax and debuted in 2006.

"Precious minutes can be saved by starting CPR and using the AED while waiting for help to arrive," McGuire-Wolfe says. According to the American Heart Association, if bystander CPR is not provided, a sudden cardiac arrest victim's chances of survival fall 7 percent to 10 percent for every minute of delay until defibrillation. Few attempts at resuscitation are successful if CPR and defibrillation are not provided within minutes of collapse.

The woman who went into cardiac arrest while riding Moulder's bus that November day in 2007 was one of them. There's no doubt that the combination of CPR and the AED helped save the unknown woman's life. But another important factor was Moulder's willingness to respond.

Incidentally, public buses in Tampa and Pinellas County do not have AEDs. You have to hope someone willing to perform CPR is either behind the wheel or in the seat next to you.

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