Zoll AED Plus - Case Studies

CAS E S T UDY Boston’s Logan

International Airport Has Traveler and Employee Safety at the Forefront

Logan International Airport in Boston may be one of the safest airports in the world—should you suffer sudden cardiac arrest (SCA) while traveling. Logan was one of the first airports to install automated external defibrillators (AEDs) as far back as 1996. More recently, the Massachusetts Port Authority (Massport), which owns and operates Logan, undertook a technology upgrade and installed over 170 ZOLL AED Plus ® units throughout Logan and the other transportation facilities it operates in Massachusetts. Today, Logan can boast that over the past year it has achieved a 75 percent survival rate from sudden cardiac arrest. “That’s triple the national average,” said Chief Robert Donahue, who heads Massport Fire and Rescue. “The safety and security of the tens of millions of passengers who use Logan each year and the 12,000 people who work here are our top priority.” Logan is also at the forefront of cardiac defibrillator training. To date, over 50 percent of Logan’s workforce—some 8,000 employees—have been trained to use the AED Plus as part of Massport’s ongoing training program, which includes first aid, CPR and AEDs. That’s a “force multiplier,” according to Donahue, because most cardiac arrests at Logan are witnessed events.

The AED Plus units are dispersed throughout the airport in high-volume areas at intervals that are no greater than a 90- second brisk walk. Signage is very conspicuous. When a cardiac arrest event is reported, a call goes out over the public address system signaling the victim’s location to the four EMS rescue stations at Logan; Massport Fire and Rescue mobilizes a rapid response ambulance crew to be

at the scene in less than three minutes. Logan also has the advantage of the resources of Boston’s large medical community. From Logan, SCA victims can be transported to some of the best hospitals in the world within two minutes.

That systematic approach, and Boston’s robust hospital network, paid off in life-saving dividends for 48-year-old computer programmer, Doug Hale, whose SCA was witnessed by two transportation security officers Massport had trained. Both TSA officers and a passenger, an off-duty police officer, jumped to his aid with CPR and an AED Plus. Fire dispatch arrived in three minutes, shocked Hale, and continued CPR. He was rushed to Massachusetts General Hospital, where he was treated with therapeutic hypothermia and then sent to rehab for a few weeks. After his recovery, Hale and his wife came back to Logan to publicly thank his rescuers for saving his life.

“What happened to me is testament to how critical having AEDs in public places can be,” said Doug Hale. “And having one that coaches rescuers with visual and audio prompts through a life-saving event gives rescuers assurances when every second is vital.” Doug’s wife, Tammy, a dental hygienist trained in CPR and AEDs, witnessed the event. “It seemed the rescuers were there almost immediately and hooked Doug up to the AED so fast. The AED Plus coached them every step of the way—where to place the “We’re grateful this happened in Boston because we might have had a different outcome if it had happened someplace else.” Rescuer Tammy Hale

“We’re proud of our Chain of Survival; it’s the best of any airport in the world,“ said Deputy Chief Costa. “Having Doug and his wife, Tammy, come back to Logan to thank us meant so much to us. Being able to save someone’s life, does it get any better than that ? ”

The ZOLL AED Plus, the first and only Full-Rescue AED that provides Real CPR Help ® for depth and rate of chest compressions, audibly coaches rescuers with prompts such as “Push Harder” or “Good Compressions.” during CPR.

electrodes, when the compressions weren’t deep enough. This was so critical because when you are usually doing compressions, you are blind to how effective they are.”

“Anyone could use this AED. It was so simple, not like the one I was trained on,” she added. “We’re grateful this happened in Boston because we might have had a different outcome if it had happened someplace else.”

ZOLL Medical Corporation Worldwide Headquarters 269 Mill Road Chelmsford, MA 01824

ZOLL Medical Corporation, an Asahi Kasei Group company, develops and markets medical devices and software solutions that help advance emergency care and save lives, while increasing clinical and operational efficiencies. With products for defibrillation and monitoring, circulation and CPR feedback, data management, fluid resuscitation, and therapeutic temperature management, ZOLL provides a comprehensive set of technologies that help clinicians, EMS and fire professionals, and lay rescuers treat victims needing resuscitation and critical care. For more information, visit www.zoll.com. The Asahi Kasei Group is a diversified group of companies led by holding company Asahi Kasei Corp., with operations in the chemicals and fibers, homes and construction materials, electronics, and health care business sectors. Its health care operations include devices and systems for critical care, dialysis, therapeutic apheresis, transfusion, and manufacture of biotherapeutics, as well as pharmaceuticals, diagnostic reagents, and nutritional products. With more than 25,000 employees around the world, the Asahi Kasei Group serves customers in more than 100 countries. For more information, visit www.asahi-kasei.co.jp/asahi/en. Copyright © 2012 ZOLL Medical Corporation. All rights reserved. AED Plus, Real CPR Help and ZOLL are trademarks or registered trademarks of ZOLL Medical Corporation in the United States and/or other countries. Asahi Kasei is a registered trademark of Asahi Kasei Corporation All trademarks are the property of their respective owners.

978-421-9655 800-348-9011 www.zoll.com

For subsidiary addresses and fax numbers, as well as other global locations, please go to www.zoll.com/contacts.

For more information on the ZOLL AED Plus, please call 800-804-4356 or go to www.zoll.com/aedplus.

CAS E S T UDY

ZOLL AED Plus and Bystander CPR Help Save Basketball Player’s Life

Because they were prepared, the Shenandoah County, Virginia school system and its staff were equipped to help save a life when every second counted.

The Incident: Recreation Department Basketball Game Turns into an Emergency Bill Simmons, a special education teacher and coach in the Shenandoah public schools, and a 36-year old, Greg Long, were opponents in a Shenandoah County Parks and Recreation Department league basketball game. Before the end of the game, they found themselves on the same team. Halfway through the game, Greg collapsed on the court, and Bill helped save his life. The Rescue: Quick Bystander Action Aids Victim Bill had been trained in cardiopulmonary resuscitation (CPR) and the use of an automated external defibrillator (AED) a few months earlier through the school system. When he saw Greg collapse, his first instinct was to grab the AED from the hallway. Even though Greg had regained consciousness and was sitting up, Bill ran to get the AED while a fellow player called 911. By the time Bill returned with the AED, Greg had no pulse and was not breathing. Three of Bill’s colleagues, who also had been recently trained in CPR through Parks and Recreation, were taking turns administering CPR. Bill turned on the ZOLL ® AED Plus ® and followed the voice and visual prompts to guide

him through the Chain of Survival. When the AED prompted “Attach Electrode Pads,” Stuart Leake, who coincidentally was Bill’s partner during AED training, wiped off Greg’s chest, and Bill applied the electrodes. The AED Plus advised that a shock was needed and, when instructed, Bill pressed the flashing shock button. After one shock was administered, the AED prompted the rescuers to “Start CPR.” The AED Plus, equipped with Real CPR Help ® technology, gave real-time feedback to the rescuers on the correct rate and depth of compressions. The AED instructed the rescuers to “Push Harder,” which helped them to provide high-quality CPR to Greg. Bill estimates that approximately seven to eight minutes elapsed from the time Greg first collapsed until the paramedics arrived. “All I know is that before Greg was transported to the hospital, he was breathing on his own; it happened 2 minutes after the paramedics got there. Within 10 minutes, Greg had gone from not having a pulse and not breathing to breathing on his own. I’m not sure this would have been the case if we didn’t have an AED to provide a needed shock and didn’t perform good CPR chest compressions.”

“I’m a big supporter of having AEDs in the schools,” said Dr. B. Keith Rowland, superintendent of Shenandoah County Schools. “This is one of those things that you don’t need until you need it. If you think you’re going to never need it, you are probably mistaken. We’ve already needed it twice in the short time I’ve been superintendent.” “The public needs to know that AEDs need to be in schools, people need to be trained, and people need to know that AEDs are available and where they are,” said Bill. “They give people a better chance of surviving sudden cardiac arrest.” According to the American Heart Association, in most emergencies the quality of CPR the rescuer provides can make the difference between life or death. 1 Even trained professionals often do not perform CPR optimally and can benefit significantly from monitoring and support. A recent study reported in Resuscitation shows that audio and visual CPR feedback improves the quality of chest compressions delivered by healthcare providers. 2

Bill emphasized that he is “not a hero. I get credit for being trained, which gave me the confidence to get the AED and know when to use it. Anyone in that situation would have done the same thing. Because the school administration had AEDs and their staff were trained to use them, which helped save Greg’s life.”

Bill Simmons

The Resources: Importance of AEDs in Public Places Greg Long had a fighting chance because of bystander intervention as well as the foresight of the Shenandoah County school system to install AEDs. Each school building is equipped with at least two AEDs, and all coaches are trained on CPR and the AED. “We wanted the broadest reach possible,” said Jeremy Raley, director of finance for the Shenandoah County Schools. The district’s health services coordinator, Barbara Streett, R.N., oversees the AED program, working with each school nurse to coordinate follow-up training at least once a year as well as to oversee AED maintenance. “This is one of those things that you don’t need until you need it… We’ve already needed it twice.” Dr. B. Keith Rowland, Superintendent Shenandoah County Schools

The AED Plus provides voice and visual feedback on the quality of chest compressions, such as “Push Harder” and “Good Compressions.” The adaptive metronome helps the rescuer maintain the correct rate.

1 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care .

2 Peberdy et al. Effect of Caregiver Gender, Age, and Feedback Prompts on Chest Compression Rate and Depth. Resuscitation. 2009 .

ZOLL Medical Corporation Worldwide Headquarters 269 Mill Road Chelmsford, MA 01824

ZOLL Medical Corporation develops and markets medical devices and software solutions that help advance emergency care and save lives, while increasing clinical and operational efficiencies. With products for defibrillation and monitoring, circulation and CPR feedback, data management, fluid resuscitation, and therapeutic temperature management, ZOLL provides a comprehensive set of technologies which help clinicians, EMS and fire professionals, and lay rescuers treat victims need- ing resuscitation and critical care. A NASDAQ Global Select company and a Forbes 100 Most Trustworthy Company in 2007, 2008, and 2009, ZOLL develops and manufactures its products in the United States, in California, Colorado, Illinois, Massachusetts, Pennsylvania, and Rhode Island. More than 400 direct sales and service representatives, 1,100 business partners, and 200 independent representatives serve our customers in over 140 countries around the globe. For more information, visit www.zoll.com.

978-421-9655 800-348-9011 www.zoll.com

For subsidiary addresses and fax numbers, as well as other global locations, please go to www.zoll.com/contacts.

For more information on the ZOLL AED Plus, please call 800-804-4356 or go to www.zoll.com/aedplus.

Ride the Rockies Cyclist Saved with Help of AED Plus CAS E S T UDY

For cycling enthusiasts, the rigorous, six-day Ride the Rockies Colorado Bicycle Tour is a not-to-be-missed event. For a father riding tandem with his 13-year-old daughter, it became an experience both will likely remember for the rest of their lives. The life-saving event happened during day one of the cross-Colorado, 412-mile course. Just shy of the 50-mile mark, the 57-year-old father was ascending Cottonwood Pass with its 126-foot elevation, when he felt a lightening-like pain strike his chest. He dismounted his bike, collapsed in sudden cardiac arrest, and fell to the ground. Fortunately for this cyclist, the organizers of this popular tour, which is limited to 2,000 cyclists, take great strides to ensure the safety of the participants, their fan base of followers, and event volunteers. Bike medics patrol the route ready to assist. Medical teams riding in technical support vehicles, each equipped with a ZOLL AED Plus ® , are strategically positioned along the course should an emergency occur. The medical teams are trained on the AEDs a month in advance, so they have time to prep and practice using them when every second counts. Radios are distributed among the rescue squads so they can make contact in an emergency. Within seconds of the collapse, the first bike medic arrived at the cyclist’s side, checked his vitals and began CPR. Shortly thereafter, other bike medics

arrived to assist with scene management and help with traffic flow. They also escorted the victim’s daughter away from the scene. The medics and some volunteers took turns delivering chest compressions until the closest of the 15 support vehicles arrived with an AED Plus minutes later. Chandler D. Smith, tour director of the Denver Post –sponsored event, was in that support vehicle with the AED Plus and became an eye-witness to the resuscitation. “One medic exposed the victim’s chest, applied the electrodes, and followed the AED’s audible prompts. CPR was continued until a shock was advised and we stood back. CPR was started again

The ZOLL AED Plus, the first and only Full-Rescue AED that provides Real CPR Help ® for depth and rate of chest compressions, audibly coaches rescuers with prompts such as “Push Harder” or “Good Compressions” during CPR.

when instructed by the AED Plus, followed by a second shock. Then more CPR. When the AED Plus advised no third shock, a volunteer at the scene applied oxygen. Within minutes the patient had a pulse!” According to Smith, the AED Plus was so easy to use it was seamless. “We followed the AED’s prompts, and the event unfolded just like our training. Everything worked just like we practiced. If it wasn’t for the AED Plus, we would have had a different outcome,” he said. “During the tour, which is now in its sixth training. Everything worked just like we practiced. If it wasn’t for the AED Plus, we would have had a different outcome.” Tour Director Chandler D. Smith “We followed the AED’s prompts, and the event unfolded just like our

year, we typically deal with road rash and head injuries, especially on the descents. This was our first incidence of sudden cardiac arrest. With the AED Plus, we were prepared to handle it—with a positive outcome.”

The ambulance arrived on the scene about 10 minutes into the cardiac arrest, and the survivor was transported to the nearest hospital for further treatment. He was later air lifted to St. Anthony’s Hospital in Denver for open heart surgery. Smith had lunch with the survivor, who prefers to remain anonymous, two months after the event. He lost weight and looked good. The thankful cyclist was happy that everything came together, making it possible for him to see his daughter turn 14. Whether riding another tour is in his future is something he will need to eventually take up with his doctor. In recognition of their efforts, the Ride the Rockies Colorado Bicycle Tour organizers and volunteers received the Adult Life Save Award from the local chapter of the American Red Cross at their annual Breakfast of Champions function. What could have been a tragedy became a story with a happy ending for all involved.

ZOLL Medical Corporation Worldwide Headquarters 269 Mill Road Chelmsford, MA 01824

For more information on the ZOLL AED Pro, please call 800-804-4356 or go to www.zoll.com/aedplus. Copyright © 2013 ZOLL Medical Corporation. All rights reserved. AED Plus, Real CPR Help, and ZOLL are trademarks or registered trademarks of ZOLL Medical Corporation in the United States and/or other countries. Asahi Kasei is a registered trademark of Asahi Kasei Corporation. All trademarks are the property of their respective owners. Printed in U.S.A. PN-265 041301 ZOLL Medical Corporation, an Asahi Kasei Group company, develops and markets medical devices and software solutions that help advance emergency care and save lives, while increasing clinical and operational efficiencies. With products for defibrillation and monitoring, circulation and CPR feedback, data management, fluid resuscitation, and therapeutic temperature management, ZOLL provides a comprehensive set of technologies that help clinicians, EMS and fire professionals, and lay rescuers treat victims needing resuscitation and critical care. For more information, visit www.zoll.com. The Asahi Kasei Group is a diversified group of companies led by holding company Asahi Kasei Corp., with operations in the chemicals and fibers, homes and construction materials, electronics, and health care business sectors. Its health care operations include devices and systems for critical care, dialysis, therapeutic apheresis, transfusion, and manufacture of biotherapeutics, as well as pharmaceuticals, diagnostic reagents, and nutritional products. With more than 25,000 employees around the world, the Asahi Kasei Group serves customers in more than 100 countries. For more information, visit www.asahi-kasei.co.jp/asahi/en.

978-421-9655 800-348-9011 www.zoll.com

For subsidiary addresses and fax numbers, as well as other global locations, please go to www.zoll.com/contacts.

Cas e S t udy

Student EMTs Save Senior with CPR and AED Plus at College of the Ozarks

That February morning had started out like any other day on the campus of the College of the Ozarks in Point Lookout, Missouri. Senior Walter Watts, a 21-year-old psychology major, woke up late and scrambled to class, just barely making it through the door on time. Afterwards, he went upstairs to the second floor psych office to grade papers, instead of his usual job of delivering lunches. Meanwhile, Gavin Harnstrom, also a senior, ran into Dakota Williams, and the pair decided to skip their Bible class and drop by the student-run campus fire station before heading out for an early lunch. Harnstrom and Williams were among four seniors who were employed as emergency responders at the fire station as part of the college’s work–study program. All full-time students of the college are required to work 15 hours each week in return for tuition at the Christian liberal arts college. When the emergency phone at the fire station rang about 11:30 a.m., little did any one of them know that February 7, 2012, would be a day they would probably remember for the rest of their lives. The caller was a professor from the psych office urging them to come quickly, a student had collapsed from what she assumed was a seizure. Harnstrom and Williams immediately hopped into their rescue vehicle and sped the two blocks to the psych office; they were the first to arrive at Watts’ side. There they found him, on the floor, turning blue from lack of oxygen. This was not a seizure!

Finding no pulse, Harnstrom bounded down the stairs to the rescue vehicle to retrieve the ZOLL AED Plus ® as quickly as he could. By then, Jessica Messer and Dalton Trussell, also student EMTs, had arrived, alerted by the emergency radio Jessica carried with her. CPR was started. Watts’ shirt was removed so the electrodes could be applied. Seconds later, the AED Plus announced that a shock was advised. Stunned, the three student EMTs looked at each other. This was real, not a student drill, someone’s life—one of their classmates—was at stake. It was all happening so quickly.

Harnstrom pressed the shock button; then the AED Plus prompted the rescuers to “Start CPR.” By the time the paramedics arrived with the ambulance minutes later, Watts had a pulse. He was rushed to Skaggs Hospital in Branson,

Walter Watts

then to Cox South in Springfield, where an EP study showed symptoms of Wolff−Parkinson−White, a rare heart condition caused by an extra electrical pathway in the heart. He was then fitted with the ZOLL LifeVest ® Wearable Defibrillator, which he wore for two weeks, while he was sent to the Mayo Clinic in St. Louis for a second opinion before undergoing surgery back at Cox for an implantable cardioverter defibrillator (ICD).

After recuperating at home with his family in California, Missouri, and taking online classes, Watts returned to college to complete his degree. He hopes to become a clinical psychologist. He has since celebrated his 22nd birthday, says he can do everything except obtain a commercial driver’s license or fly a commercial airplane, and is actually more physically active than he was before. He runs and kayaks. “Surviving cardiac arrest changed my life and has given me a new perspective,” he said. “I actually feel that day was serendipitous and divinely planned. It was nothing less than a miracle. It’s given me more opportunities and I appreciate my health every day.” Reflecting back on that day, “Surviving cardiac arrest changed my life and has given me a new perspective.... I appreciate my health every day.” Walter Watts

According to Williams, the AED Plus “worked fantastic” and Watts wouldn’t have made it without it. “The AED Plus put us at ease, like a big helping hand. It saved our skins and it saved Walter’s. Even though we were trained, this was so spur of the moment. The AED told us what to do and reassured us. Using it made us feel like we couldn’t do anything wrong,” he said. “Saving a life is a surreal experience. Walter’s family must have said ‘Thank you’ 6,000 times. It puts you on Cloud Nine to save a life. But I’m just happy that I was able to be there when it counted,” Williams added. Both Harnstrom and Williams have graduated from the College of the Ozarks. Harnstrom earned a degree in mass communications and would like to pursue a career as an EMT after having served as fire chief of the campus fire station. Williams, after earning his degree in sociology, has since moved to Springfield, where he is in training to become an EMT for Mercy Hospital.

The ZOLL AED Plus, the first and only Full-Rescue AED that provides Real CPR Help ® for depth and rate of chest compressions, audibly coaches rescuers with prompts such as “Push Harder” or “Good Compressions” during CPR.

Harnstrom says it was the first emergency he had ever handled. “I was scared, excited, and nervous when I first arrived on the scene, but after about five seconds, my training kicked in,” he said. “The AED Plus told me exactly what to do. I didn’t

College EMTs who saved Walter: (from left) Gavin Harnstrom, Dakota Williams, Dalton Trussell, and Jessica Messer.

have to think about it. The AED instructed me to go deeper on the chest compressions. I thought I was doing fine, but thankfully, it guided me to provide high-quality chest compressions.”

ZOLL Medical Corporation Worldwide Headquarters 269 Mill Road Chelmsford, MA 01824

ZOLL Medical Corporation, an Asahi Kasei Group company, develops and markets medical devices and software solutions that help advance emergency care and save lives, while increasing clinical and operational efficiencies. With products for defibrillation and monitoring, circulation and CPR feedback, data management, fluid resuscitation, and therapeutic temperature management, ZOLL provides a comprehensive set of technologies that help clinicians, EMS and fire professionals, and lay rescuers treat victims needing resuscitation and critical care. For more information, visit www.zoll.com. The Asahi Kasei Group is a diversified group of companies led by holding company Asahi Kasei Corp., with operations in the chemicals and fibers, homes and construction materials, electronics, and health care business sectors. Its health care operations include devices and systems for critical care, dialysis, therapeutic apheresis, transfusion, and manufacture of biotherapeutics, as well as pharmaceuticals, diagnostic reagents, and nutritional products. With more than 25,000 employees around the world, the Asahi Kasei Group serves customers in more than 100 countries. For more information, visit www.asahi-kasei.co.jp/asahi/en. Copyright © 2012 ZOLL Medical Corporation. All rights reserved. AED Plus and ZOLL are trademarks or registered trademarks of ZOLL Medical Corporation in the United States and/or other countries. Asahi Kasei is a registered trademark of Asahi Kasei Corporation All trademarks are the property of their respective owners. For more information on the ZOLL Aed Plus, please call 800-804-4356 or go to www.zoll.com/aedplus.

978-421-9655 800-348-9011 www.zoll.com

For subsidiary addresses and fax numbers, as well as other global locations, please go to www.zoll.com/contacts.

PN-245

Save of First Grader Shows Community Importance of AEDs CAS E S T UDY

Logan Powell, a happy-go-lucky six- year-old, didn’t want to go to school on October 13. He loved first grade, but he was feeling crummy. His mother, Laura, took his temperature, and when she saw it was normal, she sent him off to the East Meadows

up the electrodes to Logan, and the ZOLL ® AED Plus ® advised a shock. Seven to eight minutes after the initial call, a shock was administered. Logan gasped. But still his heart did not beat. As the AED advised, Lt. Adams resumed CPR. The AED Plus encouraged the rescuers by announcing “Good Compressions,” which helped reinforce that their chest compressions were the correct depth and rate. The ambulance arrived within a minute of the first shock, and the EMTs took over. They administered another shock, and this time, Logan’s heart began to beat again. “CPR was not bringing him back,” said Laura. “He needed his heart to be shocked back into rhythm. It was an incredible event when it did!” Logan was rushed to the hospital, where it took cardiac specialists four days to determine the cause of his sudden cardiac arrest (SCA). As Logan was undergoing surgery to insert an internal defibrillator, the doctors discovered he had a major congenital heart defect. His aorta was not attached to his coronary artery on the left side of his heart. The doctors rescheduled the surgery, and Logan soon underwent open heart surgery to repair his previously undiagnosed heart defect and to insert the internal defibrillator. The 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency

Elementary School, in Spanish Fork, Utah. But the day turned out to be far from normal.

“He looked fine,” said Laura. “I honestly thought he was just faking it and he was just tired. I had no clue that something was severely wrong with his heart.” In the late morning, Logan headed to gym class right after recess. As he and his classmates were on the playground listening to instructions, he dropped to the ground. A girl realized something was wrong and alerted the teacher. The teacher, noting that Logan had vomited and was not breathing, called the front office. The school secretary ran onto the playground and began cardiopulmonary resuscitation (CPR) while the office called 911. Lieutenant Steve Adams of the Spanish Fork Police Department arrived on the scene just over two minutes after the call. He took over CPR as well as performed mouth-to-mouth resuscitation. Lt. Brandon Anderson of the Spanish Fork Police Department arrived next, followed by a patrol officer who brought one of the department’s automated external defibrillators (AEDs). Lt. Anderson helped hook

"CPR was not bringing him back. He needed his heart to be shocked back into rhythm. It was an incredible event when it did!”

"AED's have been a great asset to the department and the citizens who live and visit our community,” said Lt. Anderson. “After seeing the AED work first-hand on more than one occasion in our community, words can’t describe how valuable these devices are in helping save lives.” Two Years Later After two years, Logan is finally back playing soccer again for the first time. “I couldn’t believe it when we went to his first soccer practice,” said Laura. “The odds are that I wouldn’t still have him, and he is back kicking and running with kids his age. How normal is that ? ” Logan also serves as a spokesperson for the Nebo School District as well as Tender Heartbeats, an organization that helps elementary schools in Utah purchase AEDs. He talks about the importance of AEDs and of training staff to use them.

Logan's mother, Laura Powell

Cardiovascular Care say that in most emergencies, the quality of CPR the rescuer provides can make the difference between life and death. A research study also shows that audiovisual CPR feedback improves the quality of chest compressions health care providers deliver. 1 ZOLL’s AED Plus provides Real CPR Help ® technology, which gives rescuers real-time depth and rate feedback on the CPR they are delivering. This guidance can improve CPR quality and give them confidence that they are providing good-quality CPR. ZOLL was the first to introduce CPR feedback technology in 2002 to help improve CPR performance. Importance of AEDs “It is vital to have AEDs in every one of our buildings since we have only seconds to save a life,” said Lana Hiskey of the Nebo School District. “We now have AEDs in each of our schools. We are very grateful to the Spanish Fork Police Department for helping to save a life with their AED.” Within three months of Logan’s incident, all Spanish Fork schools had at least one AED in the building. Within six months, all Spanish Fork Police Department vehicles, including unmarked cars, had their own AED assigned to them. Up until then, the department had AEDs in most of its vehicles. The department had received the majority of its AEDs anonymously from a business owner who saw their value after a Spanish Fork police officer helped save the life of one of his employees using an AED. Since 1999, when the department began its AED program, officers have helped save 10 lives, including Logan’s, with its AEDs.

“It’s been a journey,” explained Laura. “When you’re really tested and tried with challenges, so many good things can come out of it. We have had lots of opportunities to grow and help others.”

The ZOLL AED Plus, the first and only Full-Rescue AED that provides Real CPR Help ® for depth and rate of chest compressions, audibly coaches rescuers with prompts that say “Push Harder” or “Good Compressions” during CPR.

For more information on the ZOLL AED Plus, please call 800-804-4356 or go to www.zoll.com/aedplus.

1 Abella B, et al. “CPR quality improvement during in-hospital cardiac arrest using a real-time audiovisual feedback system,” Resuscitation , 2007;73:54–61.

ZOLL Medical Corporation • Chelmsford, MA, USA • 800-804-4356 ZOLL Medical Corporation, an Asahi Kasei Group company, develops and markets medical devices and software solutions that help advance emergency care and save lives, while increasing clinical and operational efficiencies. A D V A N C I N G R E S U S C I T A T I O N. T O D A Y. ®

Printed in U.S.A MCN PP 1312 0037

Fitness Center Staff Go the Extra Mile to Save Member CAS E S T UDY

Joe Saia, a 51- year- old fitness fanatic, has been working out religiously four to five days a week at the Cresco Fitness Center in northern Iowa for the past five years. His standard routine is running a mile, followed by walking to cool

About five minutes before Josh was to finish exercising, he heard a big thump. “I thought it was someone dropping a weight on the black rubber mat. Then I thought how I hadn’t heard anyone scream from it dropping on their foot. Right then my wife, who had just finished her workout, started pulling at me and telling me there was something wrong with this guy.” Josh ran to where his wife was pointing and saw Joe lying on the track. A weight lifter was asking Joe, “You okay ? You okay ? ” Joe wasn’t moving. His pupils were dilated. He was struggling to breathe. “Joe’s eyes were open and I said, ‘Joe, are you awake ? ’ Then I felt for his pulse, and I didn’t feel one. I thought, ‘This is not good.’” Josh immediately began cardiopulmonary resuscitation (CPR) and was about to ask someone to get the automated external defibrillator (AED), when Becky Creger, a front desk employee at the center, ran in with the ZOLL ® AED Plus ® . She had been alerted that something was wrong by two fitness center lifeguards, who were waving frantically at her as she was exiting the pool area. She grabbed the AED as they called 911. Once Becky reached Joe with the AED Plus, she opened the case and pulled out the electrodes. Josh hooked Joe up to the AED, turned it on, and the AED Plus immediately advised a shock. “I told everyone, ‘Back away! Back away!’” Josh says.

down, then lifting. He usually runs on the indoor track, which circles the workout area. Occasionally, he runs outdoors when the weather is hot to build stamina and endurance—just as he learned in the military. “This particular day it was over 95 degrees, and I was going to go do the outside gig,” Joe remembers. “It’s roughly a mile and a half with hills, and I enjoy it. But I changed my mind and decided to work out inside. I believe there are no coincidences. I’m a strong believer in God.” As Joe was finishing his second walk-down and taking a sip of Gatorade, he collapsed. “The whole ironic thing is that I felt exceptionally well that day,” Joe says. “I did an extra half-mile.” But Josh Moore, a paramedic and certified first responder, saw a different picture. Although Josh didn’t know Joe personally, he often watched him go by on the track when he was on the elliptical machine. “I noticed that Joe wasn’t his normal self that day,” Josh says. “I thought he might not be feeling well. He was sweating profusely, and he had his arms down by his sides and was struggling.”

After administering the shock, Josh continued CPR, with the AED Plus giving real-time feedback through Real CPR Help ® on the quality of his compressions: “Good Compressions.” After 30 seconds, Josh remembers looking down into Joe’s face and, all of a sudden, seeing his pupils constrict and his eyes blink. Joe then took a giant, deep breath. “I would bet my left leg on it that the AED saved his life,” says Josh. “I was just there. The AED did the work. I believe early defibrillation is so vital to saving a life. No amount of CPR was going to do it for Joe. He was in a life-threatening rhythm that he needed to be converted out of, and the AED was the tool to do it.” Joe was transported 50 miles to the Mayo Clinic in Rochester, Minn. While doctors performed tests, Joe reiterated that he had no telltale signs or red flags. The data automatically recorded by the AED Plus during the event helped Joe's doctors diagnose him with an arrhythmia. Joe received an implantable cardioverter defibrillator to help manage any future rhythm problems. Giving Thanks When Joe and Josh met again, Joe said, “I thanked Josh for all he’s done. God had him in the right place, at the right time, for the right reason. As I see the big picture, this guy was the best of the best, did everything just as he was taught, did it by the book, and got the best results. I believe I have a lot of unfinished business, so God sees fit to keep me here.” “No amount of CPR was going to do it for Joe. He was in a life- threatening rhythm that he needed to be converted out of, and the AED was the tool to do it.” Rescuer Josh Moore

“I don’t think there’s an EMT or paramedic I know that doesn’t sit there and say there’s a higher power,” adds Josh. “You can’t go through this job without having faith. There is a reason why I was there.” The Importance of AEDs Wendy Bohr, assistant manager of the Cresco Fitness Center and a Red Cross certified CPR/AED trainer, was hesitant at first to get an AED for the center. She was afraid of shocking someone mistakenly. The facility staff, along with local medical doctors, strongly recommended purchasing an AED, emphasizing that cardiac arrest strikes suddenly and that an AED is how you prepare for this type of catastrophe. After being trained, Wendy understood that “the AED does all the analyzing and takes all the fear and concern away.” She is now concerned that all area pools do not have AEDs. “Thank goodness we have the AED Plus,” adds Becky. “Seeing it used and the life-saving power it has, as well as how it walks you through the rescue step by step—it is the best thing ever. Every place where people gather needs to have an AED.” Joe has the green light to go back to the gym. He’s decided to wait until he’s fully recovered from his surgery so he can power lift. “It will take time to get to where I was, but I believe I can get there.”

The ZOLL AED Plus, the first and only Full-Rescue AED that provides Real CPR Help ® for depth and rate of chest compressions, audibly coaches rescuers with prompts that say “Push Harder” or “Good Compressions.” during CPR.

For more information on the ZOLL AED Plus, please call 800-804-4356 or go to www.zoll.com/aedplus.

ZOLL Medical Corporation • Chelmsford, MA, USA • 800-804-4356 ZOLL Medical Corporation, an Asahi Kasei Group company, develops and markets medical devices and software solutions that help advance emergency care and save lives, while increasing clinical and operational efficiencies. A D V A N C I N G R E S U S C I T A T I O N. T O D A Y. ®

PN-272

Fitness Trainer, Trained in CPR, Helps Save Gym Member’s Life CAS E S T UDY

Dale Bierschbach, a heavy equipment operator in manufacturing, had just finished work and headed to East Howell Snap Fitness, in Howell, Michigan, for his workout. The 52-year-old had been working out three times a week at the 24-hour fitness center for the past month. Before he began, Dale spent a good half-hour talking with Emily Jermov, the center’s membership director and fitness trainer. After their conversation, Dale proceeded to the arc trainer to get in his cardio workout, and Emily went to get a quick lunch. After Dale finished his cardio workout, he walked around to cool down and catch his breath. Suddenly he collapsed. That’s the last thing he remembered for 10 days. “I had no symptoms other than being out of breath, which I attributed to working out,” he said. “I never go out to lunch,” Emily said. “I’m usually a packed-lunch girl, but I didn’t have time to pack a lunch that morning. I was out for about five minutes, and when I got back, two members met me at the door and said a guy was down.” Having administered oxygen to a handful of members in the past, Emily grabbed the oxygen kit and headed over to where Dale was lying next to the arc trainer. Within seconds, she realized no oxygen was moving and that Dale was purple. She had a member push one of the panic buttons and call 911. “I knew I was going to have to do something now,” said Emily, who is certified in cardiopulmonary resuscitation (CPR) and first aid and is a former

CPR instructor. “I quickly began my rescue breaths and compressions. I then realized I had a machine that could help me." Emily instructed a member to get the automated external defibrillator ( AED) . She continued doing CPR, then quickly attached the pads to Dale’s bare chest. The ZOLL AED Plus ® analyzed Dale’s heart rhythm and advised a shock. Emily administered the shock and continued CPR until the paramedics arrived. Less than100 pounds and just shy of 5 feet tall, Emily spent eight minutes administering CPR to Dale, who is 5-foot -10 and weighs 240 pounds. “I was getting really tired,” she said. “The AED Plus was very helpful. It said to push harder. In CPR training classes, the manikin clicks when you reach the

proper compression depth. In real life, there’s no way to tell how deep you’re pushing. Luckily, the AED Plus could help guide me to get to the right depth of compressions. As soon as the paramedics arrived, I let the professionals take over.”

Dale Survives Following CPR and AED Shock Before the paramedics left the gym with Dale, he was breathing on his own. Although he remained unconscious, color was beginning to come back to his cheeks. Dale was transported to Woodland Medical Center of St. Joseph Hospital, where he

“Without immediate access to the AED, I would be dead.” Survivor Dale Bierschbach

“The cool thing is,” added Emily, “your training takes over, but in your mind you are freaking out. It is an out-of-body experience. I kept talking to myself, saying, ‘Oh my gosh, what is going on ? Calm down. You’re a powerhouse. You’ve got this. Calm down.’ People must have thought I was crazy.” Dale Returns to Working Out Within a few months after his cardiac arrest, Dale was back at the gym working out with a personal trainer. Following his bypass surgery, Dale had physical therapy, which he said has helped him identify safe parameters for exercise. He also wears a heart monitor when exercising, which makes him feel more confident. “I watch Dale like a hawk now,” said Emily. “I tell him, ‘I saved you and I don’t want to have to do it again, so take it easy.’ But he knows his limits.” Dale says, “I have developed more realistic goals and timelines for

was stabilized. He was then transferred to St. Joseph’s in Ann Arbor for cardiac treatment. Dale’s cardiologist requested the data from the AED so he could gain a better understanding of what happened to Dale’s heart. The data helped him determine that Dale needed a triple bypass. “The paramedics explained to me that Dale was dead,” Emily said. “If we hadn’t performed CPR and if the AED hadn’t been there to restart his heart, he would have remained dead. Dale had an erratic heart rhythm that only defibrillation and high-quality CPR could have helped. It was absolutely terrifying at the time.” Being a first responder, Emily knew the importance of AEDs. “Even if you aren’t confident on how to use an AED, it will tell you what to do. The AED Plus has pictures and it prompts you through the rescue. If something happens, you have peace of mind that it is there. My dad’s a paramedic and a firefighter, so I have observed that what can go wrong usually will go wrong. It’s always good to play it safe.” Dale also understands the significance of AEDs. “My rhythm did not return to normal with CPR alone,” he said. “It was only after the shock of the AED that my rhythm became stable enough to support life. Without immediate access to the AED, I would be dead. Thank God that Emily took the time to receive the training and didn’t allow fear to paralyze her.”

my exercise and health since realizing my human limitations. I use to be one of those aging men who tried to deny getting older. Now I accept that I am not 22 and bulletproof.”

The ZOLL AED Plus, the first and only Full-Rescue AED that provides Real CPR Help ® for depth and rate of chest compressions, audibly coaches rescuers with prompts that say “Push Harder” or “Good Compressions” during CPR.

ZOLL Medical Corporation Worldwide Headquarters 269 Mill Road Chelmsford, MA 01824

ZOLL Medical Corporation, an Asahi Kasei Group company, develops and markets medical devices and software solutions that help advance emergency care and save lives, while increasing clinical and operational efficiencies. With products for defibrillation and monitoring, circulation and CPR feedback, data management, fluid resuscitation, and therapeutic temperature management, ZOLL provides a comprehensive set of technologies that help clinicians, EMS and fire professionals, and lay rescuers treat victims needing resuscitation and critical care. For more information, visit www.zoll.com. The Asahi Kasei Group is a diversified group of companies led by holding company Asahi Kasei Corp., with operations in the chemicals and fibers, homes and construction materials, electronics, and health care business sectors. Its health care operations include devices and systems for critical care, dialysis, therapeutic apheresis, transfusion, and manufacture of biotherapeutics, as well as pharmaceuticals, diagnostic reagents, and nutritional products. With more than 25,000 employees around the world, the Asahi Kasei Group serves customers in more than 100 countries. For more information, visit www.asahi-kasei.co.jp/asahi/en. Copyright © 2012 ZOLL Medical Corporation. All rights reserved. AED Plus, Real CPR Help, and ZOLL are trademarks or registered trademarks of ZOLL Medical Corporation in the United States and/or other countries. Asahi Kasei is a registered trademark of Asahi Kasei Corporation All trademarks are the property of their respective owners. PN-257 091201 For more information on the ZOLL AED Plus, please call 800-804-4356 or go to www.zoll.com/aedplus.

978-421-9655 800-348-9011 www.zoll.com

For subsidiary addresses and fax numbers, as well as other global locations, please go to www.zoll.com/contacts.

Cas e S t udy

AED Plus Hits a Hole in One

gray-purple in color,” Ted said. Ron checked his vital signs and found nothing. Ron’s wife, Julie, was talking to Bob, “Come on Bob, talk to me, Bob,” but he was not responding. Now Ted was thinking cardiac arrest. Ted hopped in a golf cart and quickly drove back to the clubhouse, then ran in to retrieve the automated external defibrillator (AED). He met up with Bob’s daughter-in-law, and she and Ted sped back down to the green in Ted’s car. Now two more golfers, Paul Niznik, the owner of a local medical staffing company, and Frank Rice, had taken over CPR and giving rescue breaths. Ron and Frank quickly removed Bob’s turtleneck and sweatshirt, and Ted attached the AED electrodes and turned on the unit. After analyzing Bob, the ZOLL AED Plus ® recommended a shock. Ted pushed the Shock button. Immediately after the shock was delivered, Frank continued CPR. The AED Plus instructed him to “Push Harder.” A second analysis also recommended a shock. Finally, the second shock was followed by a gasp. After a few more minutes, the police arrived and took over CPR until the ambulance came to take Bob to a local hospital. Just then Bob’s wife, Sheila, came onto the green after getting a call from her daughter-in-law. When Sheila got there, Bob was already in the ambulance and she thought the worst. “The ambulance wasn’t moving, and all the people looked ashen. I thought everyone knew he was dead and they weren’t telling me.” It was another 10 minutes before the ambulance transported Bob to Baystate Medical Center. He was put on medication, and less than a week after his collapse, he was released.

It was the perfect New England fall Sunday for the annual American Heart Association golf tournament at the East Mountain Country Club in Westfield, Massachusetts.

For a few years, co-owners Ted and Mark Perez have been holding a turkey shoot scramble in honor of their dad, who is age 80 and has had heart issues. They were very pleased that 40 golfers were enjoying their favorite pastime while benefitting a cause near and dear to their hearts. Mid-afternoon, Bob Genereux, Sr. was soaking in the sun, the game, and the camaraderie on the 10th green when suddenly he collapsed. Ted Perez was up at the clubhouse when he saw his father’s golf cart coming up the road toward him. At the same time, he noticed people waving on the 10th green and someone lying on the ground. When his father was within earshot, he said, “Bob fainted. Can you go open the gate for the ambulance ? ” “I should have gotten the AED right then and there,” said Ted. “But between my father saying that Bob had fainted and remembering the year before that someone had gone down on the same green after being hit by a ball, I was not thinking cardiac arrest.” The Save—Orchestrated to a Tee After Ted opened the nearby gate, he ran over to the 10th green. Ron LeVoie, who was playing at the adjacent hole, had already begun administering cardiopulmonary resuscitation (CPR) to Bob. “Bob was

“ Every golf course should have an AED . . . There was enough time before police and fire got there that I don’t think it would have been in time.” Bob Genereux, Sr.

The ZOLL AED Plus, the first and only Full- Rescue AED that provides Real CPR Help ® for depth and rate of chest compressions, audibly coaches rescuers with prompts such as “Push Harder” or “Good Compressions” during CPR.

Back on the Course A few days after that, Bob was back on East Mountain’s 10th green. But it was not to play golf—yet. He had called the local television reporters so he could tell his story. “We knew a lot of people were haunted at the course,” said Sheila, “and we wanted to let people know that Bob was okay and to encourage others to have AEDs on golf courses and in other public places.” “Every golf course should have an AED,” said Bob less than two weeks after the incident. ”If you stop and think, golf courses aren’t very close to fire stations. They are out in the country. It’s all about time. If they hadn’t had one, I wouldn’t be here. There was enough time before police and fire got there that I don’t think it would have been in time. Three people jumped in to help me with CPR and Ted got the AED. It was like a well-choreographed play and everything fell into place. I call them my guardian angels. I won the lottery. And I can’t wait to get out on the course again!”

AED Hits a Hole in One Mark Perez said the club purchased the AED Plus just two and a half years ago after his wife, a nurse, finally convinced him and his family to get one. “We knew we needed to get an AED, but we didn’t want to make the leap. It is a family business, so I talked it over with my mom, my brother, and my sister, and we decided we should have one. My dad has a lot of heart problems, and we know the importance of AEDs and CPR. Over the past 50 years, I can count five or six golfers who’ve had cardiac arrests on the course and didn’t make it. Bob was the first person we were able to save. It was the first time we’d used the AED, and we’re one for one.” “There are so many pieces to the puzzle,” said Paul, who has helped save four previous lives during his long career in the medical field. “To have the people who know what they are doing and how to do it, to have an AED—who expects an AED device ? —to have good response times for starting CPR, to getting the AED, to the police and EMTs getting here so quickly. To have all of that in a row, I can’t think of anything more a person could ask for. Every puzzle piece was there for him, and it was really something. Without that AED, forget it.” “Bob was given a second chance because of the AED” said Ted. Bob concurs, “I owe my life to it.”

For more information on the ZOLL Aed Plus, please call 800-804-4356 or go to www.zoll.com/aedplus.

Ted Perez and Bob Genereux, Sr.

ZOLL Medical Corporation • Chelmsford, MA, USA • 800-804-4356 ZOLL Medical Corporation, an Asahi Kasei Group company, develops and markets medical devices and software solutions that help advance emergency care and save lives, while increasing clinical and operational efficiencies. A D V A N C I N G R E S U S C I T A T I O N. T O D A Y. ®

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