As nurses, we use our hands often to give medications, treatments and personal care. How often, though, do we use our hands to pray with our patients and their families? Are we prepared to use our hands in our faith communities to save a life, if necessary? Our health ministry and congregation were faced with this question in October 2000.
A parishioner, who was assisting with the first two morning services, suffered a heart attack and died in our sacristy between services. He was forty-seven years old, a husband of over twenty years and the father of four children.
Were our hands and hearts prepared adequately for this event? The first responder did not know cardiopul-monary resuscitation (CPR) but quickly found two helpers who were CPR instructors. Their hands worked diligently to revive our friend, and their hearts prayed with a fervor they had never known, "Please let him live." Despite the paramedics' arrival within five minutes, our friend died.
In working through our grief as a faith community, we began to see important lessons in this experience. First, one responder stated that she was trying so hard to resuscitate our friend that she was willing him to live, but it wasn't working. After many months of healing, she realized that her hands were to do God's will, not hers. As a faith community, we were vividly reminded that we are God's instruments to do his work. Psalm 138:8 reminds us, "The LORD will fulfill his purpose for me."
Second, our congregation of 2,400 families realized that our church, school, gym and social hall are our home-away-from-home, as large numbers of people use our facilities each day. Charged with promoting the healing ministry of Jesus, we have committed ourselves to be ready to meet the physical, emotional and spiritual needs of those using our facilities. However, although we come together in prayer and classes to meet our spiritual needs, we are often unprepared to provide physical care.
We learn from the Scriptures that, "Great crowds came to him, bringing with them the lame, the maimed, the blind, the mute, and many others. They put them at his feet, and he cured them, so that the crowd was amazed when they saw the mute speaking, the maimed whole, the lame walking, and the blind seeing" (Mt 15:30-31). We began to explore what this might mean for us.
The health ministry of our congregation partnered with our community fire department paramedics and Providence Hospital and Medical Centers and discussed how we could improve the Chain of Survival (promoted by the American Heart Association) in our congregation.
We decided that we should provide access to an automated external defibrillator (AED) in our facilities. An AED is a portable device used to shock the heart into a functional rhythm, if needed. When the AED is applied properly to the chest, it assesses the heart rhythm, determines if a shock is needed and provides a shock when the rescuer presses a button.
The AED has easy-to-follow visual and audible prompts. A shock cannot be given accidentally. The machine will not deliver a shock unless the heart is in ventricular fibrillation or ventricular tachycardia. CPR without defibrillation in these instances is futile. In sudden cardiac arrest, each minute without defibrillation decreases the victim's survival rate by 10 percent.
The cost of each AED is approximately $3,000 to $4,000. After personally surviving a heart attack, a generous donor provided the funds for our AEDs. Other funding sources could include grants, congregational donations and fund-raisers. Grants are often available through the national health ministries association of your denomination. Quantity discounts may be available from the AED sales representative, as well as possible hospital purchase discounts if your health ministry is affiliated with a hospital.
The hospital staff and Lt. Thomas Shurleff's fire department paramedics provided training for our CPR/AED classes. In three months, 150 parishioners in our congregation were trained. Participants ranged in age from fourteen to eighty-four. A protocol developed by the parish nurse and fire department paramedics was implemented, based on American Heart Association guidelines and a review of the current literature related to AEDs.
The pastor and parish council expressed legal concerns, which were resolved by research into the state's Good Samaritan Law and by contacting the church's insurance company. A statement from the insurer to the pastor said that our policy covered the use of AEDs in the congregation. Each congregation will have to explore legal issues based on their state laws and insurance coverage. To date, no known lawsuit has been filed against a congregation for using an AED.
The AED is easy to use. Our non-medical parishioners did extremely well in their training program. Recertification classes will be held annually for those trained, and initial training for newcomers will be offered twice a year.
We have not had to use our AEDs, yet. However, since our parishioner died last year, four similar incidents have occurred in our geographic area. These people may have benefited from the use of an AED. Our parishioners feel safer now, knowing that the AEDs are available if needed.
Note: To obtain a copy of the AED protocol and program, contact Donna Carrico at: [email protected]
Chain of Survival & Cardiac Arrest
LINK ONE: Recognize an Emergency and Call 911
First, you or other witnesses must recognize the emergency. You must recognize the warning signs of a heart attack, cardiac arrest, stroke or choking. Anyone who is unresponsive should receive emergency care. As soon as an emergency is recognized, call 911.
LINK TWO: Begin Cardiopulmonary Resuscitation (CPR)
CPR is the critical link that buys time between the first link (call 911) and the third link (use the AED). The earlier you give CPR to a person in cardiac or respiratory arrest, the greater their chance of survival. CPR keeps oxygenated blood flowing to the brain and heart until defibrillation or other advanced care can restore normal heart action.
To learn CPR, call 877-AHA-4CPR to find a CPR training center near you.
LINK THREE: Use the Automated External Defibrillator (AED) to Treat Ventricular Fibrillation
The sooner you provide defibrillation with the AED, the better the victim's chances of survival. For every minute that a person in cardiac arrest must wait to be defibrillated, their chance of survival decreases by 10 percent. After ten minutes, the chances of survival are less than 10 percent.
The AHA has developed the Heartsaver AED Course to support the public access defibrillation movement and specific PAD programs. The course is designed to help you learn how to give CPR and use an AED. These skills are essential in caring for the victim of cardiac arrest.
To learn more about AEDs or how to take the American Heart Association's class, Heartsaver AED, please call 877-AHA-4CPR.
LINK FOUR: Early Advanced Care.
This link is provided by highly trained EMS personnel; paramedics. Paramedics give basic life support and defibrillation as well as more advanced care. They can give cardiac drugs and insert endotracheal breathing tubes. These advanced actions (1) help the heart in VF respond to defibrillation or (2) maintain a normal rhythm after successful defibrillation. Source: American Heart Association, http://216.185.112.5/presenter.jhtml?identifier=6980
The information in the American Heart Association (AHA) website is not a substitute for medical advice or treatment, and the AHA recommends consultation with your doctor or health care professional.
Contact Us: American Heart Association National Center, 7272 Greenville Ave., Dallas, TX75231; 1-800-AHA-USA-1 or 1-800-242-8721;http://www.americanheart.org/presenter.jhtml?identifier=1200000