After each trip to the gym-as tired as we may be-we know the benefit has set in. We are stronger, we are faster, but we never think that the workout could have been our last.
It is a sad reality that some people do die unexpectedly while exercising. The cause is a cardiac arrest that can occur without warning.
At first, individuals may appear to be quite normal, with no visible sign of any abnormality. Suddenly, the victim loses consciousness, has no pulse, and fails to breathe normally. Brain death begins to occur in just four to six minutes, and soon after, they are dead.
In Canada, between 20,000 and 30,000 people die annually from a sudden cardiac arrests (SCAs). An SCA is an event in which the heart suddenly ceases to beat normally, which differs from a heart attack in which the heart continues to beat, albeit with low efficiency.
According to the American Heart Association, as many as 50 per cent of SCA victims have no prior indication of heart disease. For individuals without heart disease, recreational drug abuse has been shown as a leading cause of SCA. In addition, a catastrophic SCA typically occurs during or shortly after physical training, which suggests that intense physical exertion is a precipitating factor for SCA.
During an SCA, abnormalities in the heart’s electrical system cause the heart to twitch rapidly and chaotically, leaving it unable to pump blood to the brain and vital organs. The heart of an SCA victim is not beating, but still electrically active, so an electrical jolt from a defibrillator is the only definitive way to restore proper electrical activity and a normal heart rhythm.
It is important to emphasize the immediacy with which defibrillation is required, as the survival rate after SCA decreases by ten per cent for every minute that passes without defibrillation. To be effective, defibrillation must occur within the first few minutes of a SCA.
Studies show that 90 per cent of SCA victims that receive defibrillation within the first two minutes following an SCA survive to be discharged from hospital.
The urgency of defibrillation following an SCA is the primary reason why ambulances carry defibrillators; however, paramedic response time affects the chance of revival. In Toronto, the average ambulance response time to a casualty scene is eight minutes, with more time required to reach victims inside buildings.
Victims waiting for paramedics to arrive and use a defibrillator are not likely to survive. The bleak reality of response times is one of the driving forces behind campaigns for Public Access Defibrillators (PADs).
The goal of PAD programs is to place defibrillators in public areas for members of the general public to access and use on a cardiac arrest victim. These defibrillators are specifically designed for use by virtually any member of the general public.
These defibrillators will only permit the user to deliver a shock to the heart if it is safe to do so and the shock is likely to restore normal electrical activity. The cost for a single unit is approximately $3000.
Under Ontario law, in an emergency, a defibrillator can be used by a member of the public to provide temporary aid to a victim. The Good Samaritan Act of 2001 protects individuals from liability if they use a defibrillator in an emergency situation.
According to information desk staff, the Hart House Athletic Facility does not have a defibrillator unit, while at the Athletic Center, the David L. MacIntosh Sport Medicine Clinic has a defibrillator unit. Given the size of the U of T’s student and faculty body, a new PAD program for early response to an SCA would enhance the superb safety and preparedness of our athletic facilities.
