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AEDs are an important part of rescue protocol

My name is John Tyler. I am the founder of the Kauai Rescue Tube project and a resident living in Haena. For the past 25 years I have owned and operated a business that teaches CPR and certified Red Cross lifeguard courses nationwide. In that time, my company has trained over 45,000 students in lifesaving procedures, following Red Cross and American Heart Association national standards. A key part of our training for at least the last 15 years has been the use of AEDs (Automated External Defibrillators). These devices, when used promptly, can double the chance of survival of a victim whose heart has stopped.

Last fall, I witnessed CPR being performed by Kauai Jet Ski lifeguards and KFD personnel to a middle-aged woman who was pulled from the water at Lumahai Beach. Sadly, the woman was not revived. Given my background, I stopped at the scene right after the fire truck arrived, and was ready to help if needed. I was between 25 and 50 yards away from the victim. After about two to three minutes, one of the firemen began walking back to the engine, and I asked if they had an AED because I had one at my house three minutes away. The fireman said that they had an AED on the truck and for me to “back up and make room for the ambulance which would be coming.” I watched the CPR progressing for the next several minutes before heading home, the ambulance still hadn’t arrived, and no AED was used the duration of the time I was present, as I clearly saw the woman’s bare chest with no AED pads in place.

On my way home I wondered why, if the firemen had an AED on the truck, it wasn’t immediately used on this victim. Being a 20-plus year veteran CPR instructor, I know protocol requires that when an AED is on scene, it is immediately activated for victim’s increased survival. This victim was obviously in cardiac arrest with full CPR in progress.

For the last several months, I have gone through the “proper channels” to try to address this, or be educated if the national AHA or Red Cross protocols have changed for AED use or the Kauai Fire Department uses different protocols.

Our fire chief responded to me in January stating: ”In this case my review of the records for this incident indicate that the Ocean Safety Officers, the Firefighter’s and the EMS personnel responded appropriately. Additionally an AED was applied with no shock advised.”

The question I asked the fire chief, however, was not if an AED had been applied, but when, and what will be done to insure its timely use in future rescues. Proper protocol for the use of AEDs is “immediate use when available” and I did not see an AED used in all my time on scene, even though the firefighter said they had one 25 yards away. As you can imagine, it does little good to have an AED first applied by an ambulance crew arriving 20 minutes later when it could have been used in the first minutes. In my reply email to the chief and county management, I cited AED defibrillation protocol from the AHA website and to date received no further answers.

It is my deep conviction that all possibilities to save a life should be exhausted. I thus would like to bring this incident to the public’s attention so that AED rescue protocol can be fully implemented by our first responders. We all want the greatest possible revival chances given the equipment on hand if we or our loved ones are ever in need.

Thank you and God Bless.

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John Tyler is a veteran Red Cross lifeguard instructor and former chairperson of AHA’s Los Angeles NW Region CPR Training Network, supervising 27 hospital and private CPR programs

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