"Oh, it's safe to go into ventricular fibrillation here. Don't worry."

Seeing as I complain all the time about school eating things I value-- time, social life, sleep, sanity-- let me introduce you to what I am actually doing at the School of Public Health this semester.

Semester Two: The Sleeping Giant of Semester Projects

For the duration of the semester, many of my classes focus on a semester project, where each assignment is one more step towards a completed product to turn in at the end. Community Health Theory and Practice II, my major's core course, has plunged me feet-first into the world of sudden cardiac arrest and automated-external defibrillators (AEDs). This topic of my choice is not really related to emergency preparedness, I know. Here's why: when one is first learning the public health model and the theories we use to justify behavior change and message creation, it is advantageous to use a topic that closely fits the public health model and that fit is supported by empirical research. This is not the case for emergency preparedness. So, while I love emergencies, I was not interested in absolutely mutilating my self-confidence in my ability to learn this semester by choosing a topic that was going to require so much work to justify why it even fits as a part of public health, much less completing the assignment tasks.

I had no idea how ridiculously interesting sudden cardiac arrest and the role of AEDs would be. I mean, the role of an AED in a cardiac incident is pretty straightforward-- it saves lives. But some of the statistics I have come across are astonishing and certainly point to the need for more people to be trained in AED use. For example, while sudden cardiac arrest typically only strikes 450,000 people in the US each year (this is really not high compared to people diagnosed with other diseases such as cancers or STDs), 95 percent of people who suffer a sudden cardiac arrest will die within 4-6 minutes of the occurrence of irregular heartbeat. Sudden cardiac arrest is not a heart attack, although many people who have a heart attack later go into cardiac arrest. A victim of sudden cardiac arrest has no warning signs or symptoms of heart trouble until they simply faint with no heartbeat. Most people who suffer from a sudden cardiac incident are young adults in their mid-thirties to mid-forties and are in all visible ways healthy.

Like I said earlier, a victim of sudden cardiac arrest has approximately 4-6 minutes before permanent death sets in. Serious health complications can certainly begin to set in earlier than the 4-minute mark. Each minute that passes from onset of irregular heartbeat reduces the victim's chance of survival by 7-10 percent. However, the average response time of emergency medical responders is 11 minutes in the best conditions. So, add some urban traffic, road construction, or a rural location and that response clock begins to tick away potential heartbeats.

My project is designing a program that ensures that all employees at selected high-incidence locations (health clubs and golf courses to start in the pilot program) are trained to use an AED. The program also begins a coalition to build support for legislation that requires AEDs in high-incidence locations in the state of Minnesota. The state currently only has two laws related to AEDs on the books. The first includes AED use in the Good Samaritan Law and the second is a funding earmark to make it easier for AEDs to be present in squad cars of local and county law enforcement. Great laws, or at least a good start. But it really isn't enough. And in fact, AED placement isn't enough. We do see AEDs in a lot of public locations. After starting this project, I am hypersensitive to them and every time I notice one in a public place I usually say something about it. However, an American Heart Association survey showed just how ineffective simply increasing access to AEDs has been in increasing their use. 89 percent of the respondents said they would be willing to provide help if they were on the scene of a medical emergency, but only 15 percent felt confident to use an AED. Unfortunately, bystanders used an AED as a lifesaving technique only 2 percent of the time in all public sudden cardiac arrest incidents.

AED training programs allow people to get familiar with the technology and practice using it outside of the hysterics of an actual emergency. The training is really not at all about giving people the skills to use an AED because spoken and illustrative instructions in several languages make the device terribly easy to use. Instead, the training is focused on giving people the confidence to use the device and understand that they cannot actually do harm to a sudden cardiac arrest victim by using an AED. While no medical device is flawless, advanced technology in the AED is designed to distinguish ventricular fibrillation (the irregular heartbeat characteristic of sudden cardiac arrest) and will not deliver an electrical shock unless that rhythm is detected and the device can determine that the pads are correctly placed on the individual. In fact, instead of lawsuits claiming that AEDs are dangerous or have done harm, there is a recent trend in lawsuits filed because a business or event venue did not have an AED on site.

My most recent assignment for this class regarding AED use was to submit a draft of my program implementation plan, a budget, and a budget justification. I have never done these things before, so I am sure they are really rough and I accidentally overlooked a lot of things, but I certainly feel I am learning a lot. In some ways, by using a real topic of interest, it feels a bit like trial by fire, but I will be happy to have these skills in the "real world."

I am using the same topic in my Skills for Policy Development class, where I am learning to create different documents and use different communication outlets to support two Minnesota statutes that would "encourage" AED training in high schools are part of the regular health education curriculum. I think the passage of these bills into law is kind of a long-shot, although it doesn't require any additional state funding. I just don't think it is on the minds of legislators this session.

I am taking a host of other classes, one which has a semester long project as well. It is not exciting and certainly NOT worth spending my free time writing about. My feelings about that class: Worst three hours of my week. Ever.

Speaking of all these classes, I guess it is time to go back to my eventful Saturday night of peer reviewing and editorial revisions. Ahhh, livin' the dream, livin' the dream.