What would you do if during the 10:00 service at your church, Mt. Zion Baptist, you see Floyd Crawford drop to the floor with an ashen gray look and remain unresponsive — call 911 or start CPR?

Doing CPR and calling 911 are important first steps, but may not be enough to save someone suffering from sudden cardiac arrest (or SCA, as it is known). This is not new information for the administrators of Saint Thomas Health Services or church leaders in Nashville, Tennessee who worry about the safety of their parishioners. When Saint Thomas, the only faith-based health services organization serving Nashville and middle Tennessee, learned from local EMS that many of the cardiac related emergencies occur on Sunday mornings, when folks are gathering for worship, they decided to help.

Nashville and its surrounding communities have hundreds of churches and synagogues some with membership from 5,000 – 10,000 and 3 to 4 services each Sunday. For emergency personnel Sunday mornings represent a vulnerable time for effective emergency cardiac care. EMS agrees that their response times are sometimes not quick enough to successfully rescue someone in cardiac arrest. For every minute rescue is delayed the survival rate declines by 10%. According to the American Heart Association, the only solution to an out-of-hospital cardiac arrest is early defibrillation by a first responder within 3-to-5 minutes. Armed with this information, Saint Thomas took the bold step to supply churches in their community with Automated External Defibrillators and help train church personnel to use them in case of an emergency.

Sudden Cardiac Arrest
In SCA, the heart suddenly stops beating normally. The electrical impulses that control the rhythm of the heart become so disorganized that the heart begins to quiver and can no longer effectively pump oxygenated blood and death occurs within minutes. CPR cannot reverse this chaotic cardiac rhythm called ventricular fibrillation. External defibrillation promptly administered with an on-sight Automated External Defibrillator, is the best-known effective treatment to halt sudden cardiac arrest.

Public Access to AED's
Public access to an Automated External Defibrillator (AED) is more common today in high risk locations such as in health clubs, aboard airline flights, or during sporting events. Saint Thomas realized that little attention was given to smaller venues such as churches and synagogues that face the same risks. According to Patrick Jansen, Executive Director of the Saint Thomas Heart Institute, the initial goal of the program was very general.

“We simply wanted to increase on-scene response to cardiac failure and ultimately reduce treatment time for the patient through public access defibrillation,” said Jansen. When they learned of the risks facing Nashville's churches, the hospital's momentum shifted to determine what impact they could have on the community, specifically during Sunday mornings.

With this in mind, Saint Thomas Heart Institute requested and received a $50,000 grant from its Foundation to purchase AED's, distribute them, and train an AED Liaison in each church who would then coordinate further training. Saint Thomas' AED project committee had two goals: (1) Select an easy-to-use AED suited to this application and (2) Create a process in which the churches could apply for an AED.

The committee's search for help brought them to the AED Instructor Foundation. The AED Instructor Foundation, working through emergency care instructors around the world, provides information, resources and, access to a low cost AED helping prepare communities for cardiac emergencies (see sidebar).

Saint Thomas' goal was to supply as many churches with an AED through the initial $50,000 grant as possible. With the help of the AED Instructor Foundation, which is funded by an unconditional grant from ZOLL Medical, the hospital acquired 35 AED's for the churches – more than twice the number it had originally hoped. Saint Thomas felt even more confident in their choice when they learned that the AED purchased through the AED Instructor Foundation was manufactured by ZOLL Medical – the same company the hospital trusts to supply its in-hospital defibrillators.

“St. Thomas Hospital's AED program will undoubtedly become a model for other medical centers wishing to help provide optimal emergency cardiac care and extend the lives of people with ‘hearts and brains too good to die'”, stated Frank J. Poliafico, RN, Executive Director of the Pennsylvania based AED Instructor Foundation.

Mt. Zion Baptist Church
Mt. Zion Baptist Church located just outside Nashville, qualified for one of the first AEDs. It met the criteria of having over 1000 members – Mt. Zion has 10,027 and located more than 3 minutes from rescue – Mt. Zion is 5.5 minutes from rescue and more if EMS catches the red light.

With more than 10,000 members, three services every Sunday, and other church events almost every day of the week there was concern that Mt. Zion was not fully prepared for a sudden cardiac emergency. As they prepared to purchase an AED they heard about the Saint Thomas program and applied immediately. Since then they have received their AED, trained the initial key people in the ministry. According to Barbara Meriweather, Clinical Educator at Saint Thomas and Mt. Zion's AED Liaison, “Lay people love the ZOLL unit because it takes them through all the steps including if and when to administer treatment and when to continue CPR. This makes the user feel better during a very stressful situation.” It is the goal of the AED Instructor Foundation to assist and support initial emergency care instructors in their critical function of preparing communities and workplaces – especially public gathering places and small businesses – for reasonable, appropriate and effective emergency medical response.    AED

Bellevue Community Church
Like Mt. Zion, Bellevue Community Church met all the criteria and received an AED. Bellevue is a nondenominational church located in Nashville with over 2000 members. To date they have trained 11 people to use the AED and received requests from 15 additional church members wanting certification. Paul Lindsley a church member and Director of Public Relations for Saint Thomas Health Services brought the idea to church leaders and helped them think through the logistics of getting an AED. Saint Thomas has asked (but does not require) each church that receives an AED through its program to pay a portion of the purchase price back to the hospital. This allows the hospital to continue funding AED's to more and more churches. Paul Lindsley felt so strongly that his church needed an AED that he personally donated $300 toward the AED fund.

For more information contact Frank J. Poliafico, RN
Executive Director AED Instructor Foundation
800-572-2227
director@aedif.org