The Retail Cardiac Chain of Survival; or, How to Survive a Heart Attack at the Mall
by Don Ross

What if your customer suddenly clutched his chest and passed out in front of you? Do you know what to do?



The federal Cardiac Arrest Survival Act (CASA) states that "A successful chain of survival requires the first person on the scene to take rapid and simple initial steps to care for the patient and assure that the patient promptly enters the emergency medical services system. These steps include--

• Recognize an emergency and activate EMS;
  
• Begin CPR; and
  
• Use an automated external defibrillator (AED) if one is available at the scene."
  
  
  
  While most bystanders in the USA and Mexico are not required to get involved, one would hope that the common dictate of humanity, to help our fellow human beings, would prevail over any other concerns. Standard precautions are enough to prevent the transmission of most diseases and the Good Samaritan Laws protect us from being sued, as long as there is no gross negligence. In fact, both State and Federal laws protect all parties involved, including the rescuers, the trainers, the facilities, etc. According to the National Center for Early Defibrillation, "...organizations that carefully adopt and implement early defibrillation programs face a lower legal liability risk than those that do not." So, let's explore this cardiac chain of survival and how a savvy mall rat could use it to land their next job or promotion.
  
  
  
  Recognize the Emergency
  
  
  
  Pay attention to your customers. If one doesn't look well, ask how he feels and if you may be of assistance. Know the signals of a heart attack:
  
  
  
  
• Sweating, difficulty breathing
  
• Persistent pressure in the chest, side or back
  
  
  
  If he does not look well, but does not want your help, keep an eye from a distance. Don't forget about him. Just watch. If you are still concerned, call 9-1-1. It is better to be safe than sorry.
  
  
  
  Activate EMS, the Emergency Medical System
  
  
  
  If he goes unconscious, send someone immediately to call 9-1-1. In a mall, you are rarely by yourself, so use the others to your advanage. Send someone to call security to bring the AED and yet another to fetch a First Aid kit.
  
  
  
  Begin the ABCs of CPR
  
  
  
  
• Open the Airway (head tilt, chin lift).
  
• Give two Breaths.
  
• Check for signs of Circulation.
  
  
  
  If there is no coughing when you give breaths and they're pale, limp and lifeless, they are probably in cardiac arrest. This means their heart is no longer beating well enough to stay alive. Without CPR until the AED arrives, this person will not survive. The optimum chance he has for survival is if you, the person standing next to him, know what to do.
  
  
  
  Use an Automated External Defibrillator (AED) if Available
  
  
  
  An AED is an electrical device which helps to "re-boot" a person's heart when it is out of rhythm. Every minute an AED is delayed decreases a person's chance of survival by 10%. You may have noticed the push to make these easy to use, life saving devices widely available, from the FDA's recent approval of the first in-home AED without a prescription, to local television commercials seeking to make AEDs as common as pay phones.
  
  
  
  When the American Heart Association studied giving immediate CPR alone vs. both CPR & AED before paramedics arrive, those receiving the electrical shocks from an AED were twice as likely to survive. Even more dramatically, when the casinos in Las Vegas acquired AEDs, survival from cardiac arrest went from 10% to 54%!
  
  
  
  AEDs in the Malls!?
  
  
  
  While most do not, only the largest malls now have AEDs, but not always. Talk to management to ask if and where they're located. Show that you care for humanity. Learn how to save a life and put it on your resume! It will make you a more attentive sales person with excellent management potential.
  
  
  
  Sources:
  
  
• California Good Samaritan Law: http://www.swc.cc.ca.us/~kjacobs/goodsam.htm
  
  
• The Cardiac Arrest Survival Act (CASA): http://www.suite101.com/article.cfm/8954/67328
  
  
• Public Access Defibrillation (PAD) Study Results: http://depts.washington.edu/padctc/results.htm
  
  
• Understanding Legal Issues by Richard Lazar, EMS, Esq.
  http://www.early-defib.org/03_06_02.html
  

  About the Author

  Copyright by Don Ross, CEO of OptiWell, the Optimum in Wellness Training, who began in retail management in the 1980s. Call (619) 204-3838 or visit OptiWell-inc.com for First Aid & CPR/AED certification in San Diego County.