Sudden Cardiac Arrest: Minutes Matter, Lives Depend on It

Every year 60,000 people suffer a Sudden Cardiac Arrest (SCA). A cardiac arrest simply means the heart has stopped beating and blood will not get circulated to the brain. The brain will start to die in 5 minutes without circulation and even with chest compressions chance of successfully re-starting a heart is lost by 7-10% with each passing minute.  So, in 10-15 minutes the heart will not likely be restarted and the patient will die.  While virtually, every paramedic unit and fire truck in Canada has a Manual Defibrillator or Automated External Defibrillator (AED). The problem still remains the 9-1-1 response times to the scene (address location) might average 10 minutes for the highest priority emergency response like a Sudden Cardiac Arrest (SCA), it will still take a few more minutes for the crew to get the stretcher and equipment out of the vehicle, and make their way into the building or site and get to the patient’s location, access the patient and begin treatment. So unfortunately, 9-1-1 Emergency Services take too long to get to the patient and save their life. 

The Chain of Survival Starts with You

The international Liaison Consortium on Resuscitation (ILCOR) consisting of official organizations like the Heart and Stroke Foundation of Canada, American Heart Association, British Heart and so on said when AEDs were first developed in the late 1990s “they are so sophisticated and easy to use,  that lay-rescuers with minimal training can use an AED. If AEDs were placed in community locations like sports complexes, community centres, and workplaces, then bystanders could use the AED long before the 911 responders arrived and  thousands of lives could be saved.

The Automated External Defibrillator will access the heart rhythm and determine if a shock is advised, then the AED will set the therapeutic energy (shock) level, and all the bystander  has to do is get people away from the patient and say “Clear” and “Press the Flashing Shock Button”.

The Chain of Survival was developed back in early 2000 by the American Heart Association to illustrate the 5 key steps in saving a life and the huge role that bystanders play in sudden cardiac arrest response. If any link breaks the patient will not likely survive. It showed the importance of having the public participate and start care before 911 crews arrived

You Can’t Make It Worse—You Can Save a Life

To date, literally thousands of AED’s have been purchased and placed across Canada in virtually every government building, school, post-secondary institutions, public buildings, community centres, sports complexes, commercial retail, commercial business and residential condominiums, businesses, airports, aircraft, sub-way and transit terminals almost everywhere.  so anyone can use the AED, BEFORE 9-1-1 Emergency Services arrive.

The reality however, is,  the public are not using AEDs, they are afraid of making a mistake or getting sued.  On hospital and emergency TV shows cardiac arrests look very stressful and intimidating and the Medical Teams must take complete control of the situation and yell CLEAR!!! to everyone and then Shock the patient holding the Shock Paddles (Even though this old technology hasn’t been used in years) – it is still more dramatic and exciting when the staff applies the electrode paddles to the patient’s chest. So, most people think running a cardiac arrest is very technical, intense and requires a great deal of training and expertise.

Cardiologist Simon Hansom, director of Inherited Arrhythmia Clinic at the University of Ottawa Heart Institute, says bystander CPR is "the number one thing you can do to save people." "You do your best," the doctor said. "If someone's had a cardiac arrest, you're not going to make them any worse than they already are." (Read Full article from CBC News · Posted: Jun 27, 2025)

The new Ontario AED Bill 141 just received it’s third and final reading in the Ontario Legislature.

When bystanders do start CPR and use an AED the survival rate is over 30% - so any effort to get AED into the hands of the public is good. One of the components of the new Ontario AED Bill 141 law AED Registry so 9-1-1 Call Centres will know the location of the closest AED when a 9-1-1 call comes in.  MPPs are saying this will make finding public defibrillators easier. The Defibrillator registry ‘will help save lives across Ontario.  While it might help a little, the real problem still remains, and that is that bystanders are afraid or unwilling to use them even if they know where they are located. Learn more about 141 on the Heart & Stroke website

There are six key components to the new AED 141

  • AEDs must be placed in designated premises
  • AEDs must be easily accessible
  • AEDs must have appropriate signage
  • AEDs must be registered with the 911 AED Registry
  • AEDs must be properly maintained and ready for use
  • AED training is required

We feel much more structure and support is needed for Component 6 – AED Training 

Literally, millions of people have been trained over the past 25 years and yet people forget their training (perishable skills).   

Highlights of the Study done by WorkSafe BC - CPR and First Aid Skill Retention, RS2006-IG06   

  • Repetition of training appears to be a significant variable in skill retention, and hence, strategies for increasing the repetition of the skills and knowledge should be included  
  • As many skills deteriorate rapidly over the course of the first 90 days, changing frequency of certification is not necessarily the most obvious choice to increase retention of skill and knowledge. Alternatively, methods of regularly “refreshing” a skill should be mandated as high frequency refreshers – such as every 90 days. 

The public needs to know they are protected by the Good Samaritan Law and will not be sued or make the patient’s condition worse (like possibly breaking ribs), they cannot override the AED and shock a person that doesn’t need it. If the AED accesses the patient’s heart rhythm and says “No Shock Advised” the operator cannot deliver a shock – even if they press the Shock button many times.  

The difference early response makes is huge!  If a Willing bystander does chest compressions and pumps blood to the patient’s brain, the brain will stay alive longer. If the AED can be used within the first few minutes, long before 9-1-1 Emergency Services arrive the patient has a much better chance of survival like 30+%.  This is way better than 5% - 20,000 lives saved, or the current 3,000 lives saved every year. 

Our new Chain of Survival uses the word “Willing”.  Bystanders typically don’t do enough, we must help people have the confidence to get involved.  We need to convert bystanders (lay-rescuers) to Willing bystanders!!  So, the real challenge is how do we convert bystanders into Willing Bystanders?   

We need to correct THE BIG MISTAKE and convert bystanders into willing bystanders! 

It’s ok, to help and our program gives immediate access to life saving information and first aid treatment checklists, a person or group of people like family members, co-workers sports teams etc.  Can review the information and follow the instructions right from their mobile device, so they can start care long before 9-1-1 Emergency Services arrive. 

Naturally helping care for a person in cardiac arrest will be stressful and upsetting but keep it simple and just start chest compressions and turn on the AED and follow it’s voice prompts.  If people practiced or reviewed the information in Ready First Aide every couple months they would likely be much more confident and able to respond.  

Our next 3 blogs are each 3-minute videos (in 10 minutes you will know what to do)! 

  1. How the Heart Actually Works a Simple Explanation That Makes Sense) Check out our YouTube Video.

  2. How CPR Actually Works (and Why IT Saves Lives) Check out our YouTube Video

  3. How an AED Actually Works (And Why a Shock Can Restart the Heart) Check out our YouTube Video.

You spend most of the time with your family, friends and co-workers, they will be happy you helped.  Become a willing bystander™. 😊 

About the author -

Scott Ashley has a very relevant work history in the AED industry. Scott worked an EMT in Banff and Canmore Alberta, an EMT-P in Los Angeles CA, as an EMCA in  Ontario with Kirland Lake, Peterborough, Guelph, Cambridge and Toronto EMS services before working as Critical Care Flight Paramedic on Bandage One Air Ambulance helicopter based with Sunnybrook Health Science Centre. In 1998 Scott helped to write the AED Program implementation Guide for Health Canada and Federal government facilities.  He was also worked as part of the team that started and implemented the Toronto Cardiac Safe City Program and the Ottawa PAD Program. Over the past twenty-five years he continues to oversee and advise businesses and organizations across the country on their AED programs.