When Danny Berger, 29, woke up in a hospital room in Salt Lake City eight years ago, his first thought was that he must be late for his college basketball game. The then-22-year-old shooting guard for Utah State University wasn’t aware that he was regaining consciousness after collapsing on the court due to sudden cardiac arrest. His athletic trainer had given him cardiopulmonary resuscitation (CPR) and used an automated external defibrillator (AED) to shock his heart back into a normal rhythm, saving his life. (Here are the 11 silent signs that you have an unhealthy heart.)
As he groggily awoke, Berger turned to his dad and said he needed to get to the game. Berger’s dad assured him that he didn’t need to go anywhere. The game had been rescheduled and his teammates and coaches were waiting to see him. Berger had actually been in a coma for two days.
“Everyone had to keep explaining to me what had happened and how serious it was,” Berger says. “I couldn’t comprehend it all at first.”
One of the last things Berger remembered happening before finding himself in a hospital bed was that he’d been reviewing plays with teammates at an afternoon practice to prepare for a game the next day against Brigham Young University. “It was a pretty light practice and we were doing what we called ‘scout defense,’ preparing for plays that we were getting ready to guard and going over our game plan,” he says. His teammate made a shot toward the end of practice and he was frustrated that he didn’t stop it. Then all of a sudden, he started to fall. “It felt like my body was shutting down,” he says.
Berger later learned that after he hit the ground he started making seizure-like movements, gasping for air, and turning blue. Utah State’s athletic trainer Michael Williams ran over to start CPR while team manager Jesse Parker, who was also Berger’s roommate, ran to the nearby training room to grab an AED that Williams then used on Berger to deliver the lifesaving shock that reset his heart rhythm. (Here are 44 Heart health tips cardiologists follow.)
“The amount of time from when I hit the ground to when they had the AED on me was under two minutes. It was so fast and ideal. I’m extremely lucky,” Berger says.
What is an AED?
An AED is a user-friendly portable device that can be put in public places where people gather, such as schools, gyms and sports facilities, community buildings, high rises, and offices. It’s similar to the heart-shocking device used in hospitals—just about everyone has seen dramatic scenes in movies and television shows where a doctor yells “clear” and applies paddles to a patient’s chest to shock the heart back to life.
The AED is pretty much the same thing, but is intended for public use. When you open an AED, there are voice prompts and pictures and visual instructions that explain how to use it, says the American Red Cross. An AED has pads with sensors that are put on a person’s chest and built-in computer software that analyzes the heart rhythm and delivers a shock to the heart if it senses issues. If its reading indicates a normal heart rhythm, it won’t deliver a shock.
How AEDs save lives
Berger is among the estimated 1,700 people whose lives are saved each year in the U.S. because a bystander used an AED—a number of saves that researchers say could be twice as high with improved public awareness about AEDs, according to the National Institutes of Health.
A 2018 study published in the journal Circulation found that your chance of surviving a cardiac arrest more than doubles if a bystander uses an AED to deliver a shock to your heart instead of waiting for emergency responders to arrive and do it. You’re also more likely to survive with better outcomes and minimal disability.
Berger fully recovered and was able to return to school weeks later and the basketball team the following season. The incident happened in December 2012 and since then he hasn’t had any additional incidents with his heart or other major health issues.
Berger’s heart had gone into an arrhythmia (abnormal rhythm) called ventricular fibrillation (electrical impulses in the lower chambers of the heart become erratic and ineffective), according to the National Heart, Blood, and Lung Institute, and it took only one shock from the AED for his pulse to return.
“The only way to get someone’s heart out of a lethal arrhythmia, such as ventricular fibrillation, is with an electric shock—and that’s what an AED provides,” says Jonathan Drezner, MD, professor in the department of family medicine at the University of Washington, director of the University of Washington Medicine Center for Sports Cardiology, and team physician for the Seattle Seahawks, Seattle Reign, and Washington Huskies.
Berger says his doctors couldn’t pinpoint why his heart went into fibrillation. He’d recently had food poisoning, and it was the week before finals and he was stressed and low on sleep. In addition, tests of his magnesium and potassium came back low. “It was likely a bunch of things that came together,” he says. Berger didn’t have a pre-existing heart condition or a history of them in his family. (Doctors reveal the heart secrets they want you to know.)
The difference between cardiac arrests and heart attacks
A sudden cardiac arrest is different from a heart attack. A heart attack occurs when a blockage in an artery prevents blood from getting to the heart, but the heart usually doesn’t stop beating. A person may experience heart attack symptoms like shortness of breath, nausea, or chest pain, but they might be able to walk or talk, and they don’t usually lose consciousness. A sudden cardiac arrest is an electrical malfunction of the heart that causes a person to collapse, lose consciousness, stop breathing, and die within minutes if their heart isn’t shocked. So although, a heart attack can lead to sudden cardiac arrest, they aren’t the same thing.
“When someone goes into cardiac arrest their heart is sort of quivering and not pumping blood forward. From the moment they collapse, the clock is ticking. Every second counts,” Dr. Drezner says.
The critical window for using an AED
Each year more than 350,000 people go into cardiac arrest outside of a hospital and 100,000 of those cases happen in public spaces, according to the American Heart Association.
Berger is fortunate that his trainer and teammates acted quickly. Your chance of survival from cardiac arrest decreases by seven to 10 percent for every minute that passes without an AED. Plus, the longer you wait for an AED, the longer your brain is deprived of oxygen, putting you at risk of severe brain injury if you do survive.
Emergency medical services take between four and 10 minutes, on average, to reach someone in cardiac arrest, which is why public distribution and use of AEDs is critical. Here’s how to handle a medical emergency.
How to use an AED
The American Red Cross offers CPR/AED trainings to the public so that you can be prepared to help someone who might be in cardiac arrest. Although getting certified is advised and helpful, the devices are intended for public use by anyone—both trained and untrained bystanders, Dr. Drezner says.
“Anyone can use these during an emergency. If you open it up and follow the voice prompts, it tells you exactly what to do,” Dr. Drezner says.
The American Heart Association has a chain of survival list that identifies five things that need to happen to improve someone’s odds of survival and recovery: Recognition of cardiac arrest and calling 911, early CPR chest compressions, rapid defibrillation from an AED, effective life support from emergency medical services, and integrative post-cardiac arrest hospital care.
As soon as you recognize a potential cardiac arrest, the steps are to call 911, start CPR, and use a defibrillator (ask if there’s an AED nearby if you aren’t sure) as soon as possible.
If there are two of you, one person should start CPR chest compressions while the other gets the AED and put the pads on the person’s chest (the AED will give you instructions for putting them on). Once the pads are on, the device will tell you to stop CPR while it analyzes the person’s heart rhythm. If the AED determines that a shock is recommended, it will give you cues to step away and say “shock recommended, please stand back.” Make sure no one is touching the person during the shock. (The reason why those doctors yell “clear!” in the movies and TV is to avoid accidentally shocking anyone other than the patient.) If you happen to be using a partially automated AED, you will need to press an analyze button and then a shock button if it tells you that a shock is advised. For more information, check out the American Red Cross step-by-step guide for using an AED.
After the shock, the American Red Cross recommends that you continue with CPR until the AED tells you to stop again so it can analyze the heart rhythm to see if it should deliver another shock. “The only time you need to step away is when it’s analyzing the rhythm or delivering a shock, but otherwise keep doing CPR chest compressions,” Dr. Drezner says.
How to recognize cardiac arrest
The first step in the chain of survival, of course, it so recognize what’s really happening. If you see someone suddenly collapse when there wasn’t a collision, blow to the head, or other obvious reason for the fall, they may be in cardiac arrest. In sports, it could be during a pause in the action or while they’re sprinting or turning to walk, Dr. Drezner says. A person in cardiac arrest will collapse and lose consciousness quickly but their eyes may be open and rolled back, and they may initially have brief seizure-like movements—which is what happened to Berger. They may have some respiratory panting that looks like breathing (it really isn’t) and deep gasping movements, Dr. Drezner explains. “You don’t have to determine if their breathing is normal or abnormal. If someone suddenly collapses and is unresponsive, assume its cardiac arrest until proven otherwise,” says Dr. Drezner, who conducted a study on AED use in high schools over a two-year period. In the study, published in the British Journal of Sports Medicine, he found high survival rates for students and adults who went into cardiac arrest when there was an AED on campus.
Steps to save more lives
All states have laws or regulations requiring that public gathering places have AEDs, but what’s included in the law will vary. Researchers in the 2018 study in the journal Circulation concluded that “efforts to increase the availability and use of AEDs in public locations are likely the most promising immediate ways to improve survival from out-of-hospital cardiac arrest.”
Take note of where AEDs are in your community so you know where to find them. If you’re a business owner or administrative staff member, purchase AEDs if you don’t already have them and make sure they are placed in visible areas where all employees and the public can access them. In addition, have an emergency action plan that your team practices at least once a year and be vigilant about maintenance, such as replacing batteries and expired pads.
When it comes to sports facilities and athletic fields, Dr. Drezner recommends that AEDs be placed in central locations where it takes no longer than 90 seconds to take a brisk walk to get one. This may mean taking AEDs directly out to playing fields during games, he says.
Berger says he is much more aware of AEDs and where they’re located, and he sometimes even carries one with him. “I have this strange feeling that one day I’m going to save somebody,” he says. “It can happen to anyone and it happens more than people realize.”