Nur Aisyah Ismail

A call every mum dreads
Her mother, Madam Juriah Ahamad said that she got the fateful call at 8.46am while she was still having her breakfast. The teacher in charge had conveyed the news of her daughter’s condition and informed her that they had also called for an ambulance.

Before she was able to recover from the shock, the school called a second time, this time to inform her that the paramedics were unable to discern her daughter’s pulse and that her breathing had stopped.

She and her husband then rushed to KK Women’s and Children’s Hospital where her daughter was sent too. She told Berita Harian how she was hopeful as she knew her daughter was a fighter and had a strong will to live.

A birthday tragedy
Unfortunately, doctors were unable to revive Nur Aisyah who passed away in the hospital. She had just turned 13, that very day itself and would have celebrated the joyous event with her family and twin brother.

Her father, Mr Ismail Adan, recounted how he and his wife had planned to get their children pizza and a chocolate cake as a birthday surprise along with a birthday card written in Malay that translates to: “To my special children…We are forever thankful to God for blessing our lives with the two of you…Love you very much.”

The parents are shattered and at a loss as to how this happened especially since their daughter is both active and has no history of illness.

He is 46 years old, a father of 2 school-going children.

3 months ago, he was playing street soccer with his colleague at a company-organised game, when after a second round of play, he collapsed by the court.

He was attended to immediately by the private ambulance paramedics on duty at that time.

According to his colleagues, the paramedics thought they felt a pulse, and they also thought he was breathing. But he was still unconscious.

On the way to hospital, the colleague who was accompanying him found the paramedics performing CPR on Mr S. No mention of any use of any AED or defibrillator of any kind.

Any now he is bed-bound, un-communicative, prone to contractures, and has to be fed via a tube through his nostrils.

So what went wrong here?

I have written a topic on this, and even had it published in our local press.

On 29th June 2012 at approximately 1445hrs, our client was called to a case of a man displaying seizures. Upon arrival, they found him not breathing and foaming at the mouth.

They then applied the AED and a shock was advised, which was delivered promptly.

This ECG shows the ventricular fibrillation that the victim was experiencing before the shock.

The next ECG strip shows that the heart has reverted back to sinus rhythm only after one shock.

Kudos to our client for their 2nd life saved within 8 months! Their previous life saved can be read HERE.

Wes Leonard just before his collapse

But here is the part that has been lost: At first, nobody realized what was happening, and there were a series of mistakes.

“Everybody thought he was dehydrated or overheated,” said Fennville Superintendent Dirk Weeldreyer.

Somebody went to get ice and cold cloths.

Wes gasped for air, which some thought was a good sign. But that is actually a warning sign, commonly seen in cardiac arrest. “That led to the confusion,” Weeldreyer said. “People didn’t recognize what was happening.” Jocelyn screamed for the AED that she thought was on the wall. “I yelled for it because that’s what you are trained to do,” she says.

Jocelyn was trained in CPR. She had taught choir for six years at Fennville High in the music room across the hall from the gym. Day after day, year after year, she walked down the hallway past an AED fixed to the wall. She never noticed that it had been taken down.

“For every minute that the heart is stopped, it’s 10% less likely that you will get the heart restarted,” Jocelyn says. “So after 10 minutes, you don’t have much of a chance.”

Fennville principal Amber Lugten found the machine in a storage room and brought it out for Wes, 16. But the battery was dead. Ten minutes passed, and any hope of saving him was gone. Big Wes, the handsome, small-town hero, was dead.

“You are mad,” Jocelyn Leonard says. “There is no one to blame. I’ve never blamed anyone. I’m just so sad about it. I’m sad that it’s a $1,500 fix.”

Lugten said the AED was taken down because kids would open the case as a prank, which caused a loud, distracting alarm. “We made a very poor decision to take it down,” she said.

There was a working AED in a nearby building, but nobody thought to get it. “It probably would have taken three or four minutes to run there and get it,” Weeldreyer said. “That’s why we are trying to teach everybody these warning signs.”

Surf conditions were rough and red flags were flying.

Sean Hughes of the South Walton Fire District says the waters were not safe for the public to swim in that day.”Under red flags, knee-deep is too deep, so… certainly at the shoreline, but any deeper than that you run a serious risk of getting into trouble.”

Hess did get into trouble. He was pulled from the water at 1:20 in the afternoon.

Walton County Sheriff’s deputies arrived on scene two minutes later, with the South Walton Fire District arriving six minutes after deputies.

By 2:00 John Hess was dead.

Before the fire district paramedics arrived, an off-duty doctor on the scene, asked one of the walton county deputies for an automatic external defibrillator, or a-e-d, to treat hess.

“We were made aware that they were asking for that and there wasn’t one available” says Hughes.

Camile Cox,Public Information Officer for the Walton County Sheriff’s Office says the AED was on scene but didn’t have working batteries. She says the deputies on scene did all they could to find an alternative defribillator.

“They actually went to Hidden Dunes to see if there was one in their workout room, but his (the deputy’s) just did not have a battery, a working battery. He had notified our AED coordinator. The battery was ordered and was replaced the very next day.”

Sheriff’s officials say they don’t have any records of that particular AED’s last inspection.

They are not checked daily because the batteries usually last four-to-five years.
“The AED by design is not necessarily supposed to be checked daily because it’s long term, sitting idling, waiting for use. I can’t speak to what their maintenance schedules are or how they’re being maintained” Hughes says.

Back in 2005, The South Walton Fire District gave the Sheriff’s Office thirty brand new defibrillators obtained through a grant, but the upkeep is the responsibility of the Sheriff’s Office.

Sheriff’s officials say they ordered a battery for the AED in question before the incident because of a routine inspection

“We have a Lieutenant at the Sheriff’s Office who monitors that equipment. They do an inspection once every three months” Cox says.
When asked when the last inspection was Cox stated “I’m not sure, but I know they do them periodically”.

Even if the defibrillator was working, it’s no guarantee Hess would have survived.

Hughes says there’s no way to tell.

“Not every heart attack is a shockable rhythm. Shocking everyone?… If you’re under the belief that’s the course of action, it’s not necessarily the course of action. It interprets it and if it’s a shockable rhythm it will deliver a shock. It’s all speculation in these set of circumstances. Would it have made a difference? I don’t think anyone could say conclusively yes or no” Hughes says.

Kenzie Lahey the Survivor

“Kenzie grabbed his chest, dropped to his knees and fell to the ice,” said his mother Tanya Lahey, who spoke about the importance of defibrillators during a Heart and Stroke Foundation event Saturday.

“The referee immediately called for help. I dropped everything and ran out on to the ice.”

She was joined by an off-duty respiratory therapist, a doctor whose son played on the opposing team, and others. All originally thought her son was having a seizure.

“It wasn’t long before we realized we were dealing with much more than a seizure.”

CPR was performed and the rink was equipped with a defibrillator, but the battery for the potentially life-saving equipment was not charged.

However, a nearby ambulance had a working defibrillator and after two shocks, Kenzie’s heart regained regular rhythm.

He was then stabilized, sent to the IWK hospital and released a few days later. Six months after the March 27 incident he was back on the ice.

“Tests showed he had no underlying heart condition, so it was determined a one-in-a-million shot sent his heart into defibrillation,” Lahey said.

One doctor told her the stars had to align for her son’s heart to stop and a lot more had to align to save him.

She’s hoping other lives won’t be left to chance, which is why she shared her memories of the incident on Saturday and emphasize the importance of defibrillators.

“Kenzie’s story definitely has a happy ending, but the fact the defibrillator at the rink did not work is very unfortunate,” she said.

“The first thing I do when I enter an arena is check to see if the light is on on the defibrillator. If you see a flashing light, you know you are good to go.”

Denis Letourneau collapsed during an old timers hockey game.

It turns out the defibrillator that normally hangs on a wall near the rink was missing.

It was only found much later in the office of the arena manager who apparently removed it because of renovation work.

Annie Letourneau says her father had just recently been given a clean bill of health by his doctor and there was no indication of heart disease.

My opinion : Just because your venue has installed an AED does not exclude you from any liability. Having a misplaced, missing or stolen AED is just as bad as not having any AED at all.

We provide consultancy for risk management in the view of the organisation installing AEDs on their premises. With better risk management comes better protection for both the rescuer and victim.

Contact us at enquiry@liferesus.com.