WHEN 17-year-old badminton player Zhang Zhijie collapsed on the court during an Asian tournament in Indonesia’s Yogyakarta province Sunday evening, fate wasn’t on his side. Zhang was playing against Japan’s Kazuma Kawano at the Badminton Asia Junior Championships when he collapsed and had seizures. Badminton officials said medical teams treated Zhang on the court, and he was rushed by ambulance to a nearby hospital. Nevertheless, the promising young talent was pronounced dead at Dr. Sardjito General Hospital later that night. He suffered a sudden cardiac arrest (SCA), according to an official statement from the Indonesian Badminton Association. More than one emergency department doctor pointed out that the medical team didn’t perform cardiopulmonary resuscitation (CPR) on Zhang and didn’t use an automated external defibrillator (AED) to revive him on-site, which could have saved him. It also remains unknown how Zhang was treated during the ambulance trip to the hospital. Shenzhen citizens used CPR and AEDs to save 83 lives by the end of 2023, since a citywide initiative began in 2017 to install AEDs at public venues, according to statistics released Jan. 20, the National First-Aid Day. So far, 43,000 AEDs have been installed across the city. AEDs are different from the defibrillators used in hospitals. There are clear instructions that show you step-by-step where to put the pads and what to do next. During a cardiac arrest, there are four different types of EKG (electrocardiographic) rhythms that can occur. Only two of those are shockable, and part of the AED’s job is to determine whether the patient should be shocked. If AED usage is advised, then you have the best chance of getting somebody back. CPR can keep oxygenated blood flowing to the brain and other vital organs until an emergency response team arrives. Performing CPR involves combining two key elements: chest compressions and mouth-to-mouth rescue breathing. Even if you’re uncertain whether your knowledge and abilities are sufficient, it’s better to do something than nothing during a medical emergency like a cardiac arrest. Then, getting your hands on an AED is often a matter of life and death. The goal is getting a shock as quickly as possible because the longer a person’s heart is in a problematic rhythm and you can’t shock, it’s going to devolve quickly into a worse condition. Then your options become extremely limited, said Lauren Westafer, a U.S. emergency room doctor. For people experiencing SCA, the success rate of emergency treatment decreases by 10% for every minute that is delayed. It is therefore crucial to administer timely first aid within four minutes following an SCA incident, often referred to as the “golden four minutes.” When CPR and AED defibrillation are provided within this critical window, 50% to 70% of the patients will survive. Research has shown that the survival rate of out-of-hospital cardiac arrests is about 10% in the United States, while that figure is only about 1.2% in China. When someone collapses due to cardiac arrest, some bystanders might freeze up. Chaos might ensue. But as long as one person gets an AED to the patient, there’s a higher chance that someone will be able to step in and administer the shock. Still, the usage of AEDs in public settings remains low, mostly because of a lack of knowledge, bystanders’ reticence to put them to use, and limited access to AEDs in general. Medical professionals have called for mandatory training for staff at public venues, such as a gym or a stadium, to know where the nearest AED is. You don’t need to be an emergency room doctor to save lives; you just have to know what to look for, they say. (Li Dan) | 