How Robbie Bowers pioneered a culture of AED safety & removed the question of “what if?” from his lexicon
Robbie Bowers wasn’t handed an automated external defibrillator (AED) program from his school board. He wasn’t asked to buy a life-saving unit and make it available during his school’s events –actually, quite the opposite. Mr. Bowers built his AED program from the ground up when AED units were rare, typically only seen at airports.
Mr. Bowers, the Head Athletic Trainer at Rancho Bernardo High School, was initially discouraged from making an AED available. Nevertheless, like the signature of his email, he pushed forward. “Blame no one. Expect nothing. Do something.” it reads.
Mr. Bowers lost his father too soon – during a stress test performed after experiencing an emergency during a family trip to Big Bear. At the time, the medical consensus felt that lay-person defibrillation programs wouldn’t work and were unnecessary, but Mr. Bowers always wondered “what it?”
What if someone died and everything possible wasn’t available to revive them? Would that be acceptable? What if a student on his field died and he had to tell the child’s parents, and he knew that more could have been done to save their child, but wasn’t?
In 2003, Mr. Bowers learned of a grant opportunity that offered 50% matching funds. He applied, and was awarded the grant, raising the second one-half of the money needed to buy a life-saving AED unit.
At the time, his school board didn’t think AEDs were needed, and, worse, they felt that they posed a new liability. Supported by his principal, Mr. Bowers brought his AED to campus and made it available during events. Not one to purposefully violate the rules, Mr. Bowers felt like he could “live with it” if he needed to use the AED and provide everything available to save someone’s life. At least he wouldn’t have to live with the feeling of “what if?” he reasoned. Moreover, being a professional member of the healthcare industry, he “knew the medical community would (have his) back” should controversy arise.
program, Mr. Bowers, with the help of San Diego Project Heart Beat, crafted a detailed emergency response plan (ERP). At the time, his ERP called for an AED to be available during all school
athletic events, and so it was available during a baseball game held on campus. The problem was that Mr. Bowers was at a state soccer event at another location and no AED was available for a sudden cardiac arrest (SCA) suffered by the contests’ referee. Despite their best efforts, and continuous CPR, the 11-minute response time from the emergency medical response (911) was too much for the referee, and he succumbed to his cardiac arrest. What if?
What if an AED had been available at the soccer event in addition to the baseball game? Would the referee have lived to see another day?
Over time, as the AED industry matured and immunity protections for AED owners and responders were clarified, Mr. Bowers’ school district and campus elected to equip all schools with defibrillators.
Mr. Bowers revised his ERP over time and added drills and regular training to the mix. He was searching for continual improvement so that he could erase the question of “what if?” from his mind. As a part of the ERP, three AED units have been placed on his campus, and their deployment is flexible so that units are available when and where they’re needed the most. Amongst other factors, Mr. Bowers and his team assess the type of event and the anticipated number of spectators, “at times we might have 8,000 people in one location on campus – at that point, we’re a small town,” he says.
“Sudden cardiac arrest doesn’t just happen to the athletes,” he shares, “it’s spectators, referees, and the athletes.”
Two-and-a-half years ago, long since winning the fight for AED deployment and broadly training his team, a well-known spectator collapsed in the stands.
“We had practiced our ERP one week prior for a wrestling event and again that day. I don’t remember exactly what, but my wife said something, and I whipped off my jacket and headed for the stands,” he shares. “I recognized the victim was experiencing a SCA. He demonstrated agonal breathing, was cyanotic and had no pulse, so I began performing CPR. I turned, and before I could call for the AED, my college intern was running into the stands toward me with the AED! I didn’t need to holler for it since it was already on the way.”
As they were performing CPR and using the AED, someone in the stands had already called 911, and Mr. Bowers’ wife and the school’s football coach ran outside to flag down the ambulance. Since the gym isn’t accessible from their main address, the ERP calls for a different staging location during emergencies that occur in the gym. Bowers’ wife was set at the proper location while the coach intentionally went to the wrong place, just in case.
“Sure enough, the ambulance whizzed past my wife, and our coach saw it coming to the main entrance, the wrong entrance. He got them turned around and sent back to my wife, exactly as we planned and wrote in our ERP!”
By the time the ambulance arrived, Mr. Bowers had delivered one shock and “thirty-seconds into my next round of CPR, after the shock was delivered, the victim started to demonstrate signs of life, and was breathing on his own,” shares Bowers. The two – victim and his rescuer – were communicating when the ambulance arrived, 11 minutes after collapse.
What if they hadn’t just practice? Or, what if they didn’t ever acquire AEDs?
Robbie Bowers is in a unique position to offer advice. He fought for AEDs when it wasn’t the politically popular safety project to pursue. He’s seen the first-hand impact AEDs can have when used in a timely manner. And, he’s also witnessed the outcome of not having an AED when it’s needed the most.
“For Athletic Trainers, portability is vital. We’re always carrying so much gear; it’s another piece of equipment that we have to lug around. It’d be nice in they were smaller and lighter so that we could keep them in our normal bags.”
“We’re also always tossing our equipment around. It’s getting dirty or we’re out in the rain, so AEDs need to be resilient to these environmental factors. If AEDs were more affordable, we’d be able to get more of them, and we wouldn’t have the need to flex our units from one location to the next. More AEDs mean that we’d be able to keep them where they’re needed the most and provide a more rapid access to defibrillation,” he adds.