- The Washington Times - Monday, February 9, 2004

District resident Richard Brown remembers watching in horror as a fellow Sports Club/LA member collapsed nearby more than two years ago. The man died, and Mr. Brown suggested to the District club’s employees they install one of those automated exterior defibrillators, or AEDs, that can help resuscitate people who have sudden cardiac arrests.

Little did he know that a few months later, the club not only would have installed its own AED, but that its trainers would use the device to bring Mr. Brown back after he suffered his own sudden cardiac arrest.

More health clubs, schools and airports than ever before are being equipped with AEDs to prevent sudden cardiac arrests — disruptions in the heart’s normal rhythm — from proving deadly. In most cases, rescuers have just 10 minutes to act, which makes having an AED handy a life-and-death scenario. Survival rates decrease by 7 percent to 10 percent for every minute that goes by without treatment.

The electric shock delivered by the device, the publicly accessible version of the shock paddles seen on “ER” each week, briefly stops all electrical activity in the heart, which gives the organ a chance to resume its normal rhythm.

A study that measured the outcome of using AED-type devices showed survival rates for sudden cardiac arrest cases doubled when AEDs were used. The study results were released in November at the American Heart Association’s annual Scientific Sessions conference.

“There are so many survivors now,” says the 59-year-old Mr. Brown, who heads a survivors network. Someday very soon, he says, “it will be considered a duty to have one.”

Some cases of sudden cardiac arrest are brought on by heart disease. Some people can have artery obstructions that spark the arrests. Others, particularly younger people, could have heart defects that haven’t been discovered.

Those who try to save a stranger’s life using an AED have a measure of legal protection, according to the National Center for Early Defibrillation in Pittsburgh. Every state has a variation of “Good Samaritan” legislation to give would-be rescuers protection in case the person doesn’t survive; the federal Cardiac Arrest Survival Act gives additional protection.

The devices are built for use by both experts and health care neophytes, but no equipment is perfect. Last month, a paramedic using a defibrillator in New London, Conn., set a patient on fire while trying to revive her. The fire, still under investigation, started when a spark from the device ignited 47-year-old Brenda Jewett’s clothes inside an ambulance. The woman wasn’t resuscitated.

Robert White, president of Medtronic Physio-Control in Redmond, Wash., which produces AEDs, says the technology dates back to the 1950s.

Disney World alone has 500 AEDs on site, he says, and school districts in New York and Pennsylvania have legislated their use in schools. Locally, an AED is installed at Cardozo High School. The Northwest school has lost three students over the past two years from sudden cardiac arrest.

“Awareness is the number one challenge. Most people don’t know what they are,” Mr. White says.

The devices can cost as little as $2,000, he says, but he estimates between 7,000 and 10,000 children die from sudden cardiac arrest each year in the United States.

Mr. White says the devices are so simple even a child can use one properly. AEDs analyze a person’s heart rhythm and deliver a defibrillation shock only if it detects one is needed.

“It’s recommended to have training, but it’s not needed,” he says. “It’s simply a matter of taking the device off the wall, turning it on and applying two patches to individuals and stand[ing] back. It’s extremely intuitive.”

If the pads are placed on a person who isn’t suffering a cardiac arrest, the device won’t deliver a shock, he says.

Dr. Rick Morrissey, a cardiologist at Georgetown Hospital, says anyone could, in theory, suffer from the kind of cardiac problem that AEDs are meant to treat.

“These have definitely saved lives, and they’re definitely worthwhile,” he says. “I think the average person can handle it.”

Dr. Morrissey says he has seen AED units at high school football games become more common in recent years. Teen athletes should be the epitome of health, but if a player is hit in the chest a certain way, his or her heart rhythm could be affected, he says.

Mary Newman, executive director of the National Center for Early Defibrillation, says the devices are designed to be foolproof.

“The machine will read what the cardiac rhythm is,” Ms. Newman says. “It will not let you shock someone who doesn’t need it.”

The devices began appearing routinely in public over the past five years.

“It’s been an evolution of the technology. The early defibrillators used back in the early ‘80s were used primarily by physicians and nurses. Then they were used by [emergency medical technicians],” she says. “It’s been moving along to more general [audiences].”

The devices may be self-explanatory, but a response plan is required to make sure rescuers can help as quickly as possible.

“You need to have a plan in place,” Ms. Newman says. “Anybody potentially available to help should be trained. Teachers, nurses, coaches, students, etc.”

Few people survive a sudden cardiac arrest without near-instant treatment, about 7 percent, she says.

“It could be much higher if people were treated quickly enough. Most people don’t realize the most important person is the person closest to them,” she says.

Some locales with readily available AEDs have experienced survival rates as high as 70 percent, she says. As the fatalities in places like Cardozo High School prove, everyone can be affected by these irregular heart rhythms.

“It’s a lot more common in young people than most of us realize,” she says.

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