More Laypeople Turning to Public Defibrillators

The moment accountant James Russom fell to the floor, a victim of cardiac arrest, his Shell Oil co-workers rushed into action.

One called 911. One began CPR. And another rushed to fetch one of the company's portable defibrillators. Within minutes, co-workers applied it to Russom's chest and his heart returned to a normal rhythm.

"If it had happened anywhere else, I wouldn't be here today," said Russom, 62, who has no memories of the 2005 incident before his release from the hospital a week later.

"I'm thankful my co-workers, my guardian angels, didn't just wait for EMS to arrive."

Increasingly, laypeople are not waiting for paramedics. Once thought to be equipment reserved for professionals, defibrillators are now being used by laypeople, whose efforts are saving lives.

The usage follows a national strategy to install the laptop-sized machines in public places - airports, malls, schools, fitness clubs, arenas, parks, any location with high-density population, activity that can stress the heart or barriers to quick EMS response. In 2004, the Federal Aviation Administration ruled U.S. jets must have a defibrillator on board.

As a result, the annual number of the devices distributed between 1996 and 2005 increased almost ten-fold, from fewer than 20,000 to nearly 200,000, according to Beth Israel Deaconess Medical Center in Boston, which has studied usage of the device.

The idea behind the strategy is that cardiac arrest - when hearts suddenly stop pumping blood through the body - is a time-sensitive killer.

Permanent brain damage begins about four minutes after the heart stops. The chance of increased damage or death rises 10 percent each additional minute a victim isn't administered cardiopulmonary resuscitation and defibrillation, or an electric shock, to jump-start the heart.

Increasing chances

Used within minutes of cardiac arrest, studies have shown defibrillators dramatically increase victims' chances. Two large studies in the New England Journal of Medicine in 2000 found the devices saved nearly half of all victims - 10 times the usual survival rate of those who suffer cardiac arrest outside a hospital.

"The great thing about defibrillators is that they're so easy to use," said Dr. David Persse, medical director of Houston's Emergency Medical Service. "The training's fairly quick and easy, and on top of that, the devices are designed to talk people using them through the process. They also refuse to administer shocks to people who aren't suffering cardiac arrest."

As part of the campaign to increase defibrillator usage, the Houston Fire Department last year urged private individuals and companies to notify it upon purchasing the device.

The campaign never got much traction, but Persse downplayed it, saying, "the real goal isn't so much that the fire department knows exactly who has defibrillators as that those that have them know how to use them."

Houston now has nearly 300 defibrillators in public buildings, the greatest number in airports - 75 at Bush Intercontinental, 23 at Hobby.

Although the Houston Airport System keeps no statistics on lives they've saved, spokeswoman Marlene McClinton said the defibrillators have been used frequently.

The jury still is out on the comparative effectiveness of laypeople using defibrillators. But at least one study, reported at a 2003 meeting of the American Heart Association, found no real difference in the survival rates of people treated by emergency and non-emergency responders.

Emboldened, the Food and Drug Administration in 2004 approved the sale of home defibrillators without a prescription. About 80 percent of sudden cardiac arrests occur at home.

Cost an issue

Although the FDA action had its critics - some feared it could lead to a delay in 911 calls and actually hurt a patient's chances of survival - others say home defibrillators are a good thing for those who can afford the $1,000 to $2,000 price tag.

Cost is definitely an issue in determining placement of defibrillators. In a study at three Chicago airports, the cost per life saved was $30,000 to $40,000, considered a reasonable amount because of the high volume of traffic passing through.

But the study's authors added it wouldn't necessarily be cost-effective to put a defibrillator in a 7-Eleven.

But there was no question at Shell, which installed defibrillators on every floor of its buildings after the incident involving Russom.

"It didn't take long to make the decision," said Randy Braud, who oversees Shell's U.S. finances. "We did an investigation and concluded we couldn't depend on the next incident happening at a floor without a defibrillator."

...

TOP KILLER

225,000 lives: Cardiac arrest, which is caused by heart attacks, heart disease and accidents, is the nation's leading cause of death, claiming about 225,000 lives. About 95 percent of victims who don't receive emergency treatment die before they reach the hospital.

News stories provided by third parties are not edited by "Site Publication" staff. For suggestions and comments, please click the Contact link at the bottom of this page.