New York Firefighters Given Defibrillators for Personal Cars

Posted: 05-25-2008
Updated: 05-26-2008 09:40:06 AM

Newsday (New York)

When it comes to cardiac arrest, seconds count. The sooner a person receives help, the higher the chances of survival. In fact, the American Heart Association estimates, more than 95 percent of cardiac arrest victims die before reaching a hospital.

That's why the Melville Fire District has decided to blanket the community with automated external defibrillators - by putting 50 of the machines in its members' personal cars. As a result, the lifesaving equipment is closer to potential emergencies.

If rescue volunteers can get to the scene quicker than an ambulance can - because they live around the corner or happen to be dining at the restaurant where a heart attack is taking place - the chance of survival is greater. Chief Jim Harrison said that members typically reach the scene of an emergency before the ambulance shows up.

All vehicles covered

All the district's vehicles, including fire trucks and chief cars, now have the machines, as do district buildings.

The AED program cost the Melville Fire District about $225,000: Each machine costs $1,500 to $2,000 and is expected to last 10 years. Batteries need to be replaced about every two years.

Funding came from different sources, including $50,000 from grants procured by state Sen. Carl M. Marcellino (R-Syosset) and Assemb. James Conte (R-Huntington Station); $45,000 from local Melville corporate sponsors (including Newsday) and $25,000 from the department's budget. The rest came from annual fundraising.

Some of the funds paid for larger, more advanced defibrillation machines that were placed on the department's ambulances.

An automated external defibrillator, or AED, uses electrical shocks to restore the victim's heart out of a dangerous defibrillation and into a normal rhythm. The new AEDs are user-friendly, said fire officials, and can be used by almost anyone - not just by doctors or trained emergency technicians. Once the rescuer places pads on the appropriate places on the victim's chest, the machine, using a small computer, assesses whether the type of cardiac condition is in fact one that will be helped by a shock. If it finds a ventricular defibrillation, in which the bottom part of the heart beats very rapidly, the machine will instruct the rescuer, through voice commands, how to administer a shock to the heart. If it finds another condition, it will tell the operator not to deliver the shock.

Through publicity on behalf of a nationwide public access defibrillation program, the machines now are available in airports, office buildings, schools and other public places where they can be used quickly.

Saving lives

"The whole program is one of the greatest advances in medicine since penicillin," said Dr. Gerard Brogan, medical director of the public defibrillation access program for the North Shore-Long Island Jewish Health System, as well as medical director for the Melville Fire Department. "Its ability to significantly impact a patient's outcome in a positive way is unprecedented."

Brogan explained that for cardiac arrest situations, a patient initially has a 70 percent chance of survival - which decreases 10 percent with each passing minute. And with average ambulance response times of about five minutes, that means a dismal chance of survival. Those numbers got Melville's fire officials intent on improving the odds, said Salvatore Silvestri, a commissioner at Melville Fire District - and, thus, the idea to "blanket" the community with members who can respond immediately.

Ex-chief David Kaplan, who with Silvestri and Harrison was instrumental in getting the program off the ground, said the units "can only help, they can't do harm."

Success stories

The AEDs were distributed to members of the department about six months ago. So far, none of those placed in personal cars have been used in a cardiac care situation. Nevertheless, officials say they're certain of the program's value: At least three times in the past few years, AEDs have saved lives in the district, including that of a pregnant 29-year-old who went into cardiac arrest as she was choking at a bowling alley. She survived and her baby was saved, said Kaplan.

Nationally, the public access program has recorded success stories.

At Chicago's O'Hare and Midway Airports, where the machines are prominently displayed, 9 out of 12 victims in ventricular fibrillation have been revived with no brain damage, according to the American Heart Association Web site.

And in Las Vegas, the numbers are even more compelling, Brogan said.

The survival rate of someone having a heart attack on a casino floor had been about 7 percent - which he said rose markedly after the casinos trained their security personnel to use the machines.

"Where else can you implement a drug or therapy where you save four times as many lives?" Brogan said. "I don't know of one."

The ABCs of AEDs

What is an AED?

The automated external defibrillator (AED) is a computerized medical device. An AED can check a person's heart rhythm. It can recognize a rhythm that requires a shock. And it can advise the rescuer when a shock is needed. The AED uses voice prompts, lights and text messages to tell the rescuer the steps to take.

If AEDs are so easy to use, why do people need formal training in how to use them?

Although the machine gives vocal directions for people to follow in an emergency, training is always useful. An AED operator must know how to recognize the signs of a sudden cardiac arrest, when to activate the EMS system and how to do CPR. It's also important for operators to receive formal training on the AED model they will use so that they become familiar with the device and are able to successfully operate it in an emergency. Training also teaches the operator how to avoid potentially hazardous situations.

SOURCES: American Heart Association, NEWSDAY STAFF