THE HEART IS A FRAGILE THING. It can break anytime, anywhere – a football field, a parking garage, a county courthouse. Sudden cardiac arrest kills 95 percent of its victims before they even make it to the hospital.

When the heart stops, every minute counts. A person’s chances of survival decrease 7 to 10 percent each minute; according to the American Heart Association, five minutes without a heart beat, and a person has a 49 percent chance of survival; 10 minutes go by and the chance of survival is “few.”

After the deaths of four Houston-area student athletes in less than a three-week period in September and October, and the lucky save of Austin-area high school football player Matt Nader, there’s been a new push toward requiring all Texas public schools to have automated external defibrillators, the life-saving devices used to jump-start a person’s heart, available for use on campus.

“AEDs save lives. With a solution to save lives this simple, I can’t think of any reason why AEDs should not be in all public schools,” Lt. Gov. David Dewhurst said during a press conference in which Nader stood next to him.

Though recent media attention has focused mostly on those cases – athletic young people who ran cross-country and played football, all who died during or right after “light” workouts – another recent tragedy highlights the importance of having defibrillators not only in schools, but in all heavily-trafficked public buildings.

Harris County Prosecutor Di Glaeser died last month, three weeks after an apparent heart attack led to cardiac arrest. She had been driving into work when the incident occurred and parked in her usual parking space in a parking garage a block and a half away from her downtown office. Before the incident, she had called a friend and told them she wasn’t feeling right but that she was going to try to make it into work. Nobody heard from her again, and worried about her condition, two investigators from her office went rushing over to the garage after grabbing an AED that had been purchased by the county for use in the public building.

Sadly, use of the AED only prolongued her life, but could not save it. Records show that Glaeser tried to use the phone at 8:05 a.m., but perhaps couldn’t get a signal to work from her location inside the garage. Help from her office arrived at 8:14 a.m., according to the AED, which keeps a record of its actions and the responses it receives.

“We got over there and we used the defibrillator and it was easy to use,” said Johnny Bonds, one of the investigators who tried to save Glaeser. “You open it up, and it just starts talking to you. It tells you everything – it tells you where to put everything, it tells you when to get away, when it’s going to deliver the shock, everything.”

At first, the AED showed no heart beat at all. Nothing. Bonds and fellow investigator Woody Woodruff didn’t give up, and the defibrillator kept delivering shocks, telling the pair when to stand back and exactly what to do. Eventually, it worked.

“It took a long time to get a heart beat,” Bonds said. Glaeser lived in a coma for three weeks before passing away. Bonds said that, despite the tragic experience, he is glad he at least had the opportunity to do something to try and save his friend and believes defibrillators should be placed in all public buildings. He would not hesitate to use one again.

“It’s so simple,” he said, adding that he had been trained to use the machine as part of Harris County’s public access defibrillator program, but that even those without training could successfully use the device in an emergency.

The county first began purchasing defibrillators for its public buildings in 2004. In Commissioner Sylvia Garcia’s precinct, the purchases proved themselves worthwhile almost immediately. “About a week after we put our first defibrillator in one of our community centers, we had to use it,” said Gail Miller, who oversees the precinct’s defibrillator program and makes sure the machines are maintained regularly.

A participant in the county’s Senior Olympics race, held at one of the county’s parks, had gone into cardiac arrest. The recently-trained county employees were quick

“People did exactly what they were supposed to do,” Miller said.

Interest in the program expanded, and Miller said she couldn’t think of a single reason why anyone would have opposed the purchase of the AEDs after that.

“Why wouldn’t you have one?” asked Miller. “Most public buildings are putting them in, a lot of sports teams have them on the sidelines now. I think pretty much in the future, every public building will have one.”

Travis County also has a public access defibrillator program, which it started about three years ago, after the City of Austin and the Austin-Bergstrom International Airport began putting AEDs in their buildings.

Airports were one of the first sectors, either private or public, to begin large-scale purchasing of the machines. In June 1999, the Chicago O’Hare and Midway airports both mounted AEDs one minute from each other and in clear view to the public. According to the American Heart Association, 14 cardiac arrests occurred during the next nine months.

Nine of the victims, or 64 percent, were saved due to the program. That statistic is much higher than the 7 percent average.

The county has 62 defibrillators located in 43 of its most trafficked public buildings, said Emergency Management Coordinator Pete Baldwin, who helped get the program started.

To his knowledge, none of those defibrillators have ever had to be used, but Baldwin said he has no doubt that they are each still good investments for the county.

“We worked with the American Heart Association and physically walked through each of our buildings and said, ’this has enough foot traffic and would certainly warrant one’ or not,” he said. “We don’t have full coverage everywhere, but they are in buildings that are most highly trafficked by the public. It’s a worthwhile program that will benefit not only our employees, but also the public that comes and visits us.”

The average defibrillator now costs somewhere between $1,400 and $1,600, with some models as inexpensive as $895.

“I am a firm believer that they may sit on the wall for four or five years, but, that one time you need it … the fact that they are there, you can access them very easily and help save that one life.”

Nearly every AED on the market – if not every – is designed for easy use, with audio instructions that give step-by-step commands about what to do and when to do it. The machines also each store the patient’s data - number of shocks given, responses, sounds happening at the scene, etc. - that can be used by an area’s EMS personnel, once they arrive.

Because they are designed in such a way that nobody should be afraid to use one if the need arises, training, though recommended, is not necessarily important.

“Training is important, however, if someone is not trained and there is a defibrillator there, absolultely, positively, we would hope that they would use that device,” said Ed Racht, with the American Heart Association.

“Logically, it makes sense that people who have training are much more likely to use the device. But the Chicago O’Hare airport looked at their device use, and a majority of the individuals that used the device there had not been through formal training.”

Racht is hopeful that in the future, all public and private buildings will have AEDs located in them. The State of Texas recently started adding AEDs to their public buildings, he said.

“I think the medical literature, and the medical community, are really demonstrating the importance of rapid defibrillation,” Racht said. “And the government has chosen to kind of take the lead and say, ’we’re going to put it in our buildings and hope private companies do the same.’

“I would have never imagined in medicine 15 years ago that I would be talking to someone that sends information out to county officials about putting defibrillators out into county buildings. It has a huge impact on survival,” he added.

When purchasing an AED, Racht said a county’s main concerns and criteria should be what support a company offers for the machines, the device’s user-friendliness, what sorts training is available, the machine’s maintenance schedule and whether it will be compatible with the devices being used by their EMS system.

The AHA recommends that purchasers use a 3-minute response time to determine how many defibrillators may be needed and where they should be located.

“Effective AED programs are designed to deliver a shock to a victim within 3 to 5 minutes of collapse. When deciding where to place AEDs, use a 3-minute response time as a guideline to help you determine how many AEDs you need and where to place them,” states the AHA Web site, www.americanheart. org, which said the best locations for AEDs are often reception areas, cafeterias, walls of main corridors, fitness facilities and near elevators. “Companies should determine if there are places on-site where the incidence of sudden cardiac arrest may be higher, such as corporate health clubs, or that are hard to reach quickly.”

Racht added that just because a county may not have a health club or cafeteria doesn’t mean that there’s no good place to locate a defibrillator after it’s been purchased. “The ideal is that you would want a defibrillator in every place where a cardiac arrest could occur, and that could be anywhere.

Senior centers, clinics, places where there are already ill people… golf courses, jails, airports,” he said. “Anywhere there is a large gathering of people, you increase the risk that a cardiac arrest may occur.”

When the “Big One” happens, defibrillators can mean the difference / By Maria Sprow

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