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Simple device – surprising results

October 2002

by Aileen Salinas

They’re in casinos, libraries and grocery stores. More police departments are carrying them in patrol cars and they can save 50,000 lives a year. Automated external defibrillators (AEDs) give heart attack victims a greater chance of survival.

A person collapses at the grocery store. Someone calls 9-1-1. EMS dispatches an ambulance. But one traffic setback could keep the ambulance from getting to the scene within six minutes, the small window of time during which defibrillation can save the victim’s life. "Every passing minute without defibrillation accounts for a 10 percent loss in survivability," said Steven Mormino, instructor of emergency medical technology at the Health Science Center.

Meanwhile, the victim is dying because her heart is not pumping blood to the brain. Someone grabs an AED off the wall, puts the pads on the victim, turns on the machine and follows the machine’s instructions. Total time: about 2.5 minutes. This quick response dramatically increases the victim’s chances of survival. The administered shock stops the heart’s fibrillation, which happens when the heart is quivering or not beating enough to continue blood flow. After the shock, the heart can begin pumping normally again.

"This person goes home from the hospital in a couple days. That's the big difference," Mormino said. He’s part of the Health Science Center team that trains first responders such as police officers and firefighters how to use rescue procedures and equipment, including the AED, a device now installed in many police patrol cars, fire trucks and public areas. If used quickly, the small device can send a lifesaving electrical shock that could bring a person out of cardiac arrest.

"AEDs have been the biggest improvement as far as survivability," Mormino said. "The technology started in hospitals, then moved to ambulances. Now it's so portable we can teach everybody to use it. We’ll see real high survivability rates with it."

Fourth-year medical student Theresa Howell and Capt. Mark Black of the SAFD demonstrate the ease and importance of using an automated external defibrillator to save heart attack victims.

  automated defibrillator demo
Now non-medics can save someone from a heart attack
Designed for non-medical personnel, the AED is as easy to use as plugging in electrode pads to the machine, turning the machine on and attaching the pads to a victim. Once electrode pads are placed, the portable AED analyzes the victim’s heart rhythms, then instructs the user how to proceed. "Shock advised. Charging. Stay clear of patient," the AED says when it has determined shock is necessary. "Push orange button now." It will continue analyzing a victim and offering instruction to the user until paramedics arrive to take over the rescue.
"The first few minutes after collapse are critical. We want to save people’s lives, but we also want them to have a good quality of life. The longer a victim goes without defibrillation, the higher the risk for greater complications, even death," Mormino said.

The machine is virtually foolproof. "You hook it up, turn it on and a voice tells you what to do. Mistakes are so rare with this machine because it will only shock when it senses the heart quivering," Mormino said. "You cannot make the machine shock if it has sensed shock is not necessary."

From January to June of this year, 352 San Antonians went into cardiac arrest. An AED was used 37 percent of the time with those patients. In 2000, 29 percent of people treated with an AED went home from the hospital.

That's why local businesses, fitness centers, school districts, malls and even country clubs are buying their own. "They are in at least 40 places around San Antonio," said Joi Shumaker, assistant professor of emergency medical technology and San Antonio Fire Department AED coordinator. Large companies such as USAA and Valero have installed AEDs and Bexar County is putting them in every patrol car. H.B. Zachry’s goal is to have AEDs at every one of its job sites in the country. The device now is required in all federal buildings.

"We're hoping they'll soon be in all school districts and colleges," Shumaker said.

All that is required to own an AED is training and a prescription from a physician. The lifesaving device costs a little less than $3,000. "There's so much emphasis on it now that we're teaching the general public how to use it," Mormino said. After a training session much like a CPR class, anyone can easily use the AED to save someone’s life.

With more access and increased awareness, AEDs will give more people a second chance at life.


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