Inexperienced Can Use Defibrillators

October 19, 2002

FYI!

October 17, 2002 BOSTON (AP) -- No medical degree? No job on an ambulance? No sweat!

A study suggests you can still operate the simplified defibrillators that many heart specialists want to spread around public places to revive people who go into cardiac arrest.

The first-of-a-kind research project found that ordinary passers-by, without any training, were willing and able to come to the rescue with defibrillators stationed like fire extinguishers in glass cabinets around three Chicago airports.

"It was extraordinary," said Sherry Caffrey, the paramedic who ran the city-sponsored project with help from the University of Chicago. "We never imagined we were going to have the results we had."

The study was published Thursday in The New England Journal of Medicine. Though several previous studies have examined the effectiveness of automated defibrillators in the hands of trained and designated staff members at casinos and other public places, this one is the first to evaluate their use by untrained passers-by in real medical crises.

Sudden cardiac arrest - from heart attacks, heart disease, accidents or other causes - strikes about 250,000 American adults every year outside hospitals. About 95 percent die before reaching the hospital.

People stand a much better chance of surviving if they undergo defibrillation, which restores a normal beat to a helplessly quivering heart, within the first few minutes of cardiac arrest. Ambulances often fail to arrive with their rescue equipment within 10 minutes.

Small, easy-to-operate defibrillators that automatically detect the heart's rhythm and decide whether it needs a shock have been developed over the past 20 years.

The Chicago study's four-pound defibrillators were distributed in labeled cabinets around O'Hare, Midway and Meigs Field airports. About the size of a toaster, they carried both written and recorded instructions.

During the two-year study, someone tried to use one in each of 18 witnessed cases of fibrillating cardiac arrest. Eleven people were revived.

Though some airport personnel were trained on the defibrillators, six of the primary rescuers in the 11 successful efforts were passers-by, largely travelers, with no connection to the program or experience with the machines.

However, three were doctors. Also, in each case, someone helped by applying cardiopulmonary resuscitation, a manual technique for temporarily restoring some blood flow.

Still, the research gave momentum to the drive to install automated defibrillators in airports, shopping malls, casinos, stadiums, schools and other public places. "I think there's enough evidence that these devices should be in every public place, and ultimately they ought to be in every home," said Dr. W. Weaver of the Henry Ford Heart Institute in Detroit.

Patrice Duker, a spokeswoman for the International Council of Shopping Centers, said many shopping centers are rolling out such programs - but with designated operators, usually security staffers. "The biggest issue is liability and making sure people who use the equipment know how to do it properly," she said.

Illinois and many other states have adopted good Samaritan laws, which offer varying protection from lawsuits for well-meaning rescuers. No one was sued during the Chicago airport study.

However, one of the 53 defibrillators was stolen. They typically cost about $2,500 each.

Actress and motivational speaker Tracey Conway, 46, of Seattle, said the devices are well worth spreading around. Her brother died when his heart gave out at home in 1989, and help arrived too late. Six years later, she went into arrest in front of an audience, and emergency personnel arrived in time with an automated defibrillator.

"I made it because my personal heart event happened later, it was a public setting, the technology was available," she said.

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Inexperienced Can Use Defibrillators

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