Health & Fitness: When every minute counts Health & Fitness: When every minute counts (August 11, 2004)

Fire district begins effort to make potentially life-saving, easy-to-use defibrillators available in the community

By Renee Batti
Almanac News Editor

It's small, light-weight and conspicuously yellow. It talks, and it shocks -- and therein lies its value.

Mini-sized defibrillators designed to be used even by the uninitiated are springing up in airports, workplaces and, locally, the schools and community gathering places.

During the last few months, the Menlo Park Fire Protection District has placed four of the heart-shocking devices, known as automated external defibrillators (AEDs), in Menlo Park and East Palo Alto, and another will soon be placed at the Little House senior center in Menlo Park.

Although not as sophisticated as the state-of-the-art defibrillators used by paramedics and in hospitals, AEDs have a huge advantage over their brawnier brothers: Even a child with no training can use them. The devices are being touted nationwide -- including by the federal Occupational Safety and Health Administration (OSHA) -- as a life-saving tool that can be used by almost anyone to treat a person in sudden cardiac arrest until paramedics arrive on the scene.

Menlo Park fire officials hope to increase the number of AEDs in the community as soon as funds are available, or they can persuade larger businesses in the area to obtain their own. And they also hope to increase the number of residents and employees in the area who know cardiopulmonary resuscitation, or CPR -- a procedure that a three-person team teaches every month at a local fire station.

The Menlo Park fire district board last year authorized the purchase and installation of the five devices, for a total of $10,000. Because the Atherton community already has a number of the easy-to-use devices in all its schools and several other places, the fire district focused on its southern territory.

The AEDs have been installed in publicly accessible cabinets in the Belle Haven Community Center, the Menlo Park Recreation Center, East Palo Alto City Hall, and IKEA in East Palo Alto.

When minutes count

Local firefighter/paramedics take great pride in their quick response time and their high-level training in emergency medical service. But they are also realists. They know that every minute counts when a person is suffering cardiac arrest, and that even the four to five minutes that it typically takes for paramedics to arrive on the scene may mean the patient will die or be permanently damaged.

"With every minute that goes by, your chance of living are reduced by 10 percent," said Paula Alloro, the district's division chief in charge of emergency services. Even if the department's paramedics arrive in five minutes, she said, "you've just dropped down to 50 percent (chance of) survival."

David Dickinson, a firefighter and paramedic who is part of the three-person team offering CPR training, agreed that the availability of an AED can make the difference. "It's important to get early defibrillation," he said, adding, "After five minutes, it's hard to bring a person back.

"If a citizen gets there before we do, that's all the better."

In addition to teaching monthly six-hour CPR courses, Mr. Dickinson, firefighter David Carr and Fire Captain Jim Stevens train employees at all the sites where AEDs are installed so that at least one person at the site knows CPR and has had a chance to practice using the defibrillator.

Practice is sure to help, but it's not required. When the little yellow box is unlatched and the on-button is pushed, a voice guides the user. There are two patches that must be applied to the chest area of the unconscious victim, and when that's done, the AED electronically ascertains whether the person is "shockable" -- that is, if he or she has a heart beat.

It's a "smart" device that will not administer the shock unless the victim's condition requires it, so there's no chance the patient will be harmed with an inappropriate shock, Capt. Stevens said.

Division Chief Alloro said that AEDs are found in a growing number of communities in the country as news of their effectiveness grows. She noted that they've become highly popular in Las Vegas casinos, where there's never a dull moment.

"People would win, or people would lose -- then they'd keel over," she noted. So a number of casinos now have multiple devices on site because "they've had such a significant rate of 'saves.' "

In the workplace

OSHA, the U.S. Department of Labor's agency that oversees workplace safety, encourages employers to install AEDs in their businesses. In a brochure published by the agency and posted on its Web site, it writes: "There are 220,000 victims of sudden cardiac arrest per year in the United States; about 10,000 sudden cardiac arrests occur at work.

"Waiting for the arrival of emergency medical system personnel results in only 5 to 7 percent survival. Studies with immediate defibrillation have shown up to 60 percent survival one year after sudden cardiac arrest."

It concludes: "These devices have a proven track record of saving lives in public places as well as in the workplace. They can do the same for you and your employees. Please consider installing AEDs in your workplace."

Division Chief Alloro said her goal is to convince local businesses of the wisdom of installing the defibrillators, but so far there has been a lack of interest. The number-one fear, she said, is liability. But, she insisted, those who install or use these devices are protected against liability by California law.

Another obstacle, she said, is that training a designated employee in CPR and in use of the AED now must be done during the department's regular classes, which are held at night. Employers have balked at having to pay overtime or require an employee to take a night class, Division Chief Alloro said.

To address that problem, she's tapping another trainer in the department who will be able to offer classes during the day, she said.

Ms. Alloro said employers who work with the department to acquire an AED would pay about $1,800 for the device and the cabinet it would be installed in. "A big bonus is that they get people on site trained in CPR," she said. And, there will be no charge for the training. "Any time someone is that proactive, we'll train them for free."

Knowing CPR helps

Knowing CPR isn't required to use an AED, but it can be helpful -- and in some cases, important. Menlo Park fire officials and the emergency medical team encourage local residents to sign up for monthly classes, which give about six hours of training over a two-evening period at a cost of $25.

Pointing to the AED used for training, paramedic David Dickinson said, "This will defibrillate the heart, but sometimes the (person's heart) goes back into a non-shockable rhythm," he said. At that point, CPR is needed.

Capt. Stevens said the classes are limited to 12 people, so there's a one-to-four ratio of teachers to students. "We're able to give a lot of individual attention," he said. He added that the classes are "not high-pressure -- we want people to feel comfortable that they can use it when necessary."

Atherton led the charge

The Atherton Police Activities League last year installed 10 AEDs in Atherton schools, including Menlo College. The league paid for the devices with private donations.

Police Chief Bob Brennan said patrol cars have been equipped with the defibrillators for years. He said the Lindenwood homeowners' association recently asked for training on the use of AEDs -- a service his department offers at no charge.

Menlo fire district Division Chief Alloro said her goal is to have an AED in all schools, but it will take some time to fund the project. Although kids are not at high risk of heart attack from natural causes, play-yard trauma -- such as a blow to the chest during a soccer game or other sport -- can cause cardiac arrest.

While most schools will have to wait for an AED from the fire district, it is likely that one will be offered a device in the near future. Division Chief Alloro said last week she had just received a letter from Menlo Park resident Joan Haskell Naber, who had read about budget cuts that would affect the fire district.

Ms. Naber sent the district a donation to help pay for emergency medical equipment that might otherwise not be funded, and Ms. Alloro and Fire Chief Paul Wilson decided that the district will match the donation to buy an AED for a yet-to-be determined school, Ms. Alloro said.

Information

** The fire district's next CPR course, which includes AED training, is set for the evenings of September 7 and 13. The following month, the course will be offered on the 4th and 5th. Classes are at Fire Station 6, 700 Oak Grove Ave., Menlo Park. For more information or to sign up, call 688-8400.

** Business owners who want to learn more about installing an on-site AED may call Menlo Park Fire Protection District Division Chief Paula Alloro at 688-8405.

Where the new AEDs can be found

Four new automated external defibrillators have been placed in the community, and another will be installed soon. Here's where they can be found:
** Belle Haven Community Center
** Menlo Park Recreation Center
** East Palo Alto City Hall
** The IKEA store, East Palo Alto
** Little House senior center, Menlo Park (to be installed soon)

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