Small devices so simple and effective, they've already saved countless lives

Lee Curtes' heart couldn't have picked a more beautiful -- or more inconvenient -- place to stop.

At 11,400 feet, on the peak of Vail's newly-opened Blue Sky Basin ski run, the 54-year-old businessman from Milwaukee went into sudden cardiac arrest.

"We'd just skied off the lift and out to the middle of the mountain, where we had 360 degrees of gorgeous views, and I suddenly had trouble breathing," says Curtes, an avid skier who had no history of heart problems.

Within minutes, he was struck with a pain "like a monkey jumping up and down on my chest," says Curtes. "The last thing I remember is looking up at the beautiful white clouds and blue sky and thinking how much I wanted to stay alive."

One year later, Curtes is alive and thriving, and he owes it all, he says, to a tiny machine that ski patrollers happened to have on hand that fateful day: an automatic external defibrillator (AED).

All across the country -- on ski slopes and golf courses, at airports and shopping malls, and inside office buildings and Vegas casinos - the defibrillators, called AEDs, are now saving lives on a daily basis.

The machines, approximately the size of laptop computers, used to be the exclusive tools of ambulance drivers and paramedics. Beginning in the 1990s, however, the American Heart Association and others began to push for wider use of the life-saving devices.

Defibrillators are used to restore a normal heartbeat almost instantaneously in victims who suffer sudden cardiac arrest. (They are, in fact, portable and automated versions of the large metal paddles used in hospital emergency rooms to "shock" the heart back to life.) Sudden cardiac arrest, which many people confuse with a heart attack, is usually caused by ventricular fibrillation -- a chaotic electrical activity in the heart that prevents the organ from pumping blood out to the body. Victims typically lose consciousness rapidly, and unless a defibrillator is used to restore a normal heartbeat, they die within a matter of minutes. In the United States alone, about 850 people succumb every day to sudden cardiac arrest before they ever reach a hospital.

But vigorous distribution of AEDs, along with training programs on how to use them, have the potential to dramatically increase survival rates, says Tom Aufderheide, M.D., a past basic life support science editor for the American Heart Association.

For every minute that passes between onset of cardiac arrest and treatment, chances of survival are reduced by 10 percent. In other words, if a defibrillator is not used within 10 minutes of the heart distress, the victim's chances of survival are practically nil, Aufderheide says.

"AEDs are the single greatest advance in the treatment of cardiac arrest since the development of cardiopulmonary resuscitation," says Aufderheide.

One reason for their astonishing efficacy is that AEDs are remarkably simple to use. One AHA study found that even sixth graders were able to use the machines effectively after receiving only brief instructions.

Small wonder that the City of Chicago dispatched 49 defibrillators to its O'Hare and Midway airports in June of 1999. Over a two-year period, the shipment had saved 10 lives: Of the 18 people who experienced ventricular fibrillation and were treated with the handy airport AEDs, 10 were revived and had no brain damage. That's a 55.5 percent survival rate -- a dramatic improvement over the national average of only 5 percent. (The survival rate for the entire city of Chicago, where traffic often holds up ambulances, is a mere 1.8 percent.)

Since Chicago installed its airport defibrillators, numerous cities across the country have followed suit. In addition, most state legislatures have enacted laws designed to make defibrillators more widely available in public places.

In a study of defibrillator use in Las Vegas casinos, 56 of 105 people who suffered sudden cardiac arrests on the casino floor, or 53 percent, survived. In cases where casino staff were able to reach and shock the victims within three minutes of the acute heart distress, the survival rate jumped up to 74 percent.

Robin Marler, a security guard at the Orleans Casino in Las Vegas, reports that he has already helped save four people's lives by using the AEDs recently made aviailable at his casino.

"We had one guy who was in his 70s go down on the blackjack table," says Marler. "He fell backwards off the chair and scared the dealer to death."

One shock with the defibrillator brought the gentleman gambler back, says Marler, who takes justified pride in being able to use the AEDs.

"Without that defibrillator, a lot of these people got no chance. By the time they dispatch an ambulance to the casino, they'd be brain dead."

To their credit, airlines were among the first companies to make use of the innovative defibrillator technology. A study of American Airlines' use of AEDs reported a nearly 40 percent survival rate for victims who were administered shocks by trained flight attendants between 1997 and 1999. Since 2004, the Federal Aviation Administration has required all airlines to make the lifesaving devices available aboard all domestic flights.

Before leaving office, former president Clinton also signed two AHA-endorsed bills promoting the use of automatic defibrillators. The Cardiac Arrest Survival Act requires the federal government to establish guidelines for placing AEDs in federal office building and training employees to use the devices. The other bill, the Rural Access to Emergency Devices Act, granted $25 million to rural communities to purchase the lifesaving devices and train emergency personnel in their use. A 2002 federal law provided an additional $30 million in federal grants to states and cities to purchase defibrillators for public places and to train first responders in their use. Currently there's a drive to install more AEDs in office buildings and other public places where cardiac arrests are common.

Carrier Corporation, one of the largest heating, ventilation and air conditioning companies in the world, has outfitted many of its plants and office buildings with defibrillators.

Carrier's "Operation Jumpstart" isn't cheap, says Sammy Suriani, the company's clinical coordinator of medical services in Syracuse, New York. Each device costs up to $3,000 (they've installed 30 to date), and the four-hour training courses approved by the American Heart Association run about $50 per employee.

Suriani says he is often asked if Carrier's program is cost effective. "How do you put a value on a human life?" he muses. "If we end up saving one life, it's cost effective." In fact, Suriani says, the availability of AEDs demonstrates to employees that you take their healthcare concerns seriously.

The American Heart Association would like to see more companies follow Carrier's example, as would Lee Curtes, who works for a company that serves as a wholesale distributor for Carrier Corporation.

As Curtes lay unconscious on that snowy slope just a year ago, ski patrollers were able to restore his heartbeat within seconds. All it took was a single shock from their brand new AED the unit had just received. The Milwaukee father of three was then flown by helicopter to an area hospital where he underwent emergency surgery to clear a blocked coronary artery. If

One year after his heart attack, Lee Curtes held a family reunion and a "celebration of my rebirth" at Blue Sky Basin in Vail. Accompanied by members of the ski patrol who saved him, Curtes skied the slope he wasn't able to conquer last year.

Afterwards, he and members of his family (including his wife, daughters, aunts, nephews and brothers) joined the ski patrollers and the helicopter nurse who had saved Curtes' life for a festive dinner. The lively celebrants told stories, toasted their host's robust health, and otherwise honored his near-miraculous resurrection.

"It was a rebirth," says Curtes of the emotional reunion. "And the one thing that just became crystal clear through all the stories that were told is that, if the ski patrol hadn't had that AED on the top of the mountain, none of the experts who worked on me [later] would have been able to save me."

-- Paige Bierma is an award-winning health journalist who lives in San Francisco. Her last piece for Consumer Health Interactive was on the hazards of smokeless tobacco.

References

First published May 17, 2001
Last updated June 26, 2008
Copyright © 2001 Consumer Health Interactive

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