AED center promotes use of life-saving defibrillators

by Paula Gleason

SBJ Contributing Writer

sbj@sbj.net

Four lives were saved in Springfield last year because of the automated external defibrillators on board the city's fire trucks. An AED is a portable, battery-powered device that delivers an electrical shock through a person's chest wall to the heart. AEDs were first installed on city fire trucks in May 1997.

"Sudden cardiac death, in which an electric anomaly in the heart causes it to misfire, is the most common form of death for men and women over the age of 30 in this country," said Elizabeth Turner, director of the AED Center of Excellence in Springfield.

Located in the Springfield Fire Department's Administrative Offices at City Hall, the Center of Excellence was established in 2002 as a nonprofit organization to work within the American Heart Association's "Operation Heartbeat" guidelines to assist organizations that have AEDs on their premises.

"Early defibrillation is the critical factor because this treatment can help restore the heartbeat," said Daphne Greenlee, director of community health and safety for the Safety Council of the Ozarks. "For every minute that defibrillation is delayed, the victim's chances of survival decrease by 10 percent. There are four links in the chain of survival: early 911 access, early CPR, early defibrillation and early advanced care. The strongest determinant of survival in people having an out-of-hospital cardiac arrest is the speed with which shocks are delivered."

In March 2002, Springfield's City Council amended its Emergency Services Code to include the regulation of AEDs. In part, the ordinance requires that AEDs be registered with the fire department; that AEDs be inspected, tested and maintained; that persons expected to operate the AED complete training; and that the fire department be notified of any use of the AED.

"The Center of Excellence was established to ensure that federal, state and local guidelines are followed and to provide quality assurance for AED use," said Turner, who also works as a cardiac rehabilitation nurse at St. John's Regional Health Center.

The center is funded by grants from the American Heart Association, Cox Health Foundation, Cox Health Plans, Premier Health Plans, United Way of the Ozarks and Visiting Nurse Association Founda-tion. The Springfield Fire Department's administrative division provides office space for Turner and her assistant, Jacob Lewellen. Springfield Fire Department's Fire Training Captain Kevin Smart acts as supervisor for the center. Dr. Jim Blaine is the medical director, and the city of Springfield acts as the fiscal agent.

In addition to grant funding, an annual $35 AED registration fee paid to the city is disbursed back to the center. Turner follows up on new registrations to check for compliance. If there is a need, the center has been approved to offer the needed protocol, training and upkeep for an annual fee of $250. The center also works to promote and provide Public Access Defibrillation Programs in Greene, Polk, Christian and Taney counties.

There are approximately 130 AEDs registered with 911 communications in Greene County. These include 97 AEDs registered with the Springfield Fire Department. The fire department itself has 22 units divided among the 11 Springfield fire stations.

Cardiac Science of San Diego is contracted to provide AEDs to the city.

The Cardiac Arrest Survival Act, which became federal law in November 2000, recommends the installation of AEDs in all federal buildings and encourages state and local governments, the private sector and others to implement their own AED programs. Missouri has a Public Access Defibrillation law, as well as, a "Good Samaritan" provision to protect companies that purchase AEDs and AED users. "The threat of liability has swung the other way," said Turner, "toward not protecting by the omission of providing an AED."

"More than 700 people die every day and more than 250,000 die yearly in the United States from sudden cardiac arrest. If applied early, an AED can restore normal heart rhythm to a person in cardiac arrest. The Center of Excellence is a step toward quality assurance and assured continuity," said Karen Cooper, health initiative director for the American Heart Association. "Our goal is to reduce by 25 percent death and disability from heart disease and stroke by 2010. Public access defibrillation programs need to be integrated with the Emergency Medical System. We need some form of tracking AED use.

Turner is currently working with Dr. Alex Hover to track those saved by defibrillators.

"We are following defibrillated patients for one year after they leave the area's major hospitals to track and monitor their physical and psychological well-being," Turner said.

The center also has a pilot program with the Missouri State Highway Patrol.

"We have trained 40 officers in CPR/AED and placed 23 AEDs in patrol cars," Turner said. "The results of this study will determine the need to equip all of Missouri's highway patrol vehicles."

The most common problem with using an AED is with the adhesive on the pads that adhere to the body and deliver the shock. "Organizations and companies with AEDs need to ensure that supplies are replaced every two years," said Turner.

Turner would like to see AEDs more readily accessible to the public. "They should be in malls, at community gatherings, hotels, large restaurants and shopping centers everywhere there might be cause for an elevated heart rate."