Sudden Cardiac Arrest and Defibrillators

Health issues are always in the news. Very often, the news is sensational and frightening. The West Nile virus, Ebola virus, antibiotic resistant strains of bacteria, and HIV are newsworthy, no doubt. Meanwhile, sudden cardiac arrest continues to kill 350,000 Americans every year, continuing its unheralded reign as Public Killer Number One. Now, finally, there's some good news in the fight against this most deadly of all health problems.

In sudden cardiac arrest, a person's heart suddenly stops beating. This is usually caused by a disturbance in the small electrical impulses the heart muscle creates to coordinate the beating. The resulting condition is called Ventricular Fibrillation, or V-Fib. This condition is fatal if it persists untreated for more than a few minutes. In the past, cardiopulmonary resuscitation, or CPR, was the only treatment the average person could give to a victim of sudden cardiac arrest. By performing CPR, the rescuer provides blood flow to the brain and other vital organs until the beating action of the heart can be restored. The definitive treatment to restore that beating action is electrical defibrillation, which is the delivery of a concentrated electrical shock to the heart muscle.

Until recently, only medical professionals could provide electrical defibrillation. Defibrillators, the devices used to provide this treatment, were complex, expensive, required constant maintenance, and could only be operated by someone trained in reading and interpreting the machine's display of the heart rhythm. Advancements in computer processing power and the development of lightweight, long lasting batteries in the 1990s permitted the development of the portable, easy to use Automatic External Defibrillator (AED). For the first time, someone other than a medical professional could administer definitive care to a victim of sudden cardiac arrest.

Though early AEDs were easy to use, they remained prohibitively expensive for widespread public use, and Pennsylvania law still reserved their use to medical professionals.

In 1992, the Upper St. Clair, Bethel Park, and South Park Police joined Tri-Community South EMS in a pilot program with the University of Pittsburgh Medical Center (UPMC), St. Clair Memorial Hospital, Physio-Control Corporation, and the police and EMS agencies of several other South Hills communities to study the effectiveness of early defibrillation by police officers. Police officers were trained to use the AED, and all police units were so equipped. The study results were encouraging. Rapid defibrillation saved lives. The results of the UPMC study, one of the first, were supported by the results of other, similar studies in other settings. As a result, the American Heart Association decided to incorporate the use of the AED into its educational programs. The Commonwealth of Pennsylvania approved the use of the AED, not only by police officers, but also by any trained citizen.

Further advancements in technology have made AEDs less expensive. They are now in use in country clubs and on golf courses, in stadiums and arenas, in parks and recreation areas, in airports, on airliners and passenger trains, in schools, doctors' offices, businesses, fire departments, churches and athletic events. Soon, the AED may be as common a fixture as the fire extinguisher. But, like the fire extinguisher, the AED will only work if there's someone with the willingness and training to use it.