AED aids survival for heart attack victims
By Jack Shea
Published: December 18, 2008
Automated external defibrillator (AED) is a space age name for a simple tool that is saving lives of heart attack victims here, by providing help in the first minutes following a cardiac event.
"I can identify, without question, four 'saves' in Tisbury alone in the past 10 years," Jeff Pratt said this week. Mr. Pratt is Tisbury's ambulance coordinator and president of the Martha's Vineyard Assn. of Emergency Medical Technicians (EMTs). "We are talking back home, fishing, and bouncing the grandkids on the knee," he said.
AEDs are shoebox-sized devices that anyone, including untrained laymen, can use to regulate the heartbeat of victims of cardiac arrest. "They are simple to use." Mr. Pratt said. "If you can get it out of the package you can apply it to a victim, and they [the device] sense whether fibrillation is actually occurring and they won't function if that's not the case."
Seventy percent of what are called heart attacks are caused by the onset of chaotic heartbeat, known medically as ventricular fibrillation, which causes blood to leave the heart and thus denies oxygen to the brain. After a short period of time, the heart typically dies. AEDs are designed to restore regular heartbeat (fibrillating), limiting damage to the heart muscles.
"Compare it with a leg cramp. If you cramp, you stop and give the leg a chance to rest and heal. But the heart doesn't stop, it continues to beat chaotically," said Peter Lambos, a nurse at Martha's Vineyard Hospital and an Island AED advocate. "It doesn't guarantee survival but puts the patient in a much higher survival category."
Both men say the first six minutes of cardiac arrest are key, because studies show AED intervention within six minutes produces an 80-85 percent survival rate. The survival rate drops about 10 percent per minute. The survival rate after 15 minutes without defibrillation is about five percent, according to U.S. and European medical studies.
The presence of AEDs Island-wide makes the six-minute window available to most Islanders. "We have very good response time, far ahead of average. Every police cruiser, every school, is AED equipped. We have AEDs at the Tisbury harbormaster's office and at lifeguard stands in summer," Mr. Pratt said, noting that a cardiac event at the Steamship Authority several years ago was successfully handled by Tisbury police. "They had an AED in the cruiser and they knew how to use it," he said.
Mr. Pratt and Mr. Lambos have been early AED advocates for Island schools, public buildings and workplaces. An estimated 50-60 AEDs are in place in such locations now.
This month, The VFW post in Oak Bluffs received an AED, with the help of Mr. Lambos and the Massachusetts Nurse's Assn. (MNA), which provided $800 of the $1,600 cost of the unit, the first such grant in the state.
"The VFW had a cardiac event recently. Fortunately there were medical people in attendance, so the outcome was good," Mr. Lambos said. "The officers, however, began to investigate acquiring an AED because they have a lot of social events, many attended by older people" which led to the MNA involvement.
AEDs are showing up in private homes as well, Mr. Lambos noted. "As the cost has come down to as low as $1,200 from $3,000 to $4,000 a few years ago, more households with high-risk people are buying AEDs, just in case," he said.
"Martha's Vineyard is way ahead of the curve nationally in response time and in the use of AEDs," Mr. Pratt said.
Like Island police officers, Island health club employees are required to be qualified in CPR and first aid.
And, the Steamship Authority (SSA) has AEDs close at hand on all vessels and terminals, port captain Greg Gifford said this week.
"They are on board all vessels and right behind the counter in the terminals," he said in response to a telephone complaint made to The Martha's Vineyard Times that the equipment is not readily available. "There are some boxes to be installed to hold them, but they are available," he said.
Massachusetts, like 25 other states, has a Good Samaritan law in place to protect emergency AED caregivers from liability.
