Survival tools

July 26, 2005

LIGHTNING STRUCK an 11-year-old camper on the Eastern Shore one week ago today and quick action by the camp's staff - and the presence of some useful technology - saved him. The boy, who went into cardiac arrest, was revived by a nurse and another worker who administered cardiopulmonary resuscitation and several shocks from a defibrillator. Maryland doesn't require summer camps to have defibrillators. In fact, they aren't required in most public facilities. But this incident - and many others - raises an obvious question: Should they be?

Forget the image of defibrillators on TV shows such as ER. It doesn't take an emergency room physician, or even a paramedic, to use the latest versions. Automated External Defibrillators or AEDs are smart, lunchbox-sized devices that can tell whether an electric jolt is needed to return a patient's heart to normal rhythm. The AED calculates the proper charge and then applies it. The user just has to follow directions - mostly, that means turning the machine on and attaching the electrodes. AEDs cost as little as $800 (for a refurbished model) to $4,000 each, and a growing number of businesses are buying them to protect workers.

The usefulness of AEDs is not in dispute. When someone goes into sudden cardiac arrest (and more than 250,000 will die from it this year), a defibrillator can be the difference between life and death. The quicker one is used, the better. After 10 minutes or so, it may not help at all. What are the chances a paramedic can arrive that fast? Not always good. That's why the Food and Drug Administration decided last year that people should be able to purchase defibrillators for home use without a doctor's prescription.

Currently, the Maryland Institute for Emergency Medical Services Systems certifies facilities to voluntarily purchase and install them. Under what instances should AEDs be mandated? That's not an easy call. While last week's rescue of the youngster in Kent County was dramatic, it's also unusual. Relatively few children are struck by lightning or go into sudden cardiac arrest. And if one does, on a ball field, for instance, what are the chances a school's defibrillator will be readily available and not locked away in the principal's office?

But some applications seem obvious. AEDs ought to be a fixture in every nursing home and assisted living facility. Legislation to impose this requirement died in Annapolis this year. That was unfortunate. Not only should AEDs be readily available to seniors, but the devices ought to be required in most public buildings and physical fitness facilities, too. New York state has mandated that they be in gyms and schools larger than 1,000 students since 2002.

AEDs are no miracle cure. People still ought to be trained how to use them properly - and to know the techniques of CPR. But the American Heart Association estimates that a broad deployment of automated defibrillators might spare 50,000 heart attack victims each year. That gives Maryland an extraordinary opportunity to save lives.

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