Community Service: Creating Public Access to Defibrillation Programs

Sudden cardiac arrest is one of the leading causes of death in the United States. The survival rate for witnessed, out-of-hospital, sudden cardiac arrest is approximately 5 percent in most communities. But in communities with public access...


Sudden cardiac arrest is one of the leading causes of death in the United States. The survival rate for witnessed, out-of-hospital, sudden cardiac arrest is approximately 5 percent in most communities. But in communities with public access defibrillation (PAD) programs, the survival rate can rise to well above 50 percent.

In August 2007, Joe Farrell was golfing at a resort in North Lake Tahoe, NV, when another golfer collapsed on the course from sudden cardiac arrest. Farrell, a physical therapist from Danville, CA, was part of the group that called 911 and started CPR. In just a few minutes, an EMS team from the North Lake Tahoe Fire Protection District arrived with an Automated External Defibrillator (AED) and revived the victim. A helicopter airlifted the man to a nearby hospital.

“What I learned that day was that every second counts,” Farrell said. “When we came across this gentleman, he was blue from lack of oxygen. We did CPR, and then the ambulance arrived with an AED. And the man lived.”

Farrell had witnessed a textbook save carried out in a community that is exceptionally well prepared to handle sudden cardiac arrest – a community that has a PAD program.

Battalion Chief Michael Schwartz, one of the paramedics who responded to the golf course that day, is one of the people responsible for setting up the North Lake Tahoe PAD program.

“The need for a PAD program in our community was obvious,” Schwartz recalls. With remote ski resorts, campgrounds and beaches, the North Lake Tahoe region has many areas that can’t be reached quickly by fire department vehicles or ambulances. The population, normally 10,000, swells to as many as 100,000 people in the summer and on winter weekends, putting extreme demands on emergency services. To reach sudden cardiac arrest victims quickly enough to save their lives, the fire department needed to train the community in CPR and equip potential first responders with AEDs.

The PAD program began by placing AEDs in the community with lifeguards and members of the ski patrol. Then Schwartz developed a business plan for CPR and AED training programs for resort employees, teachers and other members of the community.

Today, the North Lake Tahoe PAD program encompasses more than 125 registered AEDs, most of them Cardiac Science Powerheart G3 models. The sudden cardiac arrest survival rate in the area has climbed to 50 percent.

Farrell was impressed when he saw the North Lake Tahoe PAD program in action. Little did he know that just a year later, he'd be involved in another sudden cardiac arrest incident – this time, as a victim.

Farrell collapsed at a friend’s house in the Northern California community where he lives. Fortunately, the friend was trained in CPR and knew what to do. He began compressions and soon an ambulance arrived with an AED. Farrell says he was told that that he required multiple shocks, and that an AED had to be used again at the hospital. Farrell now has an implanted cardiac defibrillator.

As soon as he recovered, Farrell and his wife, Edie, became American Heart Association CPR/AED instructors. They’ve worked with the San Ramon Valley PAD Community Partnership Committee to get AEDs into all of the district's schools and persuade area hospitals to adopt hypothermia protocols for treating sudden cardiac arrest. Currently, the committee is involved in spreading the word about an award-winning Smartphone application used by the San Ramon Fire Protection District to alert people who are CPR trained when a sudden cardiac arrest incident occurs in their vicinity.

While North Lake Tahoe and the San Ramon Valley are very different communities, their successful PAD programs share these key factors:

1. Strong support for PAD from public safety leadership.

“That's essential,” Schwartz said. “You have to start with that advantage, or you have to gain it, before you can take an AED program out into the community.’

2. Involvement of community leaders and key partners.

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