Aug. 25--Strange as it may seem for two men whose hearts had abruptly stopped beating, but Kenneth Richmond and George Turner consider themselves lucky.
Richmond, then a 40-year-old Memphis firefighter, happened to be in the office of Bon Lin Middle School in Bartlett picking up his kids in 2009 when he collapsed from sudden cardiac arrest. It turned out that Bon Lin and other Shelby County Schools had just been equipped with automated external defibrillators.
Turner, 56, a prisoner in the DeSoto County Detention Center, was playing basketball earlier this month when he "fell out," as he describes it, from cardiac arrest. Less than three years ago, officials had purchased AEDs for their jail facilities.
Because there were AEDs available, and people ready to use them, Richmond and Turner were sore but alive after having their hearts shocked back into proper rhythm.
Sean Patrick O'Hara, on the other hand, wasn't so fortunate.
An athletic 21-year-old Ole Miss student from Hernando, he was studying for finals on Dec. 2, 2007, when he was stricken, falling facedown in his Oxford apartment from what proved to be a fatal cardiac arrest. Although it's unknown whether an AED could have saved O'Hara, the police officers who were the first emergency responders to arrive did not have one.
"They had to wait until the paramedics got there to do anything," says his mother, Dawn Cartwright.
The three incidents underscore what health officials describe as an exasperating problem: Despite private initiatives and laws in several states designed to make AEDs more accessible and better maintained, the devices remain unevenly distributed and monitored and often hidden or locked up from potential rescuers.
In Memphis, where a recent city ordinance requires AEDs in new buildings that hold at least 300 people, the devices remain absent from existing structures that include most large grocery and department stores, restaurants, movie theaters and even nursing homes, officials say.
"There are a lot of them out there, but there needs to be more," said Gary Panzer, a paramedic and vice president of operations for Operation Heartbeat, an initiative of the Mid-South Public Access Defibrillator Program.
"We would like to make AEDs as common and prevalent as fire extinguishers."
Even in many of the facilities that have AEDs, employees often are unaware of their existence or location, Panzer said. In other cases, the pads and batteries aren't being checked and changed when needed.
The devices are critical because each year some 300,000 Americans suffer sudden cardiac arrest outside of hospitals, and, on average, fewer than 8 percent of them survive, according to the Centers for Disease Control and Prevention. That survival rate has remained unchanged for 30 years, CDC figures show, in part because in only 2 percent of the cases are AEDs employed before the arrival of emergency medical personnel.
Cardiac arrest, which often strikes seemingly healthy people with no warning, occurs when the electrical impulses directing the heart to beat misfire. It differs from a heart attack, which typically results from clogged arteries.
AEDs, which can cost anywhere from $975 to more than $1,500 apiece, are portable, battery-powered electronic devices from which electrode pads are placed on the chests of victims. They deliver electrical shocks to halt arrhythmia, in which the heart ventricles quiver rather than properly contract, and restore the normal cardiac rhythm.
A victim is two to three times more likely to survive if an AED is used before an ambulance arrives -- and preferably within four minutes. For each minute defibrillation is delayed, the chances of survival drop 10 percent.
Training helps, but it is not necessary for operating an AED, which gives audio instructions once it is turned on. "It won't even allow you to make a mistake," said Alvin Benson, director of Memphis Fire Services.
Federal and state laws provide liability protection to anyone using an AED to assist a cardiac arrest victim.
Improved training and access to AEDs could save 50,000 lives a year, according to the American Red Cross. But with some 2.5 million of the devices scattered across the nation, millions more are needed to adequately cover just the metro areas.
Richmond was among the relative few sudden cardiac arrest victims to be near an AED when stricken. He received a total of 16 shocks in the school office, the ambulance and hospital.
"The only thing I remember is coming to in the ambulance and asking what happened," he said. "They said, 'Your heart stopped,' and I said, 'Quit kidding me.'"
Shunji Brown-Woods, director of coordinated school health for Shelby County Schools, said all legacy Memphis City Schools and county schools now are equipped with AEDs. The effort in the legacy SCS system began with donations from the Kiwanis Club and was completed in 2008 with budget appropriations.
"We do require the schools to monitor them monthly," she said.
Richmond isn't the only person saved by AEDs in local schools. In January 2012, a device was used to revive a Collierville High senior who collapsed in a hallway, Brown-Woods said.
As large as some schools are, additional units might be needed to ensure that students are never more than four minutes away from an AED. "But you need funds for that," Brown-Woods said.
In response to the death last year of 15-year-old Millington Central High School football player Dana Payne, the school system also has made AEDs available to sports teams on playing and practice fields, she said. Payne collapsed after being tackled in practice, although it's not known whether an AED could have saved him.
Benson said a new ordinance added to the city's fire code requires new buildings or structures whose use is being reclassified to install AEDs if they have 300 or more occupants. The devices also must be registered with authorities so emergency-responders know where they are and can track the condition they're in.
"The bulk of our calls are EMS-related, anyway," Benson said.
In addition to schools, AEDs can be found in libraries, community centers and government office buildings, Benson said.
Memphis International Airport installed its first defibrillator in 1999, and today there are 42 scattered throughout the terminal and other facilities, said John Greaud, vice president of operations for the Memphis-Shelby County Airport Authority.
"The best we can tell, they were used twice where we believe they saved lives," he said.
In DeSoto County, a local chapter of the Sudden Cardiac Arrest Association has been distributing AEDs to schools and other public facilities. Using money generated primarily by an annual golf tournament, the group so far has acquired about two dozen, with eight more planned to be issued to Sheriff's Department squad cars in the coming months.
"It's just been our mission to teach CPR, place AEDs and raise awareness," said Cartwright, the mother of the Ole Miss student who died, and the founder of the local chapter.
Turner, the prisoner who suffered cardiac arrest earlier this month, benefited from a decision three years ago to purchase AEDs for DeSoto County's two jail facilities. Previously, the jails used AEDs borrowed from another county agency.
"We have two in each facility -- one in the booking area, one in the housing area," said Chad Wicker, director of detention services.
AEDs also can be found in Tunica County casinos. For instance, at Hollywood Casino-Tunica, which covers more than 50,000 square feet, "we have a sufficient number for the property," said Bobbie Ingram, security manager.
AED Map
But other large businesses in the Memphis area have yet to install the devices. Panzer said large chain restaurants and stores often are averse to buying the units.
"The biggest challenge for us is that the decision is never made at the local level. It's corporate ...," he said. "They're probably thinking, 'If we do it for one, we have to do it for all.'"
Richmond, who remains a firefighter, said that ever since his cardiac arrest, he makes of point of checking for AEDs while responding to fire calls. He rarely finds them, even in facilities such as assisted-living high-rises.
"They should be on every floor, but they're not," he said.
But with more than 200,000 AEDs purchased annually in the U.S., and public awareness about them rising, officials and heart patients hope the devices will become more and more prevalent.
"It's important," said Turner. "It saved my life."
AED Survey
Copyright 2013 - The Commercial Appeal, Memphis, Tenn.
