by Dr. Stephen Devries

Do people really drop dead?  

Surprisingly, nearly 1,000 Americans die suddenly from heart disease every day. Who are these people? Elderly folks with prior heart attacks? Stressed out, middle-aged men? Olympic skaters? Possibly you? Yes, to all of the above.

   Mysteriously, at least half of these sudden deaths occur in people without a history of heart disease who appear perfectly fit.

   Fortunately, medical marvels called defibrillators are highly effective if applied early. Recent breakthroughs promise to make this life preserving technology as accessible as fire extinguishers. Today’s column addresses frequently asked questions about this technology, and how it might someday bring you back from the brink of disaster. Q. What is the cause of cardiac collapse?

   The electrical system in the heart normally supplies a gentle impulse that regulates the heartbeat. Collapse develops when the electrical discharges become chaotic, causing the heart to beat in a wild frenzy. A variety of problems can trigger this electrical storm, including irritation from an enlarged heart and plugged arteries. These conditions often are silent, causing no symptoms until this critical complication is unleashed.

Q. How often do victims survive?

   On average, fewer than one out of 20 people are resuscitated. Survival requires very rapid treatment with a medical device called a defibrillator.

Q. How does a defibrillator help?

   A defibrillator delivers an electric treatment to the chest that literally jump-starts the heart and restores a regular beat.

Q. Does it hurt when someone is shocked?

   Absolutely not. Patients who require this treatment have lost consciousness and do not feel the electric treatment.

Q. Since defibrillators are so effective, why are so few people saved?

   Defibrillators are only effective if applied within the first few minutes of collapse. After that time, the body has suffered so much damage that treatment is rarely effective.

   Unfortunately, help usually comes too late.

   Defibrillation is often delayed while waiting for a rescue squad to arrive or, worse yet, not performed until the patient arrives in the emergency room. Improved access to defibrillators undoubtedly would save lives.

   First aid with CPR (breathing into the lungs and compressing the chest) helps preserve vital body functions after cardiac arrest. CPR is important because it buys additional time until a defibrillator becomes available.

Q. What advances have been made in defibrillators to make them more accessible?

   Defibrillators have become smaller, cheaper and much more automated. I recently saw a demonstration of one advanced model that weighs only 4 pounds and is the size of a book. The cost is less than $3,000.

   Even more impressive is the intelligence built into these devices. The rescuer merely has to turn the device on and place adhesive pads on the chest. The defibrillator analyzes the heartbeat and, if needed, instructs the rescuer in a commanding voice to push the button that activates the electric treatment.

   This automated system has proven to be very reliable. After a few minutes of training, just about anyone can master this device and deliver life-sustaining treatment that once required a health-care professional.

Q. Where should these new devices be placed?

   The key to success is to bring defibrillators closer to where they might be needed.

   Devices are now appearing in airports, airplanes, office buildings and even homes. Recent reports confirm that improved access to defibrillators already has saved many who might otherwise have been lost – including a 40-year-old flight attendant recently resuscitated while airborne.

   So, do people really drop dead?

   In many cases, the answer is only if we let them.