by Megan O’Matz, Tribune Staff Writer

   Although defibrillators have been installed at O’Hare International and Midway Airports, the lifesaving devices are still hard to find on the Chicago Fire Department’s engines and trucks.

   Because the city has 159 fire trucks but only 59 ambulances, firefighters are often the first personnel to respond to health emergencies, including cardiac arrest.

   But only a quarter of the department’s 99 engines and none of its 60 hook-and-ladder trucks have defibrillators , which administer electric shocks to restore normal heart rhythm. When no defibrillator is available, firefighters perform cardiopulmonary resuscitation while awaiting a truck or ambulance with a defibrillator .

   In such cases, medical experts say, every minute defibrillation is delayed reduces a person’s chances of survival by 10 percent.

   "It’s unconscionable," said Patrick Fitzmaurice, a paramedic with the Chicago Fire Department. "The firemen are capable of using defibrillators ). For them not to be on the fire trucks makes no sense."

   But top city officials defend the city’s decision to distribute defibrillators to its airports before its emergency vehicles.

   Jacquelyn Heard, the mayor’s press secretary, said it is not inconsistent for city officials to place defibrillators at O’Hare and Midway, but not have them available on every fire truck.

   "Defibrillators are an effective lifesaving tool in certain situations," she said. "However, the Fire Department has in its advanced life-support system what it believes is an equally effective method."

   Chicago appears to be lagging behind national trends. More than three-quarters of the 200 biggest U.S. cities equip each emergency medical vehicle with defibrillators , including New York, Los Angeles, Philadelphia, San Diego and Houston, according to a 1998 survey by the Journal of Emergency Medical Services.

   "Say the fire engine is right down the street and it does not have an automated defibrillator ," said Bob Scates, director of emergency medical services for the Chicago Fire Fighters Union Local 2. "Now your relative dies. Wouldn’t you be kind of upset?"

   The criticism comes at a time when the department is under fire for ambulance response times that have been up to 23 minutes.

   Instead of installing defibrillators on each truck, the department has a more ambitious long-term plan to convert all 99 engines into "advanced life support" units, carrying medicine and equipment normally found on ambulances, including defibrillators that are more sophisticated than those at O’Hare and Midway.

   "There are many fronts on which you can save lives," said Cortez Trotter, deputy fire commissioner for emergency medical services.

   But converting the units is a slow process, largely because paramedics must go through special training to serve on the advanced life support units. Since the plan was unveiled a year and a half ago, only 24 of the 99 fire engines have been converted. The department will not say when it plans to put more on the street.

   "Although we would like to be able to make this happen overnight, the reality of it is it will take some time to complete," Trotter said. "The process is ongoing."

   The process is not quick enough for Chicago resident Mary Dunne, whose husband, Cyril, died in June 1996, of cardiac arrest while waiting for an emergency vehicle with a defibrillator . Since then, she has fought for their inclusion on every emergency response vehicle.

   "A lot of this is political," she said. "They say they have to cross-train the paramedics as firefighters, and it’s a very involved process, and it can’t be done overnight. Well, hey, overnight they got ( defibrillators ) at O’Hare and Midway."

   Trotter said the department is racing to move paramedics through three-month fire-training classes. "With any department of this size, an initiative this large is going to take time," he said.

   The International Association of Fire Chiefs recommends having defibrillators on emergency response vehicles, both for the protection of the community as well as for firefighters who suffer cardiac arrest while on duty.

   Union Local 2 President Bill Kugelman said firefighters want defibrillators on each truck, but have not made it a negotiated issue.

   Noting the simplicity of the automated devices, he said: "It’s like a no-brainer to operate them."

   Dr. Ken Pearlman, one of three medical directors overseeing Chicago’s emergency medical services, said doctors generally favor greater access to defibrillators by trained people.

   "If it were up to me, they’d be on all the police cars, on all the fire trucks, on all the fire engines," he said. "You would blanket the city with these things."

   Fire officials, however, don’t appear convinced.

   They point to an unsuccessful 1996 pilot program that put defibrillators on fire trucks in the 13th Battalion on Chicago’s West Side.

   Defibrillation was considered in 48 cardiac cases–but only 11 had heart rhythms suitable for shock treatment. Despite being treated with defibrillators , none of the 11 people survived.

   The department’s resources, Trotter said, are better used developing fire engines that candouble as ambulances with a wide range of medicines and equipment on board, including defibrillators .

   But the hesitation infuriates Dunne, who appealed for the inclusion of defibrillators on each fire truck in testimony before the City Council’s Police and Fire Committee in October 1996.

   She told the committee that a fire truck arrived at her home after eight minutes.

   "The only thing they carried was oxygen," she recalled recently. "First-aid for cardiac arrest is a defibrillator . If you don’t have that equipment, you might as well send a Band-Aid for a hemorrhage."

   Since September 1998, the American Heart Association has trained 30,500 people in the use of defibrillators . As of last week, 1,063 workers from O’Hare and Midway had taken the four-hour course, heart association officials said.