by Lisa Marshall
Warren Heim, 48, had just finished his usual eight-minute rowing workout and was about 60 feet into his morning run March 26 when his heart began quivering, the blood flow to his brain slowed, and he collapsed on the track at Flatiron Athletic Club.
But for a swift 911 call, the prompt arrival of paramedics who jolted him back to life with a defibrillator, and a bit of luck, Heim’s wife and four sons might have gone to his funeral that weekend.
Close call, a still-shaken Heim recalls; closer than necessary in an age when easy-to-use, lap-top-sized defibrillator’s medical devices which deliver a shock to the heart are readily available on the open market.
"These things can save lives. They need to be everywhere," Heim said.
This week, Flatiron and Rallysport athletic clubs in Boulder became the first health clubs in the state to acquire the $4,000 devices and teach their employees how to use them. They join a growing number of companies nationwide that are taking the serious task of cardiac revival into their own hands.
Proponents of such "public-access defibrillation" say it could save as many as 50,000 lives a year by allowing lay people to quickly administer a life-saving jolt instead of waiting for emergency medical personnel to arrive.
But some cardiologists say they have mixed feelings. While it could undoubtedly save lives, they say, there is also a potential that a minimally trained person could administer a shock to a victim, or bystander, who doesn’t need it.
"It is a good news, bad news situation," said Boulder cardiologist Roy Thompson. "I am always leery about nonmedical personnel giving a therapeutic treatment."
More than 250,000 Americans die each year from cardiac arrest, often triggered by "ventricular fibrillation" a spastic heart rhythm that delivers no blood to the brain and can render a person clinically dead. Only about 5 percent of people suffering arrests outside the hospital, like Heim did, survive, according to the American Heart Association.
The only effective treatment is "prompt defibrillation," says the association, which strongly endorses widespread availability of defibrillators. Chances of survival decline about 10 percent with every minute that passes.
Until recently, defibrillators were found only in hospitals and on ambulances, and were operated only by trained medical personnel. In the mid-1990s, airlines began installing the devices and teaching stewards how to use them. And in recent years, such public places as shopping malls, golf courses, health clubs and airports have acquired them.
O’Hare International and Midway airports in Chicago have gone so far as to strategically place "automatic external defibrillator" units within a one-minute walk from any point in the airport, so that passersby can help out in an emergency.
Legislation signed in April by Gov. Bill Owens limits the liability of a Good Samaritan using the devices and has opened the door to their widespread use in Colorado.
"In a few years we’ll see these in every public venue," said Hewlett Packard sales representative Brooks Hoven. He said the company has sold about 15,000 of its AED units in the past two years, 120 in Colorado.
Brett Nickal, general manager at Flatiron Athletic Club, knows of six people who have suffered cardiac arrest at the club in the past 18 years. To him, the machine seems a priceless investment.
"From the office, where it will be kept, to the farthest point in the club is about 30 seconds," Nickal said. "I hope it is something we never have to use, but if we save one life it’s worth it."
Rallysport, which conducts post-cardiac rehabilitation exercise programs, also wants to be prepared, said the club’s wellness consultant, Steve Black.
Employees at both club went through a four-hour course for certification to use the units. Now, if someone falls ill, it will be unnecessary to wait for a paramedic to arrive, find the victim, test the person to see if the heart is truly fibrillating, and administer the jolt. Employees can simply grab the AED and go to work, said Richard Perse, who conducted the training.
The user simply places two pads on the victim and waits for a reading from the AED’s internal computer. It determines whether the victim is truly in fibrillation, and if it says "shock," the user makes sure everyone in the area is clear of the body, then presses a button, delivering a 1,700-volt charge through the wall of the heart. If it says "don’t shock," the user cannot override it, Perse said.
"My first-grader could run it," Perse said. And, he notes, "You are shocking a dead person. You are not making anything worse. Anything you can do can make it better."
Perse predicts that there will come a time when health clubs can be sued for not having such devices on hand, as was the case in 1996 when Busch Gardens was found negligent for failing to properly respond to a 13-year-old girl who suffered a cardiac arrest. According to news reports, the park personnel lacked essential medical equipment including an automatic defibrillator.
Edward Turvey, a clinical cardiologist at Boulder Medical Center, said he believes the devices are ideal for police and fire personnel who may arrive on the scene before an ambulance does. However, he voiced concern that a four-hour training session for a lay person "sounds a little brief."
Adds Thompson: "In my opinion, a computer is never idiot-proof."
Nonetheless, Warren Heim swears by the defibrillators and has devoted much of his time off over the last three months to promoting them. As a clean-living health nut who doesn’t drink, smoke, or even have coffee, he’s well aware that cardiac failure can strike anyone at any time his was a result of a virus. He points out that his malfunctioning heart didn’t start actually fibrillating until after the paramedics arrived, a stroke of luck that may have bought him some time and saved his life.
He hopes that someday AEDs are as common as fire extinguishers.
"If you don’t have one, you call 911, administer CPR, and cross your fingers," Heim said. "If you do, you save the guy’s life."