Jump-Start for a Failing Heart

Orange County is ground zero in a national trial to determine the effectiveness of making life-saving defibrillator machines available to the public to use in emergency situations.

Defibrillators are considered one of the best tools modern medicine has developed to get hearts beating by delivering an electrical shock. But until recently, defibrillators were found primarily at hospitals or in ambulances.

The goal of the new study is to make defibrillator usage as common as performing CPR; to make this happen, officials are training citizens and placing machines everywhere from the local courthouse to some neighborhood stores.

Mission Hospital Regional Medical Center and Orange County Emergency Medical Services are participating in the trials.

“Defibrillators have been proven to be a great step above (CPR),” said Linda Asbury, a registered nurse who is the trial coordinator in Orange County. “Sometimes CPR restarts the heart but sometimes they need that jump-start to get it going again. The defibrillator really works well.”

Orange County is one of 24 communities in the United States and Canada taking part in the trial, which is sponsored by the National Institutes of Health and the American Heart Assn.

Thirty sites in Orange County were selected for the study. Eleven will receive defibrillators as well as training on how to use the devices and CPR lessons. Employees at the remaining sites will receive training for CPR only. Those sites will act as the control group, Asbury said.

Facilities taking part include the Mall of Orange, Saddleback College, the Ole Hanson Beach Club in San Clemente, Leisure World in Laguna Woods and all county courthouses.

Defibrillators are contained in a bright orange box about the size of a large handbag. The device is activated when the top of the box is flipped open and an electronic voice begins to explain the necessary steps to revive a patient.

The box contains two thin electrode pads, which are attached to the victim’s chest above the right nipple and on the side of the ribs below the left nipple.

Once the pads are attached, the electronic voice orders the volunteer not to touch the patient while it analyzes the heart rhythm.

Most cases of cardiac arrest are caused by a heart that has stopped beating in a regular rhythm and begins fibrillating, pulsating in a weak and erratic manner that blocks blood circulation.

The machine delivers a shock intended to stop the erratic pulsing. If the machine detects a faint but stable heartbeat or no pulse at all, it will tell the user to perform CPR to establish a heartbeat and get the victim breathing.

If the machine detects a fibrillating heart, it will order the user to stand clear of the patient and press a flashing button to deliver the electrical charge. After the heart has been shocked, the machine will again analyze the victim to determine if another charge is needed or if CPR should be performed.

Steve Hacker, who is working on the trial in Leisure World, said the device was fairly simple to use.

“It’s hard to screw up because all you have to do is listen to what the machine is saying,” he said.