Sudden cardiac arrest – when, without warning, the heart instantly stops beating – kills 350,000 Americans of various ages and occupations a year, according to the American Heart Association.
Yet now, with high school sports teams in intensive training for their fall seasons, now is when we are most aware of these fatalities because of a tragic drama: A young athlete in peak condition, who has never flunked a physical or shown the faintest symptom of cardiac problems, suddenly collapses.
Death is usually all but instantaneous – but it is not necessarily inevitable, not if a device called an Automated External Defibrillator, or AED, and someone willing to use it are close at hand.
Sudden cardiac arrest is not the same as a heart attack, which usually is caused by blocked arteries and often gives some advance warning. Sudden cardiac arrest occurs when the electrical impulses that control the heart suddenly misfire.
The mild electric shock from an AED "resets" the heart and allows it to resume normal function. Bystanders revive several thousand people this way each year. More widespread use of the devices could save at least 20,000 more, according to the American Red Cross.
Since their introduction in the 1950s, AEDs have become smaller, simpler and basically foolproof; in one study, sixth graders mastered them quickly and easily. There are about 2.5 million AEDs in the country, far short of the 30 million experts say are needed just to cover metropolitan areas and far short of the Red Cross goal of having every person in America within four minutes of an AED.
There are no good reasons why AEDs are not now widely and readily available. They should be and the solution may require a certain amount of public outcry and political attention.
Uniform national standards need to replace the often complex and inconsistent state and local rules on where and how AEDs are placed – ordering that they be placed prominently, like fire extinguishers, and regularly maintained.
The AEDs should clearly display the Good Samaritan legal exception – all states have them – as that protects from liability for injury or wrongful death people who voluntarily and in good faith try to save a life.
Says one manufacturer of AEDs, "It's kind of blunt, but the bottom line is that when you're in cardiac arrest, you're dead before you hit the ground. There's no way you can cause that victim any more harm using that device. You're trying to bring them back."
Unlike TV hospital dramas, AEDs do not have paddles that administer massive jolts. Two adhesive leads attach to the chest and the shock, if the machine's diagnostics say one is needed, scarcely causes the patient's chest muscles to twitch – and the newer devices will talk the Good Samaritan through the process.
An American public that had no problem mastering smart phones should have even less difficulty with AEDs once they are, as they should be, highly visible and readily accessible.