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This heartfelt prescription saves lives    added 2/01/01

Oct. 24, 2000       original file is at: http://www.usatoday.com/life/health/heart/lhhea151.htm

By Robert Davis, USA TODAY

Lee Curtes bought a defibrillator after his rescue.

When Lee Curtes has friends over to play cards, he keeps his defibrillator nearby. When he drives to work, he carries the lifesaving device in his car. At the office, he has the easy-to-use gadgets mounted for anyone to grab in the event of a medical emergency.

Although Curtes, 55, has a history of heart problems, the CEO hasn't purchased defibrillators to save his own life. He wants to repay a debt.

"I want to give a life back," says Curtes, who was on the receiving end of a defibrillator's shock when he suffered a heart attack in January while skiing in Vail, Colo.

At 11,400 feet, ski patrol rescuers used an automated external defibrillator (AED) to restore Curtes' heartbeat. The quick electric jolt gave a fighting chance to the rest of the far-flung medical team that worked for days to save Curtes.

Curtes is part of a rapidly growing group of people who have been saved by an AED. These people — saved on airplanes, golf courses and other public places equipped for such emergencies — love to spread the word about how easy it is for a person with limited training to use an AED to save a life.

But as these stories are told, a common question arises: How can I get one? Beginning Wednesday, one option is the Internet.

CVS.com, the online version of the big pharmacy chain, will sell an AED to anyone with about $3,000 and a doctor's approval. The move may help put the devices into homes, where most people fall victim to sudden cardiac arrest.

To place an order online, you give CVS.com your doctor's name and phone number. After the doctor confirms the prescription, the drugstore chain will ship out an AED so that you receive the device in less than a week. And CVS.com will connect buyers with trainers.

"The important thing is people should realize, if you buy one, to be trained and know how to link up with the emergency medical system," says Vince Mosesso, director of the National Center for Early Defibrillation in Pittsburgh. "If it makes it easier for somebody to acquire one, that's a good thing."

Proven success

Studies have shown that AEDs saves lives when they're used quickly. When the heart begins to misfire in what is known as ventricular fibrillation, the difference between life and death is about 10 minutes.

The condition begins in an instant — when the heart short-circuits and begins to misfire. Electric chaos causes the heart to quiver, burning precious energy in the muscle at the same time that the blood pump is robbed of oxygen.

The result: For every minute of ventricular fibrillation, there is roughly a 10% reduction in the chance for survival. A 10-minute delay in defibrillation almost always means death.

Because it usually takes more than 10 minutes for paramedics to arrive, traditional rescue attempts most often fail.

But when a computer program was designed to recognize the fatal heart anomaly and shock only the patients who needed the jolt, AEDs began saving lives that previously were lost. The defibrillator delivers an electric shock that washes over the heart and momentarily stops the electric chaos. That gives the heart's own pacemaker a chance to resume the beat.

In the past few years, doctors have found that with very little training, even children can use AEDs. Defibrillator-wielding security guards in casinos and flight attendants on airliners, for instance, have had good success saving lives.

AEDs are now in shopping malls, on golf courses, in theaters and in other places where people gather. And the success stories, like that of Curtes, encourage more. There are as many as 100,000 AEDs in place across the nation, according to industry estimates. By 2003, the industry expects to have nearly 400,000 AEDs in the hands of would-be rescuers.

In some airports and office buildings, AEDs are mounted like fire extinguishers so that anybody — trained or not — can save a life.

Texas researchers reported at an emergency-medicine meeting in Philadelphia on Tuesday that more than half of the untrained volunteers who participated in a study were able to deliver a potentially lifesaving shock by simply following the AED's instructions. A computerized voice inside the AED tells the rescuer exactly what to do.

But some doctors argue that the money needed to put defibrillators in public places could be better spent on other health needs.

A large federal study is under way to determine the effectiveness of such public access.

Private vs. public

While defibrillators have become more common on airplanes and in other public places — and the devices have been shown to save lives in some of those public settings — most of the 250,000 sudden cardiac arrests each year occur at home.

"The more ubiquitous they are, the more people will be saved," says Mickey Eisenberg, an emergency-medicine doctor at the University of Washington. He hopes that some doctors will write many prescriptions so that AEDs can be more widely available.

But he says that many doctors still don't view AEDs as a tool that should be used by laypeople.

At first, the most likely people to get such a prescription are the families who know they might need an AED because someone in the home has heart disease.

"There are 1 million homes in the U.S. that have high-risk patients," says Deborah DiSanzo of Agilent Technologies, which makes the Heartstream AED that CVS is selling online. "A lot of these users are people who have children who are at risk for cardiac arrest. It provides them peace of mind."

'My saviors'

But many of the people who fall from sudden cardiac arrest are relatively healthy and would never suspect they might need an AED someday. They are the people on the minds of Curtes and Mosesso and others who carry their own AEDs.

"You can envision the day when they would be the price of a DVD player," Eisenberg says. "The real breakthrough will come when you don't need a prescription to buy one."

Such technical breakthroughs could come soon. "Everything is just moving so fast," Mosesso says.

Much of the change is fueled by success stories such as the one Curtes tells of his near-death experience. He travels around the nation now to urge others in his business — heating and air-conditioning distribution — to get AEDs at work.

Curtes is still haunted by how close he came to death atop the mountain.

His memory of staring at the crisp, blue sky while lying on the hard board with an oxygen mask on his face as his heart stopped has turned into nightmares in which he can't breathe.

"I was sucking for air, and I couldn't get any," he says. "The last I recall, I was trying to get comfortable on this flat board, and my wife was holding the oxygen mask on my face, and then everything went. It was over. I had a cardiac arrest right there."

Because Vail had put AEDs on the mountain, Curtes was saved atop Blue Sky Basin by the ski patrol.

"They are my saviors," Curtes says. "My guardian angels."

Now he looks for his chance to help somebody else. "You don't know who is going to get nailed," he says. "You never know."

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Note: Skyaid service will provide more protection at a fraction of the cost:
  1) Cardiac arrest can occur anywhere
  2) Cardiac arrest can occur while asleep
  3) Victim can be alone
  4) Heart Attacks (not just sudden cardiac arrests)
  5) Stroke disability greatly reduced (strokes occur about 3X more often than cardiac arrests)
  6) Medical help arrives to provide essential treatment
  7) Victim quickly brought to appropriate critical care center