Cardiac arrest generally strikes without warning when the heart's electrical system causes the heart to erratically quiver, preventing the pumping of blood throughout the body and to the brain. This is known as ventricular fibrillation. The cause can be heart disease, electrocution, drowning or trauma. Death occurs within minutes unless the normal rhythm of the heart is restored and that can only be done with a defibrillator. Cardiopulmonary Resuscitation (CPR) can keep the blood oxygenated and flowing to the brain and buys precious minutes. However, unless defibrillation occurs, quickly, the patient will inevitably die.
The window of opportunity to defibrillate is narrow, however, for each minute that the heart stays in fibrillation, approximately 10% of the ability to restart the heart is lost. Herein lies the problem, it is rare that trained paramedics can arrive with a defibrillator within that 10 minute window, thus fatally breaking the Chain of Survival.
Despite the many millions of dollars spent annually to deliver emergency medical services, the thousands of dedicated paid and volunteer EMS workers and the tremendous advances in medical technology, the sad fact is that only about 5% of Americans who go into sudden cardiac arrest live. The rest, about 350,000 a year, die from what is called Sudden Cardiac Death, the leading medical emergency in the country.
Breaking New Ground for Florida
In June of 1996, the Indian Creek Village Public Safety Department insured that persons in the community or traveling in the nearby waterways on a boat would have a significantly reduced chance to die from sudden death due to heart attack here than in other communities in the state. It did so by becoming the first law enforcement agency in the State of Florida to carry Automatic External Defibrillators (AED) in its police patrol vehicles and boats.
The American Heart Association has endorsed a plan called "public access defibrillation" which will put defibrillators in the hands of people most likely to be able to respond quickly to the scene of an emergency; the police. By virtue of random patrol, a police officer can almost always arrive at the scene of an emergency before units responding from a fixed location. And, when the officer is equipped with a defibrillator and trained to use it, there can be a significant reduction in death rates for persons suffering a cardiac event.
We have all seen the defibrillators carried by many ambulances or used in hospitals. They are bulky, heavy, complicated and require extensive training to operate. The original Automatic External Defibrillators (AED) were about the size and weight of a car battery. The newest models are even smaller, lighter, less expensive and easier to operate. The computerized units provide simple verbal instructions to the user and are fail-safe. They cannot deliver shocks to a patient whose heart is not in ventricular fibrillation, eliminating the possibility of improper use. And, they are built to take the abuse and punishment that comes with being carried around in a patrol vehicle. Some are fully waterproofed.
Operation of these units is almost foolproof. Operators must know where to place the two prepackaged gummed pads on the chest of the victim. The pads and the units themselves have clear drawings indicating proper placement. The operator then follows the computerized voice instructions, pushing the shock button when instructed to do so. After delivering the shock the units continue to instruct the operator on the proper care of the victim ("check pulse, check breathing"). Anyone who has learned CPR can be trained to operate the equipment in only a few minutes.
Spreading the Word: A Commitment to Assist Others
The ICVPSD knows that having an impact on sudden cardiac death in South Florida will require all of the area police agencies to ultimately participate in a defibrillator program. To help and encourage them though the process, in July of 1996 our agency convened a meeting of interested police chiefs and city managers with presentations by the Chief, ICVPSD officers, and members of the Metro-Dade Fire Rescue Department.
The Department has written and published numerous articles on the subject to encourage other agencies to adopt the program. To date at least two lives have been saved by police agencies who implemented an AED program with the assistance of the ICVPSD. The Department is firmly committed to assisting other agencies in the AED effort and routinely responds to requests for information throughout the country. Representatives of the Department have met with numerous civic groups and associations to promote the use of AEDs.
We believe that the implementation of the AED program is an excellent example of our agency's commitment to the community it serves and a demonstration of our willingness to address the community's needs well beyond that of traditional law enforcement requirements. Our efforts to assist others in implementing similar programs shows our department's commitment to partnerships with other agencies.