Los Angeles Times

Do you know where the nearest defibrillator is?

Seconds count if you or someone near you has a sudden cardiac arrest. It happens to roughly 1,000 Americans every day. Although it often accompanies a heart attack, sudden cardiac arrest can happen to young and seemingly healthy people, too, and 95 percent of victims die before emergency personnel arrive.

The odds improve dramatically if somebody on the scene can quickly start cardiopulmonary resuscitation, or CPR, to get blood flowing through the victim’s heart and uses an automatic external defibrillator, or AED, to shock it back into normal rhythm. If you go into sudden cardiac arrest in a Chicago airport, where AEDs are plentiful, your chance of survival is greater than 50 percent. It’s as high as 74 percent in casinos, where trained personnel are watching constantly.

Statistics like that are helping fuel the drive to put more AEDs in public places. Once seen only in hospitals and ambulances, defibrillators today come as small as laptops, cost as little as $1,300 and can be operated easily by untrained bystanders. All you have to do is follow the recorded instructions. The device itself determines whether a shock is needed and delivers it.

Some states now require AEDs in schools; some require them in health clubs, shopping malls and golf courses. There’s little uniformity; despite their foolproof nature, some businesses oppose them out of fear of being sued if something goes awry with an on-site AED.

“I predict that 10 years from now, people will say, ‘I’m not going to work in a building or stay in a hotel or eat in a restaurant that doesn’t have an AED,’ ” says San Diego City Council member Jim Madaffer, who helped place nearly 5,000 AEDs in public facilities since 2001. They’ve saved 49 lives.

Schools have been a tough sell, too, largely because of cost. Some parents are raising money for AEDs themselves, often after a tragedy. In Rhode Island, the Michael J. Monteleone Fund was established after the sudden death from cardiac arrest of 14-year-old Michael, a Lincoln resident, during a baseball practice. It promotes AEDs and CPR programs in schools. (See www.heartafeaed.org.)

AEDs are also available now for home use without a prescription. In April, a government-funded study found that the devices didn’t significantly reduce the chances of death for people who had previous heart attacks.

Still, “it’s hard to make a case not to have one if you can afford it,” says Gust H. Bardy, the Seattle electrophysiologist who led the study. “We almost never use a fire extinguisher or the flotation device on an airplane.” Dr. Bardy, who says he has seen five people die for lack of access to an AED, personally has five of them — in his two homes, his two cars and his office.

There’s no telling whether faster use of a defibrillator might have saved NBC’s Tim Russert, who died of a heart attack June 13. His doctor said coworkers were about to use the office AED when paramedics arrived. They shocked his heart several times in vain.

Still, experts say his death underscores that cardiac arrest can strike unexpectedly, and that every workplace should have an AED. All 50 states now have AED Good Samaritan provisions that help protect laypersons from liability, the American Red Cross says.

Michael Sayre of the American Heart Association says people should get over the idea that death is inevitable in sudden cardiac arrest. “This is a treatable disease,” he says. “We can do much better than we’re doing today.”Staying Alive

If someone collapses near you, follow these steps:

•Call 911.

•Push hard and fast on the center of the chest (mouth-to-mouth is no longer recommended).

•Send someone to get an AED (if you are alone, get the AED before doing chest compressions).

Source: American Heart Association