Once a month, 15 or 20 Sun City seniors go back to class to learn how to save a life. Portable shock paddles are everywhere in this retirement village, and 450 residents know how to use them.
"These things are all over airports and courthouses," said resident and trainer Gordy Guibert, who had a 40-year career as an X-ray technician. "We haven't had to use one yet. But it's like a fire extinguisher. You hope you won't need it but if you do, you'd better know how to use it."
More than 250,000 Americans die every year from sudden cardiac arrest, usually caused by an electrical malfunction, or sometimes heart attack or stroke. The heart stops pumping blood to vital organs and death follows within minutes.
The paddles, or Automated External Defibrillators, shock a stopped heart into beating again. Long a staple of hospital emergency rooms, they've now entered the mainstream, visible in casinos, airports, airliners, gyms, shopping malls, office complexes and other public places by their symbol: a heart with a lightning bolt.
"In the 1960s, I used to work in a heart cath lab where cardiac arrest was very common," Guibert said. "Most of the time the defibrillator was extremely effective - the only thing that was going to bring them around."
Portable defibrillators are only used in cardiac arrest, not heart attack. "A heart attack is caused by narrowing of the arteries and will cause intense chest pain. In cardiac arrest, the heart stops," he explained. "The heart is in a state of electrical chaos called ventricular fibrillation. The defibrillator shocks the heart back into a normal sinus rhythm."
Jack Byers heard about the portable defibrillators more than a year ago when he was a board member of the Sun City Vistoso Community Foundation, a charitable nonprofit group that serves the wider community.
"I had read something about portable defibrillators used as emergency devices by laymen," he said. "I brought it to the attention of the board and we originally purchased two units." The devices cost about $3,000 each.
The board then put out an appeal to find trainers.
It found Lani Clark, a program coordinator at the Sarver Heart Center, University of Arizona's College of Medicine, who trained eight trainers, including Guibert and Lois Kurt, a nurse who lives in Sun City.
"We want to increase the number of citizens who know how to do it," she said. "You can have the best EMS system in the world, but it's going to take six or eight minutes for them to get there. The person's chance of survival decreases by about 10 percent every minute. So citizens have the best chance of saving somebody, because no matter how fast EMS is, a citizen is faster."
Clark said that there are portable defibrillators in most public buildings at the UA and Pima Community College campuses and state and county buildings in Tucson. Heritage Highlands has a program and SaddleBrooke is starting one, she said. The Sun City foundation eventually purchased six of the units, located in the fitness center, social hall, Vistoso Center, Desert Oasis recreation center, Catalina Vista recreation center and pro shop/café.
Clark will be training the Oro Valley Police Department to use the devices, which will be kept in patrol cars. The OVPD is ordering five of the units; the Sun City foundation has agreed to pay for one, to be dedicated to Sun City patrols.
"What we intend to have them provide is an additional level of service and response that's beyond our capability right now. If something happens while we patrol a shopping center or are dispatched to someone's home for (a cardiac arrest), it's just an additional tool to save lives," said OVPD Chief Danny Sharp. "The foundation is an example of a great partnership that folks in Sun City are giving back and another example of partnering where the entire community benefits."
National interest in portable defibrillators started a few years ago with their use on airlines, which is now required by the FAA, Clark said.
"On average, survival (after cardiac arrest) is probably 5 percent nationally, and maybe a little higher in some cities," she said. "What the AED does is shoot a jolt through the heart, stunning it so the normal pacemaker picks up and starts a rhythm again."
Sarver researchers did a study at hotel casinos in Las Vegas and equipped security officers with portable defibrillators. That study, published in the October 2000 New England Journal of Medicine, found that of 105 people who suffered cardiac arrest and were candidates for shock, those shocked in three minutes or less had a 74 percent survival rate; survival dropped to 54 percent between three and five minutes.
"It was huge - the highest survival rate reported in the world," Clark said.
Along with the shock, chest compressions are vital to keep the organs and brain alive, she said. "What you're doing is forcing the heart to pump blood around the body to keep the brain alive and the heart tissue viable, otherwise all organs begin to die."
Unlike the CPR of old, Sarver no longer recommends mouth-to-mouth resuscitation for adult victims of cardiac arrest.
"Cardiologists Dr. Gordon Ewy, director of the Sarver Heart Center, and Dr. Karl Kern, have done years of research on CPR and resuscitation and their research has determined that just doing chest compression is equally effective," Clark said.
The portable defibrillators are "smart" devices that determine whether a shock is needed and "talk" to the user.
"The AED has the ability to look at the heart's electrical activity and determine whether a shock would be beneficial or whether to just continue with chest compressions," she said. "It's such an easy device to use. If you turn it on, it tells you what to do. There are no decisions - and no risk - on the part of the user. You can't shock somebody that doesn't need to be shocked."
Jack Evert, a retired product manager from Minnesota, agreed that the device is quite automated and doesn't require a lot of skill. "It's pretty straightforward. The device tells you what to do," he said. "When you've got a bunch of old characters like we do, you never know when you're going to have someone keel over and you might save them."