The Sun Sunnyvale's Newspaper Photograph by Skye Dunlap After listening for instructions from the defibrillator, Louie Alicea practices CPR on the training dummy. Sixty city employees learned how to use the machines last week in preparation for the installation of 32 defibrillators in public buildings throughout Cupertino. Shock Therapy The city makes attacking heart attacks a priority By Justin Berton Sunnyvale is one great place to have a heart attack. Especially when public safety officers Tim Macierz and Alec Lowe are on duty. In the past three months, the two officers have saved the lives of two Sunnyvale residents by interrupting cardiac arrests and restoring hearts to their normal rhythms. Both times, the officers used defibrillators, handheld machines that allow trained professionals to apply a shock to the still heart of the victim. On Nov. 28, after saving an elderly resident's life, Macierz and Lowe became the first officers in Sunnyvale to use the new automatic defibrillator. Public safety officials hope every resident in the city will soon become acquainted with the devices--by way of training, that is. Tomorrow, department and city officials will formally announce the purchase of 32 new, user-friendly defibrillators at a public ceremony. The units will be installed in public buildings throughout the city, such as the library and the community center. The hope is that should a resident suffer a cardiac arrest in Sunnyvale, a defibrillator will be close by. The event is called Gift From the Heart and will launch a public education and awareness campaign in an attempt to lower the number of deaths due to cardiac arrest. Throughout the country, 350,000 deaths occur each year as a result of out-of-hospital cardiac arrests. The American Heart Association estimates widespread distribution of the defibrillators could save 100,000 lives each year. In Sunnyvale between 80 and 100 people can expect to suffer a cardiac arrest in 1999. Of those, an estimated 45 people will have a treatable rhythm once emergency technicians arrive--the others will die. If 1999 mirrors last year, rescuers will be able to save two people of those 45. Public safety officers Mark Cunha and Steve Fisk have made it their personal priority to increase the number of saves. Cunha and Fisk are leading the campaign to train residents and local business owners how to apply CPR, and how to use defibrillators. "Fisk and I sat down and said, 'Enough is enough, let's start a comprehensive program,' " Cunha said. With the purchase of the machines, the city of Sunnyvale has given the two officers the support they've been asking for to launch the preemptive strike on cardiac arrests. Other cities in the Bay Area have installed defibrillators in police cars and on fire engines, but few have been as ambitious in their plans to disperse the machines throughout the city and train the residents how to use them. By week's end, Cunha will have trained 60 city employees to operate the machines. He and other public safety officers have taken it upon themselves--often working on days off--to give training seminars to employees at local businesses that may install the machines on site. At the first training seminar last week, city employees who will be working near the newly installed machines were surprised how easy the units are to operate. "These are amazing," said J.J. Miller, an operator at the city's water pollution control plant, who volunteered from among his staff to take the course. "Very, very simple," he added. Essentially, operators of the defibrillator need only apply two sticky patches to the victim's chest and wait for the machine to tell them what to do next. A small screen on the machine shows the of the victim's vital signs, and an audio voice gives directions: "Stand clear of the patient." "Deliver shock now." "Analyzing heart rhythm. Do not touch the patient." "It is safe to touch the patient." "Check breathing. Check pulse." Or, in some cases, the defibrillator will respond, "No shock advised." This feature prohibits the machine from administering a jolt of electricity when one is not warranted. In other words, people cannot go around shocking people with the new defibrillators. Cunha said he has never heard of a machine malfunctioning in any way. He said the software inside the unit is self-monitoring and will notify the owner when it is slowing. The technology not only has allowed the layman to apply a shock with little training but has also been crucial in shaving precious minutes off the time it takes to apply that shock. "Every minute we save, or lose, there is a 10 percent change in chance of survival," Cunha said. "If we can cut out only two minutes, that person has a 20 percent better chance of surviving." Time is the key to the survival of cardiac-arrest victims, Cunha added. The average response time from the point of dispatch to the moment of contact by city firemen or police is between seven and eight minutes. After four to six minutes of experiencing cardiac arrest, Cunha said, brain damage occurs. Cunha wants to make it clear that the seven- to eight-minute response time not only includes driving, as residents often believe, but in many cases includes the precious time officers use getting into the rig, unloading equipment and searching for the victim--a frustrating task for officers in a hurry. "Rarely is the person on the first floor near the door when we arrive," Cunha said. As usual, the city of Sunnyvale is attempting to put itself on the threshold of progressive city planning. The purchase of the defibrillators, which cost $98,915, was approved at the Oct. 20 council meeting. At the time, councilmember Fred Fowler pulled the item from the consent calendar to make a special acknowledgment of the city's purchase. Bob Koshinskie, product manager for Laerdal Medical Corporation, the manufacturer of the defibrillators, said that although the private sector continues to be the main buyer of the machines, the public sector is slowly catching on. "The popularity in the last three years has been increasing," Koshinskie said of overall sales. "More cities have been purchasing them, but they have been mostly for ambulances." Now, with several recent news reports of lives being saved on airplanes by the easy-to-use defibrillators, Koshinskie said his company is getting requests from such widely diverging sources as shopping malls and sports arenas. Cunha, who is well-known in the department for his enthusiasm, has taken an even more energetic stand regarding the new machines. "This was one of those things that, in my opinion, everything that could be done was not getting done to address the issue. Here, with the defibs, it is. It is the right thing to do. It's low cost, for big impact. You can't get more important then saving lives." Just ask the woman whose life was saved by one of the new machines three weeks ago. When Macierz and Lowe received the call in the late afternoon of Nov. 28, this is what happened: An elderly woman living in the southeast corner of the city called 911 to complain she was having difficulty breathing. She was home alone. Shortly after the 911 dispatcher instructed the woman to leave the door open for the officers who were fast on their way, the dispatcher lost contact with the woman. When Macierz and Lowe arrived at the home, they found the woman with the phone clutched in her hand, not breathing. She had no pulse and was unresponsive. Macierz applied the pads from the defibrillator and was able to apply a shock within 36 seconds. Had he been using the old defibrillator, it would have taken more than a minute to register a shock. "At the first shock," Macierz recalled, "she converted to a regular heartbeat." After 15 years of being on the scene in life-and-death situations, Macierz said he feels privileged to save one life, not to mention two lives in three months. "It is very rewarding to be able to have the tools and the training to really make the difference," he said. "I've had close ones before, but the defibrillators have made the difference." [ Back to Contents Page | Sunnyvale Sun Home Page | Archives ] This article appeared in the Sunnyvale Sun, December 16, 1998. ©1998 Metro Publishing, Inc. All rights reserved.