The next person who delivers a life-saving electrical shock to your heart may not be a doctor or even a paramedic.
It could be a firefighter who knows how to use a sophisticated heart machine designed to think like a cardiologist.
Yesterday, the Howard County Department of Fire and Rescue Services began using automatic external defibrillators, or AEDs, which analyze the heart and decide whether it needs an electrical shock in order to beat normally.
Other area fire departments have begun using the devices this year, including those in Baltimore City and in Anne Arundel and Baltimore counties. Some fire departments in Carroll and Harford have bought them, but are not yet using them.
Without AEDs, paramedics must be at the scene to determine whether a shock is needed. The machine can make the call on its own.
"Often, the paramedic doesn't arrive at the scene first," said Lt. Dan Merson, Howard County's emergency medical services manager. "When you're dealing with a cardiac patient, a couple of minutes spent waiting for the shock can mean the difference between life and death."
If a patient's heart is defibrillated within the first minute after it begins quivering uncontrollably, the odds of survival are 90 percent, said Dr. Joseph Ornato, a Richmond, Va., cardiology professor who serves on an AED task force of the American Heart Association.
Each minute after the first, he said, the chance of survival decreases 10 percent.
Paramedics, who receive 800 to 900 hours of training, make up 15 percent of the county's 200 fire and rescue workers. The rest of Howard County's career firefighters undergo about 140 hours of training to become emergency medical technicians.
The EMTs will take a four- to six-hour class to learn how to use the new equipment.
When AEDs were designed in the late 1970s, some doctors questioned whether the machines were dependable, Ornato said.
But since the late 1980s, the medical community has seen that AEDs used in cities across the country have increased survival rates among those suffering cardiac arrest.
"It became quite clear that these devices were engineered quite well," Ornato said. "The likelihood of shocking someone who doesn't need it is very remote, and the likelihood of shocking someone who does need it is quite high."
In fact, after a conference on AED, the American Heart Association issued a statement in 1994 that supported widespread use of the equipment -- even by laypersons.
"If your heart stops, it doesn't matter to you whether paramedic, a schoolteacher, a police officer or a firefighter delivers the shock," Ornato said.
Pub Date: 8/20/96