They told him later that he was a goner, his heart flat-lined. One moment, he was sitting on a stack of pallets at the Target distribution center in Woodland, Calif., talking to his boss. The next, he was on the floor without a pulse.
But Tim Joseph, a 52-year-old with no known heart condition, was jolted back from the dead within a few minutes, thanks to a machine that fits in a bright red case the size of a laptop computer.
Automatic external defibrillators, or AEDs, are becoming common in public places such as airports, shopping malls and casinos.
In a cardiac emergency, having this type of device on hand can mean the difference between death or severe brain damage and full recovery, experts say.
In Joseph’s case, Target had sprung for the US$1,200 to keep a defibrillator in the warehouse. And both Joseph and his doctor, Woodland Healthcare cardiologist Dr. Kathy Glatter, credit its use for saving his life late last year.
“If it wasn’t for that machine, I wouldn’t be talking to you,” says Joseph, who was recently cleared to go back to work.
“It’s beyond scary, man.”
So severe was Joseph’s coronary, Glatter says, that it took three “shocks” with the electronic-stimulation pads to revive him.
All told, six to eight minutes elapsed between his cardiac arrest and his heart’s return to rhythmic beating.
A heart attack starts a race against time, Glatter says: “You have 10 minutes, max” before it’s too late to help. The standard of care for the last three decades, cardiopulmonary resuscitation, can only do so much.
“Fewer than five per cent of those who have an out-of-hospital cardiac arrest will survive with their brain intact, even if CPR is done correctly,” Glatter says.
“It’s just not good enough. Of course, paramedics are great and can shock you.
“But even if you live near a fire department, there’s a certain time lag. They can’t get there fast enough.”
Glatter, who can recall several stories of lives saved after sudden cardiac arrest, is a vocal proponent of installing AEDs anywhere large groups gather.
She says they are especially needed at health clubs, where intense exercise can stress a damaged heart.
She tells the story of Juan Munoz, a 65-year-old Woodland resident who recently collapsed while playing handball at a health club there. An off-duty nurse, Suzanne Linne, saw Munoz fall, grabbed the AED off the wall and zapped Munoz’s wildly beating heart back to normal.
“By the time they brought Munoz in to me (at the hospital), he says to me through an interpreter, ‘Can I go home now?’ “ Glatter says. “I said, ‘No, you can’t. You just had a cardiac arrest.’ “
Another time Glatter was on call, a 45-year-old man collapsed while lifting weights at a different Woodland health club — one without an AED. Workers performed CPR and called paramedics.
“By the time I got to see him in the ER, he was dead, and his wife’s standing next to me, crying,” Glatter says.
Defibrillators provide the electric jolt that CPR cannot. Think of it like rebooting a computer.
“When the heart muscle doesn’t get oxygen, it causes a buildup of lactic acid, and that makes the electricity in their heart go crazy,” Glatter says.
“We say flat-line, but it’s almost the opposite. The heart beats 300 to 400 times a minute, jiggling like a bag of worms, not squirting blood. It’s electrical chaos.
“What the shock does is stop (that chaos) and enable you to restart it yourself.”
One problem is that while many businesses have AEDs, workers either aren’t trained in using them or don’t think of employing them in an emergency.
In Munoz’s case, health-club workers were administering CPR and not using the AED until Linne entered the club and called for the device.
“The chest compression kept (Munoz) breathing, but there was no pulse,” Linne says. “I had seen before at the club that they had an AED on the wall. I asked for it. It’s really easy to use. It guides you through it.”
An AED literally talks a user through three steps: turning on the machine, placing the pads on the victim’s bare chest and pressing a button when a recorded voice says “shock now.”
“It’s really idiot-proof,” Glatter says.