Defibrillators: No need to delay, selectmen say

When a heart stops, the clock is ticking.

“It comes down to basic math. When a person’s heart stops beating — that could be a family member, that could be a friend, that could be a total stranger — the heart stops, and it’s four to six minutes before irreversible brain damage,” said Fire Chief Jerry Myers. “We have this four-to-six-minute window to intervene, where we can prevent that from happening, until they get some advanced life support applied to them, typically through the ambulance.”

Because that window is so brief, and time so critical, the town has put automatic external defibrillators or “AEDs”— the devices that can restart a stopped or fluttering heart with a small jolt of electricity — in most of its buildings, and the fire department has been training town employees to use the defibrillators and provide cardiopulmonary resuscitation (CPR) to people having heart attacks.

The issue of AEDs came up when the Board of Selectmen met as the Fire Commission May 24.

The current year’s budget included about $21,000 requested for 12 defibrillators or AEDs. The proposal sailed through the budget process last spring. Nine defibrillators would replace units that were getting beyond their useful life, and three were new ones to be bought for Yanity Gymnasium, Martin Park and Founders Hall.

Selectwoman Maureen Kozlark wanted to know why there wasn’t an AED in Yanity Gym.

Myers said the fire department had followed through but was waiting until staff at the gym was trained before putting it up in the gym.

The selectmen thought it should be available for use at gym.

“We have a defibrillator, and it’s not over there,” Kozlark said. “This is a priority.”

“They have basketball there all the time, and it’s not just 18-year-olds,” First Selectman Rudy Marconi said.

Pickleball — the sport is popular among senior citizens — is also played regularly at Yanity.

The selectmen said the training needed to get done, and the AED that had been purchased for Yanity should be put out where it would be available for use in an emergency.

“A defibrillator has to be over there, in use,” Kozlark said.

Myers told The Press last Friday the machine was in the gym.

“It’s currently in the supervisor’s office with all the first-aid equipment,” he said. “My understanding is there’s always someone on staff when the gym is open.”

He said the AED unit is “scheduled to be hung on the wall out in the actual gymnasium area” this week.

Dispatcher guidance

Training people to use AEDs and give cardiopulmonary resuscitation is unquestionably valuable.

But the AED units are designed to be usable by people without training.

“The best thing about the AEDs, there’s probably 100 different kinds, but they’re all built the same way and you follow the exact same steps to use them: you turn it on, and it tells you what to do from there,” Myers said.

Beyond that, if someone is believed to be having a heart attack, people on the scene should obviously call an ambulance — and the fire department dispatchers who answer the calls are trained to guide people through what needs doing over the phone.

“We call it a scripted medical event,” Myers said. “The dispatcher has a card, a script, that the dispatcher walks the person through the steps necessary to provide CPR, and that includes use of the AED.

“Emergency medical dispatch works,” he added. “We have some very skilled telecommunicators.”

Training program

Myers said the training program for town employees was proceeding, with people who work at three of five the town’s five major locations having been trained.

“We are doing well with that program,” he said. “I believe that the two groups we have left to do are the actual town hall employees and golf course employees.

“The town hall annex is done, highway department, the parks and rec is done,” he said.

What about the schools, do they have AEDs?

“Yes, they do,” Myers said. “And they always have a school nurse, and the school nurse is trained, in addition to other persons that are trained in the schools.”

Aaron Crook, the Ridgefield Public Schools’ nursing supervisor, elaborated.

“Each school has at least one AED, larger schools have more than one,” he said.

Ridgefield High School has three AEDs. East Ridge Middle School has two. Scotts Ridge Middle School had one, but is scheduled to be getting a second one soon. Each of the six elementary schools has one

“Our nurses who work during school hours are trained in using them,” Crook said.

But they’re also available for use when a nurse isn’t around.

“They are stored in easily identifiable locations near main entrances, auditoriums and gyms, and are marked for the public to be able to easily identify and access them,” Crook said. “They are available for anyone to use in a cardiac emergency at any hour of the day.”

Locations

Other town buildings that have defibrillators, according to Myers, are: town hall, the town hall annex, the Barlow Mountain swimming pool, and the public works garage. There are three at the Parks and Recreation Center — at the front desk, in the aquatics office and the wellness center. And there are two at the golf course — one in the clubhouse, and one in the maintenance barn. There is also one in the Catoonah Street firehouse lobby.

And AEDs are in all the town’s ambulances, fire trucks and police cars.

Founders Hall and the Community Center’s Lounsbury House also have AED units.

Myers said the training program for town employees is continuing, with only the golf course and town hall still to be done.

“Golf is a complicated thing, first we have to wait until they hire all their temporary employees for the season. And then you have to split them up,” Myers said.

Splitting them up means training some employees in the morning while others work, then the people who worked the morning would get trained in afternoon while their colleagues trained in the morning keep things running.

“Same thing for town hall,” Myers said. “You can’t close all the offices.”

“At highway, we did it in two days. At the annex, we did in two groups. We’ll get everybody through it,” he said.

Other groups

After town employees are trained, the town can be an example to other employers and organizations in town who want to take up the mantle and get their employees or members trained.

The fire chief is hoping for some corporate sponsorships to help finance training.

“We have not got corporate sponsorship yet, so we’re still looking at ways to push it out to the public,” Myers said Friday. “We did a mass CPR training at the RVNA health day — I think we trained about 70 people that day. So we’re hitting some of the high traffic events.”

When he was outlining the program last year, Myers said he thought more people would be open to the training and would be willing do CPR; now that there’s a “hands-only” method and the protocol no longer requires mouth-to-mouth resuscitation.

If organizations or people want to learn more about CPR and using ADE’s, the fire department can put them in touch with groups that do training sessions — just call 203-431-2726.

It can literally be a matter of life and death.

“We have some of the most highly skilled paramedics in the state,” Myers said.

But they’re still subject to the laws of time.

There are serious consequences for a brain that isn’t getting any oxygen.

“The clock started at zero the moment when the heart stops,” Myers said. “It takes a minute or two for someone to call 911, and a minute or two for a dispatcher to process the call and get the ambulance out.”

How long it takes to get to different places in town varies, but the department’s average is “about five to six minutes in travel time,” Myers said.

“Potentially 10 minutes have gone by. If no one has been doing CPR, the brain hasn’t been getting oxygen all that time,” he said.

“If you understand the time factor involved, it really is a matter of mathematics. The faster someone starts doing the CPR, the greater the chance the person has of being resuscitated.”

“The folks that are going to be resuscitated the fastest, and the best chance of returning to a quality of life, are the folks that had CPR done early and had defibrillator applied early,” he said.

“When we do have a save, most of the time, it’s because somebody did CPR before we got there,” Myers said.