By Kristin Withrow, CSDA Communications Specialist
Rural Californians enjoy wide open spaces, the quiet of country living and the tranquility of nature even as they choose country life over city conveniences like the ability to pick up a grocery item at a store on the corner. What they may not realize is that they also can be at greater risk of death due to delayed access to emergency healthcare facilities.
Mark Twain Healthcare District in Calaveras County is in San Andreas, a city whose population was recorded as just under 3,000 people in the 2010 census. The county is 1,000 square miles with a total population of about 45,000 people. Serving in a primarily rural geography, and a population with nearly 30% of its residents over the age of 65, the district has taken steps to ensure mobile access to life saving medical equipment with its program: AEDs for Life.
The district’s Chief Executive Officer is Randy Smart, an internal medicine doctor with 35 years of experience. When it was discovered, there was a lack of life-saving equipment available to firefighters who are often first on scene in emergent medical situations, the district created the program to provide automated external defibrillators (AEDs) to rural fire personnel throughout the county.
AEDs are critical to successful outcomes in patients experiencing a heart attack. To understand the significance of these portable machines, it’s important to know what ‘heart attack’ means. Dr. Smart explained it in layman’s terms: People have plaques in their coronary arteries that usually are not a problem; however, they can crack and break open. When this occurs, the plaques can quickly block the artery to some degree. This triggers electrical activity in the heart that results in a chaotic heartbeat called fibrillation. A person experiencing this is going to die unless the electrical rhythm can be restored, and the heart can begin to squeeze and circulate blood in the body. An AED provides an electric shock to restore the rhythm. Time is of the essence in these situations: The probability of survival decreases by 7-10% for every minute that a victim stays in this life-threatening arrhythmia state. Once the heartbeat is restored, the patient can be moved to a hospital to perform the appropriate procedures to open the blockage and stabilize proper circulation to the heart.
“The district has been able to provide 20 AED so far, and we anticipate another 20 in the 2024-2025 budget cycle, then another 20 the following cycle, and so on,” explained Dr. Smart. “The units cost about $1,800 and we work with applicants whose budgets are often able to provide some degree of matching funds.”
The program has been divided into phases based on need: first responders were identified as most impactful and thus received the first units. Eventually, the district anticipates opening the application process to organizations that provide services to higher risk populations, such as senior centers and sports centers.
Modern AEDs require little training for personnel adept at medical first response, so the district did not need to develop training protocols in the initial phases. Later phases that place AEDs in areas where non-medical personnel may need access to the devices will likely require the district to develop community-based education and training programs.
Lastly, the district is working to develop an inventory system for the devices so they can be monitored for battery life and maintenance requirements. Additionally, a geo-location style monitoring system that can show AED locations on a smartphone would provide optimal, readily available information to enable anyone responding to a heart attack situation to locate and access a nearby device and, hopefully, result in a positive outcome for a patient in need.
“Life is full of cool experiences, maybe its education or love or marriage. All these cool things can happen. To be able to save someone from a heart attack by making these devices available, to give someone a second chance at life – it is so rewarding to see that happen,” Dr. Smart said.