By Lindsey Bertomen
"If you can flip a light switch or put on a Band-Aid, you can work this thing." – Chief Stephen Johnson, Rochester (Minn.) Police Department
I tested the Philips HeartStart FRX, an advanced AED, or Automated External Defibrillator. I found that, with the electronic coaching afforded by this product, almost anyone can competently aid a person suffering from sudden cardiac arrest (SCA), including me.
SCA is the leading cause of death in the US. It differs from a heart attack because it is a result of irregular electrical impulses on the heart, not the plumbing. It occurs when the heartbeat becomes rapid or irregular, or sometimes too slow. This condition is called an arrhythmia. Either of these conditions will cause the heart to be unable to pump blood to vital organs and the brain. Without some kind of intervention, patient survival is unlikely. Even some world class athletes have fallen victim to SCA.
SCA survival is measured in seconds, not minutes. The quicker the response, the the better the treatment. This is the reason why a law enforcement officer is the best user of an AED. Experts agree that the most effective program is wide dissemination of AEDs. A recent study found that strategic placing of AEDs, including patrol cars, triples the survival rate for patients.
The Philips HeartStart AED was designed, using a proprietary algorithm, to deliver the therapeutic shock quickly after chest compressions. Studies have shown that quicker defibrillation after compressions increases the effectiveness of the treatment.
An AED plus CPR is the most appropriate response for SCA because it is truly automated. Once the pads are on and the device is connected, it will analyze the patient, one of the most important features of the AED. In many cases, the "shock" or defibrillator is the necessary element to steer the heart back to its normal rhythm.
When I first received my Philips HeartStart FRX, I wanted to know the answer to the two questions foremost on everyone's mind; will it hold up and can it be used under the stress and confusion of law enforcement service? Yes and Yes. I took the thing out of the box and timed myself without reading the instructions. Within 15 seconds I had it plugged in and the device was delivering clear audible instructions. Everything is guided by simple and minimal illustrations which guide the user toward correct placement.
The Philips HeartStart FRX has a rechargeable battery that only fits one way in the unit. The plug for the pads will only fit one way into the device. The voice prompts are augmented with flashing illustrations that tell the user when to press the correct button and which button to press.
The unit tells the user to stay clear of the patient when the shock needs to be delivered. It disables the ability to shock when the shock is not needed. In other words, using the device is a no-brainer.
The Philips HeartStart FRX also has an optional training pad kit, which looks and operates exactly like the real thing, without the corrective shock. When one plugs the training pads in, the unit acknowledges them, advising that they are for training. There is a fold out plastic mat with a victim illustration where one can actually place the pads and run through a scenario. I ran through a few scenarios while the unit coached my CPR and told me to back away from the patient while it delivers a shock. If I had to be critical, I would ask for a way to turn the volume down as it was designed to be a clear voice on a battleground, which is much too loud for the classroom.
Jamie Froman, the director of marketing for Philips, explained that the Philips HeartStart FRX is one of three models available within the product line. The HeartStart Home Defibrillator and the HeartStart OnSite (HS1) are also available without a prescription
The HeartStart OnSite (HS1) Defibrillator was designed for use by persons with minimal training. The HeartStart FRX is specifically marketed for officers. The HeartStart FR2+ is marketed for emergency medical professionals. The FRX differs because ruggedness is part of the design. It is designed for its ability to survive being dropped and to resist exposure to water. Philips received design input from officers who stressed ruggedness, simplicity and minimal training.
The Philips HeartStart FRX has only has three buttons and only weighs 3.5 lbs. It is weather-sealed and ruggedized.
I asked Froman what kind of training would be typical for officers using the FRX. He said that officers usually receive about four hours of a CPR AED course, which is usually paired up with a first aid class. These types of classes are usually driven by national organizations like the American Heart Association or the American Red Cross. For police officers, these classes are usually statutory driven. The Philips Heartstart FRX was designed to fit into these programs because it requires minimal training and refreshers.
Froman reiterated that the Philips HeartStart FRX was engineered for hard use. The defibrillator pads are pre-connected, taking some of the guesswork and speed of deployment out of the equation. It performs self tests at regular intervals; daily, weekly, and monthly. It has a pediatric key, which changes the operation to pediatric mode, which reduces the defibrillator output without the need of changing to pediatric pads. It has the ability to coach through the steps of CPR, including compression-only CPR.
I practiced with the training pads, using the pediatric key. The device announces that the key has been inserted and the child illustration overlays the adult one on the lighted case, avoiding any confusion.
One of the other features the FRX has is a wireless data transfer. I asked Jamie about this and he explained that incident history, important to a treating physician, can be sent wirelessly to a Palm or similar device.
I interviewed Deputy Chief Steven Johnson of Rochester, Minnesota, a city 70 minutes south of St. Paul. Rochester has 54 square miles of patrol area with 134 sworn and a staff of 190.
Deputy Chief Johnson explained that Minnesota POST (Peace Officer Standards and Training) has a CPR requirement with no refresher or expiration. Rochester PD provides its own block of training for newly hired officers. Rochester PD has an additional new officer training, which consists of six-and-a-half weeks of office training and other in-house requirements. Some of these requirements emphasized the use of AEDs.
Rochester has the luxury of having The Mayo Clinic (Minnesota Location) in their backyard. Their input encouraged the use of a combined response for medical emergencies, which included equipping responding officers with AEDs. This practice increased the survival statistics astronomically.
Johnson told me that the feedback from officers using their program is outstanding. The Philips AED equipment has been deployed several hundred times. His officers have reported that there is "no better high" then a "save", which includes many where a shock without CPR was administered. Using the Philips AED equipment, Rochester PD has recorded a 100 percent equipment readiness rate.
Johnson related a story about a near drowning in a river in their jurisdiction. Officers responded to both sides of the river, which was impassable in the area. When the victim was pulled from the water, it was on the bank opposite from where the AED was. The easiest way to get it to the team nearest the victim was to throw it. They attached a rope and tossed it across. It hit the rocks on the opposite bank and landed in the water. The Philips AED was retrieved and tossed again. It worked flawlessly, logging another save.
Rochester PD maintains a website about early defibrillation which includes statistics, a map of "saves" in the area and a history of their program (www.policedefib.com). They are the exemplar of integrating public assets to improve survival rates.
Johnson told me they have a regular inspection program, which includes inspecting the batteries once a month. Their agency used to check the batteries daily but this proved unnecessary. Once the monthly check is performed, the unit is sealed in their Pelican Case. The Pelican Case is given an external seal. The unit only needs its routine inspection or if the seal is broken.
The Philips HeartStart FRX is a rugged, uncomplicated tool for the first responder. I found that a person of reasonable intelligence could be in the middle of an emergency and be effective with it. It is something that every patrol car should have. After all, there is no better high than a save.
For more information on the HeartStart FRX, visit http://www.healthcare.philips.com/in/products/resuscitation/products/frx/.