Casinos cut response time with new lifesaving device

Joseph Secco and his wife were dancing in the Stardust hotel-casino lounge when the first signs of a cardiac arrest suddenly gripped his chest.

The 72-year-old Secco came off the dance floor and instead of going back to his seat, he headed toward the bar and plopped down listlessly in a chair.

Within seconds, he was unconscious.

Luckily, Stardust security guards had been trained in the use of a revolutionary new lifesaving device -- the Automated External Defibrillator.

The portable AED device, about the size of a Las Vegas phone book, emits a high-voltage electrical charge via two electrodes that are attached to the chest. It's designed to shock the heart into resetting itself so it beats normally.

Time is of the essence during a cardiac arrest. The heart is merely quivering meaning blood is not being pumped to the brain or other vital organs.

The only way to reset the heart is with a defibrillator. CPR is an artificial method to prolong life, and at best is a temporary crutch until the paramedics arrive with a defibrillator.

"After three minutes of CPR, the mortality rate begins dropping off by every minute," said Dr. Keith Boman, a local cardiologist instrumental in bringing AEDs to Clark County. "You can't restart a heart after 10 minutes."

Boman said paramedics usually take from four to five minutes to arrive at the scene under the best scenario. Take into account time eaten up trying to locate a cardiac-arrest victim and in setting up the defibrillator and you're looking at on average eight minutes before a charge is emitted.

"Under the best of circumstance, this is just not fast enough," Boman said. "At Boyd (Gaming Corp. that owns the Stardust), our goal is to have trained security guards there within two minutes."

Secco survived his Aug. 16, 1997, attack. Today he has a tiny defibrillator permanently embedded in his chest. He thinks all facilities, where large groups of people assemble, should have personnel trained in the use of AEDs.

"I'm extremely fortunate, and I feel extremely lucky," Secco said in a soft and grateful voice. "I got a second chance. How can you put a price on treatment like this? There is no price. I could have been a statistic."

Since Boyd Gaming pioneered the use of AEDs by its security guards at all its properties in 1996, nearly 30 other casinos in Las Vegas and Laughlin have joined the program, Boman said. Several small businesses, including Pat Clark Pontiac, also have invested in AEDs.

The Clark County Fire Department, in collaboration with the American Medical Response Ambulance service, provides free training. The AEDs, which are manufactured by a handful of companies, cost from $3,000 to $3,500 per unit.

After nearly a year in use, AEDs appear to have made a difference in saving people's lives in Clark County.

Jon Graff, research officer at American Medical Response, said the units have so far been used on 35 cardiac-arrest victims in casinos in Las Vegas and Laughlin. Of those, 22 made it to the hospital and 16 survived.

Graff said that's a 45 percent survival rate, which is more than twice the overall survival rate in casinos since he began keeping statistics in 1993.

"The application of electricity can make all the difference in the world," Graff said. "All office buildings, airports and sporting arenas are potential locations AEDs should be used. In West Virginia, they're even used in the school system."

Boman agrees. He's surprised that some casinos still haven't asked to get involved in the program. He also would like to see certain McCarran International Airport personnel trained in using AEDs.

Aside from the initial cost per AED and a couple hours off to train people, Boman doesn't understand why casinos and other large facilities where people gather don't have AEDs available.

The 1997 Legislature passed Assembly Bill 147, the "Good Samaritan" law, that protects security officers trained in the use of AEDs from being held liable.

Dave Austin, vice president of security at the MGM Grand hotel-casino, has had all of his security guards -- 265 full-time and 45 part-time employees -- trained in the use of AEDs. Since the program's inception in September 1997, two cardiac-arrest victims have been saved at the hotel.

"It's real simple," Austin said. "You just open the lid (of the AED) and place the electrodes on. It (a voice command) tells you when to shock or do CPR."

The MGM has installed nine units at various locations throughout the casino, conference center and near guest rooms.

"I tell my security guards to take an AED on every call, even a cut finger," Austin said. "You just don't know."

Each AED, no matter what model, will not administer a shock unless the heart is fibrillating. It's internal computer analyzes the heart for any abnormality.

"The AED is 99.9 percent infallible," a confident Boman said. "It's better than I am.

"I think Las Vegas is on the cutting edge of the world. Credit should go to the Clark County Fire Department and everyone else involved. All the eyes of the world are on Las Vegas now. Large factories need to have these. They're already on airplanes of the CEOs of those factories."

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