Could a Defibrillator Have Saved Tim Russert?

A nagging question has emerged in the wake of the death of NBC’s Tim Russert. Where was the defibrillator?

NBC News has declined to comment on whether an automated external defibrillator, or A.E.D., was nearby at the time of Mr. Russert’s collapse or why a defibrillator wasn’t immediately used. Cardiac arrest typically is caused by a chaotic heart rhythm called ventricular fibrillation, which can be restored to normal if treated early with electric shock. Many public spaces, including airports, casinos, office buildings and even golf courses, are now equipped with A.E.D.’s, which are the only real hope for surviving a cardiac arrest. An A.E.D., which is about the size of a laptop computer, is a computerized device that analyzes the heart rhythm and prompts even an untrained rescuer to deliver an electrical shock if needed.

Although paramedics carry defibrillators, they typically arrive several minutes or longer after a person collapses, which often is too late to make a difference. Automated defibrillators allow anyone to administer the life-saving shock within minutes after the arrest occurs. Not all abnormal heart rhythms are responsive to the shock treatment.

Survival rates for out-of-hospital cardiac arrest are only 1 percent to 5 percent and usually are predicted by how quickly emergency workers arrive at the scene. But in studies in which defibrillation was applied almost immediately, survival rates have reached as high as 80 percent. With each minute of delay in defibrillation, survival chances drop by about 10 percent. In June 1999, A.E.D.’s were installed throughout Chicago’s O’Hare and Midway Airports so that response time would be about one minute at any location. In the first 10 months, 14 cardiac arrests occurred, and 9 of the 14 victims, or 64 percent, survived.

According to Washington physician Dr. Michael Newman, who was Mr. Russert’s doctor, NBC had a portable defibrillator on site; however, it’s not clear how soon after the collapse it was retrieved. Just as paramedics were arriving, NBC employers were preparing to use it, Dr. Newman said. Instead, the E.M.S. workers took over, defibrillating Mr. Russert three times before his arrival at Sibley Memorial Hospital.

In an interview, Dr. Newman said he did not know the exact amount of time between Mr. Russert’s collapse and the first effort at defibrillation; however, he said it was “significant — more than you would want.”

One of the many lessons from Mr. Russert’s death is that everybody should find out whether their building has a portable defibrillator and where it is located, and then learn how to use it. In the event that someone collapses, the first step is to call 911. If more than one person is present, one should start CPR while someone else quickly retrieves the defibrillator.

A.E.D.’s are surprisingly easy to use. Once they are turned on, a voice gives you detailed instructions on what to do.