Since then, Los Angeles has taken steps to become a national model in expanding access to AEDs. In November 2022, its City Council commissioned a report on the availability of these life-saving devices, and just recently the council set aside $350,000 as part of a 10-year, $1.5 million plan to equip all of L.A.’s public parks with AEDs. “There’s no telling how many lives this could save,” Council President Paul Krekorian told me. “Given the impact it will have, this is one of the most cost-effective steps we could possibly take to protect the lives and health of our people.”
But this progress shouldn’t stop in Los Angeles. Avoidable tragedies can — and should — be prevented across the country.
My dad’s cardiac arrest was no anomaly. Although he did have a history of heart issues before he collapsed at the park, the recent cardiac arrests of professional athletes such as college basketball star Bronny James and Buffalo Bills safety Damar Hamlin show that anybody’s heart can stop at any time. The National Institutes of Health (NIH) has reported that about half of victims don’t even know that they have heart problems before they experience cardiac arrest.
That’s a lethal silence, considering that more than 356,000 Americans have a cardiac arrest outside of a hospital setting every year. It’s hard to pinpoint an exact survival rate, but the NIH estimates that 90 percent of victims die before they can even reach the hospital. For context, that’s just under the Centers for Disease Control and Prevention’s estimate of COVID-19 deaths in 2020, the first year of the pandemic.
In the long term, preventive treatment is the best strategy to reduce these needless deaths. Better heart disease screening and more funding for research on cures for underlying conditions such as cardiomyopathy and coronary artery disease could reduce risk of cardiac arrest. But short of complementary game-changing new heart drugs or a massive shift in the American diet and exercise habits, it would take years, if not decades, for such large-scale treatment reforms to bear fruit. We don’t have that much time: Cardiac arrest is a public health crisis and merits immediate attention.
The data points in one direction. Expanding public access to automated external defibrillators would save thousands of lives a year.
Research in Circulation, the leading international journal on cardiovascular health, found that 66.5 percent of cardiac arrest victims who receive an electrical shock from an AED do survive and go on to be discharged from the hospital, compared with only 43 percent who aren’t shocked. Moreover, 57.1 percent of victims who are shocked retain near-normal levels of physical and cognitive function, compared with 32.7 percent of those who aren’t shocked.
Just under a quarter of out-of-hospital cardiac arrests occur in public settings such as parks, trains and shopping malls. That’s about 85,440 stopped hearts every year. Another 10 percent happen in nursing homes, where AEDs are similarly “not standard” despite the elevated risk of cardiac arrest that elderly people face. And while 911 paramedics rush to incident scenes with defibrillators, every minute that goes by before a cardiac arrest victim is defibrillated represents a 10 percent drop in the survival rate.
The good news is that bystanders can act to save a victim’s life when they have the proper equipment. Studies have shown that children as young as 11 can operate AEDs without prior instruction, and all 50 states have “Good Samaritan” laws that protect well-intentioned bystanders from legal liability if something goes wrong.
Yet there are few federal laws mandating AED accessibility in public places. Older federal regulations have made limited improvements, such as requiring that AEDs be present in all federal buildings. But the Access to AEDs Act, which would issue grants for defibrillator implementation in schools, has stalled since its introduction by a bipartisan group of U.S. senators last March. Its companion bill in the House, the HEARTS Act, has likewise been held up in committee since May.
So how should we move forward? Instead of waiting on Washington, state and local jurisdictions across the country need to take the initiative. Some big changes require the federal government’s heft to pull off; this is not one of them. Some states, including California, have already taken the lead on requiring high-risk locations like public pools and gyms to maintain AEDs. And, most recently, the Los Angeles City Council’s action shows that AED implementation and maintenance is affordable and feasible.
These are small victories, but they need not be isolated. State and local leaders can help many people, at low cost and without stirring up partisan sentiment or engaging in a culture war. If they did, more Americans would have stories with the happy ending that mine has.
Michael Isayan is a high school student in Los Angeles.
Governing’s opinion columns reflect the views of their authors and not necessarily those of Governing’s editors or management.
