November 24, 2005
Synagogues Weigh Defibrillator Benefits
After spending the week visiting his family in Phoenix, 73-year-old Benjamin Boxerbaum stood at the airport ticket counter awaiting his flight home, when he suddenly collapsed. The paramedics were called, but Boxerbaum died soon after their arrival.
"Even though there's a fire department at the airport, it took the paramedics more than 10 minutes to reach him," said his daughter, Brenda Priddy.
She believes her father's death resulted from sudden cardiac arrest, a condition that claims about 250,000 lives annually.
Priddy began to research the condition and learned that it is frequently caused by ventricular fibrillation, a disturbance in the heart's rhythm. She also discovered that other airports kept portable defibrillators -- devices that can shock a heart back into normal rhythm -- on hand for just such occasions. Priddy began a public awareness campaign to place them in Phoenix's Sky Harbor Airport and other public locations. Her son, Zach, even took up the cause and raised $2,500 to purchase a unit for the family's synagogue as his bar mitzvah project.
In the five years since Priddy's father passed away, portable defibrillators (also called automated external defibrillators) have become increasingly common in public venues. A federal Good Samaritan law protects those who purchase or use the defibrillators from liability, and recommends that the devices be placed in federal buildings. Given that synagogues, Jewish schools and cultural centers can draw hundreds or even thousands of visitors, some institutions are eagerly embracing this technology.
The Union for Reform Judaism discusses defibrillators on its Web site, and provides a series of steps for congregations to consider when setting up a program. The Orthodox Union recommends that all synagogues equip themselves with a portable defibrillator.
Rabbi Aaron Tendler of Shaarey Tzedek said several congregants have specifically asked him whether the synagogue has an automated external defibrillator, which it does. Tendler notes that his congregation includes elderly members with heart conditions, and says it gives him "a sense of confidence in knowing that [the device] is there."
Some synagogues have been deterred by the $2,000 to $3,000 investment required to purchase such a device. To address this issue, United Synagogue of Conservative Judaism's (USCJ) business services department has partnered with a manufacturer to provide the devices and training at a discounted rate.
"We're just beginning to market to congregations," said Aliza Goland of the Conservative movement's Pacific Southwest region.
Sinai Temple has two defibrillators, which were purchased before the USCJ program went into effect.
"With 1,000 people present every Saturday and children and staff here almost daily, we felt it was imperative to have one," executive director Howard Lesner said.
When it comes to restoring heart rhythm after cardiac arrest, "time is of the essence," said Dr. P.K. Shah, director of cardiology at Cedars-Sinai Medical Center. "Each minute that goes by without the restoration of normal circulation equals a 10 percent chance of irreversible brain damage."
Revival within four minutes gives the best chance of survival, and few resuscitation attempts succeed after 10 minutes have elapsed. Since it takes seven to eight minutes on average for emergency medical personnel to arrive, the devices enable trained bystanders to deliver defibrillation during the critical period before the paramedics arrive.
Portable defibrillators are designed for ease of use and prompt the user through each step. The user places pads on the victim's chest. If the machine determines that a shock is needed, it prompts the user to press a button, which delivers the shock. The device will not deliver a shock if it is not needed.
A study published last year in the New England Journal of Medicine found that survival rates were twice as high in locations where participants were trained both in cardio-pulmonary resuscitation (CPR) and defibrillator use rather than CPR alone. The researchers concluded that widespread implementation of public defibrillator programs could save between 2,000 and 4,000 lives each year.
However, to be included in the study, participating facilities needed to have the equivalent of at least 250 adults over the age of 50 present during waking hours (16 hours per day). Few Jewish institutions would reach such a threshold.
Out of 20 local Jewish institutions with sizable constituencies polled by The Jewish Journal, nine had a portable defibrillator on site: B'nai David-Judea, Leo Baeck Temple, the New Jewish Community Center at Milken, Shaarey Zedek, Sinai Temple, Stephen S. Wise Temple, Temple Beth Am, Valley Beth Shalom and Wilshire Boulevard Temple. Others said they were considering a portable defibrillator or planned to purchase one in the near future. Only one synagogue has had occasion to deploy its defibrillator. The patient survived, and the synagogue's spokesperson was not certain whether or not shock needed to be administered.
Approximately 80 percent of out-of-hospital cardiac arrests occur not in public locations but in the home. Nevertheless, Cedars-Sinai's Shah believes that the remaining 20 percent constitute a sufficient number to justify placing the devices in synagogues and other gathering places.
And Priddy, whose father suffered cardiac arrest at the Phoenix airport, believes they are a worthy investment. The devices, she said, can "give someone back their life and give families back their loved one."