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EMT adds AEDs to N.J. charter bus fleet

By Ashley Kindergan
Herald News (Passaic County, NJ)

CLIFTON, N.J. — George Simon was driving a charter bus filled with senior citizens back from Atlantic City several months ago when he heard a shout from the back that a female passenger was having a heart attack.

“The first thing (I thought) was, ‘call 911, get out of the middle of the road, and, what am I going to do until someone gets here?’” said Simon, a driver for Carefree Bus Tours Inc.

The heart attack was a false alarm ? a passenger misheard the woman’s complaints about her bad back, Simon said. Still, the incident opened Simon’s eyes about how helpless he would be if a passenger had a heart attack on his watch.

But Simon and other Carefree drivers won’t have to panic if similar situations arise in the future. Paul Lenoir, owner of the Clifton-based company, has installed automated external defibrillators on four of his 12 buses, and has ordered devices for the whole fleet. Twenty-one of Lenoir’s 35 drivers have undergone voluntary training to operate the devices and perform CPR, and the rest will be trained in a second session, Lenoir said.

"(Older passengers) may feel more comfortable on a bus with a defibrillator,” Lenoir said. “They’re life savers.”

Defibrillators are devices that gauge whether or not a heart attack victim’s heart rhythm has become irregular, a potentially fatal condition known as ventricular fibrillation. If it has, the device emits an electrical shock that stuns the heart, which often results in the return to a regular rhythm.

Defibrillators have become more popular in recent years and are increasingly common in public places such as school sports fields, shopping malls and airports. Clinical studies have shown that the most important factor in whether a heart attack victim survives or not is the amount of time before they are defibrillated, according to William H. Maisel, a Harvard Medical School researcher and co-author of a recent study on the devices.

Despite their popularity, Lenoir, who has been in the bus business since 1969, may be one of the first of his New Jersey peers to add the devices to buses. Lenoir’s fleet makes daily trips to Atlantic City and New York City, and also runs charter groups to casinos and other destinations along the East Coast. Many passengers are elderly, especially on buses that run daily to Atlantic City, he said.

NJ Transit added 65 defibrillators to major bus and rail stations, as well as NJ Transit police cruisers, but not to buses, said spokesman Dan Stessel. NJ Transit is starting to add the devices to trains, Stessel added. Thomas Dugan, president of the Greater New Jersey Motorcoach Association and owner of Safety Bus in Pennsauken, said he has not heard of any bus companies apart from Carefree installing defibrillators in their fleets.

Lenoir, a volunteer emergency medical technician in his hometown of Lincoln Park, started thinking about adding the devices in 2001. That year, Lenoir got a call while on volunteer duty to a Lincoln Park apartment, where a man in his 60s was lying unconscious and in cardiac arrest. Lenoir, who had been trained in defibrillator use, utilized the device for the first time to resuscitate the man, a feat for which Lenoir was later honored by the American Heart Association.

Though Lenoir started thinking about installing the devices after that, he acted only recently, spurred by the more frequent mention of defibrillators in the news, the growing presence of the devices in public locations and falling prices. Devices that cost about $3,500 when he first weighed costs in 2001 now cost about $1,400, he said.

Lenoir knows the devices aren’t perfect, as a new study by Maisel and fellow researcher Jignesh S. Shah hints. There have been 52 recalls and safety alerts of automated external defibrillators and their associated parts from the U.S. Food and Drug Administration in the last 10 years, the study found. During the same time period, 21.2 percent of all automated external defibrillators distributed in the United States were recalled, and malfunctioning defibrillators were associated with 370 deaths.

But researchers say lives saved by defibrillators far outweigh any risk of malfunction. The results of the study, they say, should spur the Food and Drug Administration and manufacturers to come up with a better way of notifying those who buy defibrillators when a device has been recalled or a safety advisory issued.

“This study should do nothing to dissuade someone from purchasing an AED if they were intending to purchase one,” Maisel said. “There are many more lives saved by these devices than there are device malfunctions .... What they should not do is install them and think they’re done. They should install them and check up on them intermittently. They can contact their manufacturer once a year to make sure their device has not been affected by an advisory.”

Lenoir’s wife, Marge, who also works for Carefree, read about the Harvard study this week, but said she and Paul still feel good about the company’s decision to install the devices.

“There are thousands of lives that they’ve saved,” Marge Lenoir said. “They said there were only 370 deaths.”