If it were up to Sam Patterson, automated external defibrillators would someday be as commonly available in public buildings and workplaces as fire extinguishers and first aid kits are now.

It’s the AED success stories he hears week after week that keep Patterson, the training center coordinator for the Mercy School of Emergency Medical Services, pushing for more placement of the devices by organizations throughout Central Iowa.

The portable electronic devices, which sell for about $2,100, will guide a user through the procedures necessary to evaluate the heart rhythm of a sudden cardiac arrest victim and automatically deliver a shock if it’s needed to restore a normal heartbeat.

With the likelihood of survival diminished by about 10 percent for every minute that passes once the heart stops, the devices, combined with cardiopulmonary resuscitation, can buy time or even save a life before paramedics arrive.

However, opinions differ whether a statewide registry of AED locations, which is currently not required in Iowa, should be mandated by the Legislature. Though a registry would arguably result in more lives saved by allowing an emergency dispatcher to alert a first responder that an AED is available, others say that registration requirements might deter businesses from installing the devices.

“We would really like to see an official registry that pops up with a dispatcher, rather than waiting for the EMS to arrive, because it’s time lost,” said Shannon Rudolph, community heart and stroke director for the American Heart Association’s Heartland Affiliate in Des Moines. “For every minute lost, the chances of recovery go down 10 percent, so we want to see people defibrillated in three to five minutes, tops.”

Patterson, who chairs a coalition known as the Iowa Defibrillation Education Advocates, said creating a registry would be expensive and might not work well for all 911 dispatch centers, which have various levels of technical capabilities.

“There are bigger issues than just requiring those who have them to register,” he said. “It’s possible to have people use them effectively without having to harp on them about regulations.” One of the most important aspects, he said, is that those using AEDs have adequate training on how to use them, that programs are in place so each organization has a liaison with its local EMS department , and that there are procedures for continued training and maintenance of the devices.

AEDs have become commonplace enough in public places ranging from malls, schools, office complexes, churches and clinics that several Greater Des Moines EMS schools offer public classes on how to use them, and are assisting organizations in establishing public access defibrillator programs.

“We’ll go out for free for a site visit and recommend how many (AEDs) they should have,” Patterson said. “We’re fairly active in getting the information out to the community. It’s not just about putting a machine up on the wall; that’s not a program. It’s people who save lives.”

At the West Des Moines headquarters of FBL Financial Group Inc., 34 employees are trained to use the two AEDs available in the complex, where about 1,200 people work. The company established its program in January 1999.

“We’ve been lucky,” said Kathy Baldwin, FBL’s employee health services coordinator. “We have not had to use it. But it is available.”

The company conducts quarterly training exercises for the employees who volunteer for the program, using a non-shocking trainer AED from the West Des Moines EMS department. “We try to come up with different scenarios and locations,” Baldwin said. “We talk through the scenario and practice using the trainer.”

The program meshes well with a medic/first aid course FBL offers internally for its employees, she said. About 65 workers have taken that program.

Central Iowa businesses are becoming much more aware of AEDs, said Rob Schweers, a spokesman for the Iowa Heart Center, which has assisted companies in buying AEDs at discounted prices. Schweers estimates there are probably at least 1,100 AEDs in place throughout Central Iowa.

“We really don’t have to advertise the service; we get enough people calling us,” said Schweers, who attributed the widespread awareness in large part to media coverage. “In the four years since we started, we don’t have to talk to people anymore about what an AED is and what it does. Now it’s, ‘Yes, we want one,’ and ‘How soon can we get one?’”

The city of West Des Moines was an early leader in establishing public access defibrillator programs at businesses. Beginning with just 10 companies in 1999, the city’s EMS department now has 105 AEDs registered at 74 businesses. Last year the city’s EMS officials trained more than 1,400 volunteers, including about 650 Valley High School sophomores, on how to use the devices.

“AEDs are becoming so prevalent, we think it’s important to include it in each of our (CPR) classes,” said Brian Helland, West Des Moines’ deputy chief for emergency medical services.

Last year, the West Des Moines EMS crews responded to 33 cardiac arrest calls, two of which involved the use of AEDs in public buildings by a volunteer. Of those two cases, one person survived and fully recovered.

“Somewhere between 80 and 90 percent of people who go into cardiac arrest go into ventricular fibrillation,” Helland said. “The remainder may not be in a shockable rhythm. Those latter cases have a less than 1 percent chance of survival.”

EMS crews are one of the ways that word about AEDs is getting out to businesses, Helland said.

“If one of our crews runs a call at a business where they think an AED may be beneficial, I’ll make a visit,” he said. “Also, we’ve had tremendous growth by word of mouth. We also try to target businesses that may be difficult for us to get to in a short amount of time. Insurance companies, for instance, have increased their security for privacy reasons and so it takes more time for us to get through that. Marsh, for instance, has AEDs on each floor for that reason.”

From the perspective of an emergency room physician, “it’s just very important that these devices are in public places,” said Dr. Larry Baker, director of the emergency departments of Iowa Methodist Medical Center and Iowa Lutheran Hospital. “If an individual goes down with a heart-related incident, this is by far the most effective process, far better than just doing CPR.”

Though it’s not very common for the emergency room to receive someone who has had an AED shock administered, “when you do see them, they’re saved,” he said.

For more information about AEDs or to get started on developing an AED program, contact Shannon Rudolph at the American Heart Association, 244-3278, or e-mail her at shannon.rudolph@heart.org.