City Program Saves Life of St. Luke's Patient

A patient at St. Luke's Episcopal Hospital - 50-year-old Katy resident Michael McGaughey - was the first to have benefited from a new city of Houston program that has put automated external defibrillators in city buildings.

Several city of Houston employees contributed to saving the life of McGaughey, who was a METRO passenger when he suffered a recent cardiac arrest on a commuter bus during rush hour. An automated external defibrillator, installed in the lobby of the Bob Lanier Public Works Building at 611 Walker, was instrumental in reviving McGaughey.

Purchased by the Public Works & Engineering Department, the defibrillator was one of 49 that the Building Services Department installed in various city buildings. Another 59 are currently being installed in four Houston-area airports as part of Houston's Automated External Defibrillator Program, an initiative of Mayor Lee P. Brown.

"The idea is to place enough of these devices in public buildings so that the walk to retrieve an AED will be no more than 90 seconds," said Mayor Brown. "I cannot express how gratifying it is to see that the plan has worked and that a life has been saved."

Keith Jones, a bus operator under contract to METRO, stopped his bus and flagged down Houston Police Officer Joy Smith at the intersection of Louisiana and Walker. Several passengers carried McGaughey, who was unconscious at the time, from the bus, and Officer Smith began performing CPR. McGaughey was regaining an intermittent pulse when another city employee, Caroline Ordener of the Planning & Development Department, approached. Ordener, who participated in the Houston Fire Department's AED/CPR training last year, went inside 611 Walker to retrieve a defibrillator. HPD Officer Mark Caronna, who was working in the 611 Walker lobby, offered to attend to the passenger while Ordener called 9-1-1. When she returned to the scene, Caronna had administered defibrillation, and the passenger's flesh tone was returning. HFD firefighters soon arrived and stabilized McGaughey, who was then taken to St. Luke's Episcopal Hospital.

"With cardiac arrest patients like this, two minutes can make a big difference," said Dr. Sayed Feghali, medical director of the Coronary Care Unit at St. Luke's Episcopal Hospital, home of the Texas Heart® Institute. "Mr. McGaughey is now being treated for aspiration pneumonia that resulted from his cardiac arrest, but he is fully alert and resting comfortably. The early and effective treatment of ventricular fibrillation undoubtedly saved his life and protected his brain from irreversible injury."

Dr. Feghali said nearly 1.5 million people a year in the United States have a heart attack or an acute myocardial infarction, or AMI.

"Despite impressive strides in the management of AMIs, it is still a fatal event in one-third of patients. About 50 percent of AMI deaths occur within the first hour of the event, before the individual can make it to a hospital, and are attributable to ventricular fibrillation, a severe derangement in the heart beat that leads to death within 3 minutes unless it's quickly corrected by electric defibrillation," Dr. Feghali said.

A defibrillator delivers an electric shock to the heart, restoring, in many cases, a more stable cardiac rhythm. An analysis of several studies has shown that survival from out-of-hospital cardiac arrest due to ventricular fibrillation decreases 10 percent for each minute defibrillation is delayed.

"Certainly, the AED installation and training has paid off precisely in the way we expected," said building services department director Monique McGilbra. "We knew that by installing them in city buildings, lives would be saved. But the real issue here is that there were people present that day who were trained in their usage."

AED/CPR training of city employees remains an ongoing initiative at the E.B. Cape Training facility, as does AED installation citywide. In April, Mayor Brown signed the Administrative Procedure for the Automated External Defibrillator Program, which is applicable to all city departments and divisions, as well as city-owned or leased buildings and facilities. At the U.S. Conference of Mayors meeting in Detroit recently, the U.S. Mayor newspaper featured Houston's AED Program as a "Best Practice."

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©2006 Texas Medical Center

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