NAPLES - When Joseph Crowley became director of facility operations at Artis-Naples, he added three more automatic external defibrillators to the campus of the performing arts center and museum.
"Since 2001, we've had three successful resuscitations," he said. "We are proud of the fact that we take our responsibility to our patrons to another level by being able to provide first response care, including for cardiac arrest or any other event."
On any given day, 25 to 30 employees are on duty who have been trained in cardiopulmonary resuscitation and how to use one of the five automatic external defibrillators (AEDs).
That's music to the ears of Capt. Noemi Fraguela, AED coordinator for Collier County's Emergency Medical Services. Her mission is educating the public about AEDs and adding more names to a registry of people willing to use them.
"The chances of you responding to a cardiac arrest when you are available are slim to none, but if it does happen, it could save someone's life," Fraguela said.
A Scripps Howard News Service analysis showed that after two decades of efforts to expand public access to AEDs, the devices remain hard to find in many communities. So the Daily News checked major public buildings and venues in Southwest Florida, finding Collier County in particular defies the national trend.
Collier takes part in AED Link, a national registry spearheaded by a Boca Raton company, Atrus Inc. The company uses a geo-mapping system to connect 911 dispatchers to AEDs and people willing to use one on someone nearby - within 1,200 feet - if they go into cardiac arrest.
A registry of willing responders is possible because of a state law changed in 2012. State Sen. Garrett Richter and state Rep. Kathleen Passidomo, both of Naples, spearheaded the change to make a registry of willing responders possible.
Before that, 911 operators were prohibited from notifying someone, such as a security guard in a condominium complex, that a cardiac arrest was taking place in the building but there was an AED nearby. Since that legal obstacle was lifted, there have been a couple of instances in which the AED registry has been used but the patients weren't in cardiac arrest, so no shock was given.
"We know the system is working," Fraguela said. "We know the AEDs are being found."
There now are 1,747 AEDs registered in Collier at 772 sites. That includes 600 units in Collier sheriff's deputies' patrol cars.
"Cardiac arrest accounts for less than one percent of our calls, but these calls are some of our most serious calls. A heart has stopped and (a person) is clinically dead," Collier EMS Chief Walter Kopka said.
The county's AED program began in 1999 when Dr. Robert Tober, EMS medical director, and a couple of staff members received 58 donated AEDs.
"We had an AED program before the American Heart Association (did)," Kopka said.
Florida law says state buildings, public schools and nursing homes with a certain number of beds must have AEDs. The law doesn't apply to county or municipal buildings.
But operators of most Collier government buildings, along with many churches, condominium buildings, country clubs and businesses that cater to the public have purchased units and trained employees on how to use them.
"A golf course is a deadly place for an elderly player and it's a remote spot," Kopka said. "I know there are quite a few courses that have AEDs physically located on the golf course. They are available to the golf pros."
Germain Arena in Estero has two AEDS at fixed locations but Estero firefighters are on site at all events to be first responders, said Sammy Wallace, vice president of event programming.
Still, Germain staff members are trained in how to use an AED, with one on each floor.
Lee County doesn't have a county registry system or take part in AED Link. An ordinance that required AED owners to be trained in using it was repealed in July 2008, said Benjamin Abes, deputy chief of EMS.
In Lee, 911 dispatchers tell callers who are reporting a possible cardiac arrest to look around to see if an AED is nearby.
"In time, I feel we will look at a registry system," Abes said.
The Lee County Sheriff's Office is in the process of getting AEDS when new patrol cars are purchased, he said.
"They are rapidly ramping up their vehicles," Abes said.
There are at least 94 AEDs in county government-owned buildings in Lee but there's likely many more that were purchased by the separately elected constitutional officers, such as the Clerk of the Courts, said Rich Beck, director of facilities in Lee.
The county-owned machines are accessible to the public and an alarm goes off when the door to the wall case is opened.
Lee County staff will replace the batteries but the department nearest to an AED is responsible for checking the batteries and pads, Beck said.
That compares with Collier County, where Doug Hendley, chief of security for county government, keeps a spreadsheet of where the 115 AEDs are located in community centers, libraries and other county-owned buildings.
"They are checked monthly by a security employee," Hendley said.
The AEDs automatically run a daily test and if there's a problem, a red light goes on to alert people about it.
The batteries are replaced four years from the manufacturer's date, even though the shelf life is five years, Hendley said. The pads, which have a gel-like substance inside, need to be replaced every two years.
There are six AEDs in the seven-story county administration building on U.S. 41 East, and all but one is accessible to the public, he said. About half of the AEDs in the county administration building are wired to the 911 dispatch center.
In the six-story courthouse building, there are anywhere from two to four AEDs on each floor, depending on if there is a holding cell for an inmate or a bailiff station, sheriff's Lt. Joe Fiola said.
And, although the machines are accessible to the public, he said, there are sheriff's deputies always present when the building is open - in case the AED is needed.