LOUISVILLE, Ky. The near deaths -- and miraculous saves -- of two athletes at the National Senior Games has focused attention on what cities do to protect people who gather in large numbers.
The city of Louisville and the organizers of the "senior Olympics" decided to pool public and private resources to be ready in case any of the 30,000 spectators or 12,000 athletes (who range from 50 to more than 100 years old) suffered a cardiac arrest.
Sudden cardiac arrest is a leading killer of Americans, but it is often reversible if treated immediately with cardiopulmonary resuscitation (CPR) and a shock from an automated external defibrillator (AED). Some cities in the USA save four times as many cardiac-arrest patients as other cities, USA TODAY has found, by focusing on emergency response.
The lives saved in Louisville speak to a larger question about whether cities should require AEDs at large public gatherings.
So far at the games, which end July 7, two men had cardiac arrests. Louisville's response was tested.
Norman Meyer, 64, of Lancaster, Pa., watched his jump shot go through the hoop during a basketball competition Monday night, and then his heart stopped.
John Bates, 62, of Townsend, Tenn., was practicing with his wife for their doubles tennis match when his heart stopped.
Both received a rapid shock from a defibrillator and swift care from Louisville EMS medics who were standing by. Both are recovering at Norton Audubon Hospital.
"I'm lucky to be here," Meyer says. "If what happened (had) happened anyplace else, I probably wouldn't be alive today."
Adds Bates: "I hate to be the guy who tested the system, but I'm glad the system worked."
Bates' wife, Janice Sullivan, is glad the city helped her husband.
They met on a tennis court in Richmond, Va. When they were married in 1984, they and their entire wedding party donned 1920s tennis gear and held a Wimbledon-style reception. She is grateful she didn't lose him on a tennis court.
Others across the nation have watched family members die in crowded venues. Widows, mothers and others are pushing cities to require better preparedness.
Easy-to-use AEDs are increasingly common in places where large numbers of people gather, such as airports. They are also standard equipment at many gyms.
Some cities, such as Dallas, New Orleans, Philadelphia, and Richmond, Va., require the extra layer of protection at large gatherings. But many do not require it.
"The city of Tucson expects organizers of large gatherings to arrange for necessary EMS coverage, not for the city to subsidize it," says Terry Valenzuela, medical director of the Tucson Fire Department.
Organizers of the senior games thought it made perfect sense to have AEDs on hand at all of the 13 venues across a 3-mile radius where athletes would compete.
"Safety and emergency medical services are one of the primary concerns," says Kate Killian, a spokeswoman for the games.
Louisville EMS adjusted schedules, postponed training and worked with hospitals to avoid emergency room diversions so that ambulances could remain available, says EMS director Neal Richmond.
Meeting the extra demand poses a challenge for big-city EMS agencies already struggling to get to daily emergencies quickly. "This system is working on the edge every day," Richmond says.
In California, Bobbi Cohen spreads the word about the need to protect people at large gatherings. Her husband, Stuart, 68, died on their daughter's wedding day. The Cohens were dancing at their daughter's reception Nov. 23, 2002, in La Jolla, Calif., when he said, "It doesn't get much better than this."
Moments later he had a cardiac arrest. Doctors who were attending the wedding reception at a local hotel, according to court records in a lawsuit she filed, performed CPR, but the hotel did not have an AED.
Though the city makes medical coverage recommendations for big events like the Super Bowl, they are not enforceable, says James Dunford, San Diego's EMS medical director. He says 43 lives have been saved over the past five years by San Diego's Project Heartbeat, which puts AEDs in public areas.
Bobbi Cohen wants San Diego to require sponsors of large gatherings to at least consider having AEDs. "The AED is such a lifesaver," she says. "It doesn't make sense that there are venues that are unwilling to have them on the premises."