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Employment
Study sees optimism in hiring this year

Executives and managers are a lot more optimistic about hiring this year, reports the American Management Association. In a study of 376 respondents, the AMA found that 38 percent of managers and executives anticipate that their company's domestic work force will increase this year.

By contrast, 22 percent expect to have fewer employees. Forty percent said they expected their work forces to remain the same, with no scheduled increases planned for the year.

The survey, conducted in November and December 2002, found that 90 percent expect their companies to offer pay increases, 69 percent said their firms will promote some staff members, and 68 percent are expecting bonuses this year.

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Forty-four percent expect to downsize because of restructuring; 40 percent said reduced demand for their services could lead to layoffs this year. Other reasons for possible layoffs: better utilization of staff (39 percent), re-engineering of business processes (31 percent), automation of new technology (22 percent), outsourcing or contracting (20 percent), and transfer of work to other localities (13 percent).

DIANE E. LEWIS

Workplace
Portable defibrillator has powerful friends

A human heart can stop beating anytime and anywhere - even at work.

That thought probably occurred to Senate Majority Leader Bill Frist, a Tennessee Republican. According to news reports, he keeps a defibrillator in his office.

The portable defibrillator, which is a little smaller than a laptop computer, delivers a jolt or shock to the heart that helps to revive it. Frist, the country's only senator-doctor, knows the importance of the machine firsthand: He's used a defibrillator to revive tourists whose hearts stopped while visiting Capitol Hill.

Last year, Frist and Senator Edward M. Kennedy, a Massachusetts Democrat, sponsored new legislation that provides $55 million in financial aid to help cities and towns purchase automated external defibrillators, or AEDs.

Passed last year and signed into law, the legislation allows communities to use some of the money to train lay people to use AEDs.

Nationwide, 250,000 people die from sudden cardiac arrest each year in the United States, according to the American Heart Association in Boston.

''Right now, the survival rate for someone suffering sudden cardiac arrest outside a hospital is only about 5 percent,'' said Heather Maloney, the association's director of communications. ''We estimate that about 50,000 more lives could be saved per year if that survival rate was brought up to 20 percent and the portable defibrillator could make a huge difference. If a person is defibrillated within two to three minutes, he or she is more likely to live.''

Asked whether all workplaces should have an AED, Maloney said: ''Absolutely!''

''We have advocated the placement of defibrillators in places where people routinely congregate such as airports, sports stadiums, arenas, civic centers, government buildings and court houses,'' added Maloney. ''They really are life-saving devices.''

She said companies with large offices in downtown skyscrapers are a real concern because traffic snarls can prevent ambulances from arriving on time, and some workers may be located on upper floors that cannot be accessed quickly. ''If security personnel are trained to use AEDs and can get to the person quickly, it could greatly increase the victim's change of survival,'' she said.

Some employers have gotten the message. Phil Orlandella, director of media relations at Logan International Airport, said the portable devices have been installed in each of five rescue vehicles at the airport. Three are also available in Massachusetts State Police vehicles at Logan.

''We are looking into the possibility of having them located in the terminals as well,'' said Orlandella. ''I can personally say that since we've had portable defibrillators, the rate of reviving people has been higher.''

One device, the HeartStart OnSite defibrillator manufactured by Philips Medical Systems, employs technology that senses the user's behavior and then adapts its voice instructions to the user's actions. The manufacturer's suggested price? It's $2,295, according to a company spokesman.

Several employers have purchased the HeartStart OnSite defibrillator. They include American Airlines, Chicago's O'Hare International Airport, Delta Airlines, Raytheon, Princess Cruises, and a number of Massachusetts communities, the company said.

Dr. Jeremy Ruskin, director of the Cardiac Arrhythmia Service at Massachusetts General Hospital, says just about anyone can use an AED to save a life.

''With the new defibrillators, the requirements are truly minimal,'' he said. ''The individual does not have to be trained or an expert to use it, but simply able to read and follow simple directions. The devices are easy to use, highly accurate and reliable.''

Dr. Daniel Fisher, a cardiologist at New York University Medical Center, described the device as so sophisticated it can differentiate between a seizure and cardiac arrest.

''It is programmed to recognize dangerous heart rhythms,'' said Fisher. ''If it senses that the rhythm is dangerously fast, the defibrillator shocks the heart to end the rhythm'' and slow it down.

He noted that two conditions can cause irregular heartbeats. The conditions are ventricular fibrillation and ventricular tachycardia, and both involve the ventricles of the heart. The ventricles are chambers of the heart that receive blood and pump it into the arteries.

Ventricular fibrillation occurs when the ventricles ''start to squeeze rapidly like a bag of worms,'' noted Fisher. Ventricular tachycardia is a fast heart beat that also originates in the ventricle but is not irregular, he said.

Ruskin said cardiac arrhythmia, the term for any irregularity of the heart rhythm, is the single most common cause of death among adults males in the western world.

''Sudden cardiac deaths occur most commonly in people with a preexisting (heart) disease,'' he said. ''In about a third of the patients who die suddenly, cardiac arrest was the first manifestation of their heart disease. In that situation, the only hope of saving the life is to be able to defibrillate onsite and that must be done in less than four minutes to prevent brain and heart damage.''

That's why Ruskin and Fisher, and the American Heart Association are hoping reports of Frist's use of the device will help spur change and encourage more widespread use of portable defibrillators.

DIANE E. LEWIS

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