NASHVILLE, Tenn. The Tennessee Motor Coach Association has helped kill a bill that would have required motorcoaches based in the state to have an automated electronic defibrillator on board the bus at all times.

The proposed legislation, contained in state Senate and House bills, was being considered by committees of both chambers when the association learned of the measure and mobilized its members to swing into action.

"Due to the quick action of many of our members who wrote letters, and faxed and phoned their elected officials, the bill was deferred to July 4, 2009, which kills the bill since the legislature is not in session during that time," said Tennessee Motor Coach Association Executive Director Deborah Neese.

"Will this bill be reintroduced in the future? We do not know. But the Tennessee Motor Coach Association plans to be on watch and well prepared to fight again," said Neese.

The associations opposition to the bill was based on the strong belief that having heart defibrillators on motorcoaches was impractical and inadvisable for a wide range of reasons.

"Defibrillators work well in the hands of professional medical personnel who have been trained to handle situations, but what about drivers or the general public?" asked Neese. "Would the use of a defibrillator onboard a motorcoach be feasible or even practical? Plus, the use of the device would certainly be difficult."

According to the American Heart Association, an individual has 4-6 minutes to use a defibrillator before death or brain death starts to occur after someone experiences cardiac arrest. A victims chances of survival are reduced by 7 to 10 percent with every minute that passes without CPR or defibrillation. Few attempts at resuscitation succeed after 10 minutes.

"Knowing that, now think about being on board a motorcoach," says Neese. "If the driver was alerted at the moment the persons heart stopped, he or she would have to get his coach safely to a stop, which could take several minutes depending on where the coach was traveling at the time, get out of his or her seatbelt and get to the defibrillator, which for liability sake should be in a locked area, call 911 and give them the coach location and situation, make his or her way down the aisle to the person, open their clothing and hook up the device and wait for the instructions on what to do from the automated electronic defibrillator unit.

"In the best of circumstances all of that would take quite a bit of time," said Neese.

"Would it be in the 4- to 6-minute window? Can CPR be done effectively onboard a motorcoach? Can CPR be done with the person in the upright position? The aisle on a coach is only 15 inches wide. Could you get an unresponsive person down in the aisle?

"Even with training, would a driver be able to handle this situation and would he or she be willing to take on that responsibility, or would they just find another job? Have there been that many heart-related occurrences onboard motorcoaches in Tennessee? Would defibrillators make any difference?" she asked.

Those are just some of the questions the associations posed to legislators in opposing the legislation. There were others:

How about the liability of the driver and motorcoach company?

The Good Samaritan Act is supposed to cover this type of situation. But will it? What if another vehicle struck the motorcoach while the driver was attempting to use an automated electronic defibrillator device and others were hurt or killed? Would the driver and the company be held liable?

What about the expense? The devices cost around $1,000 per unit, plus each companys employees would have to be training.

What about additional liability coverage on the companys insurance policies?

Gray Line of Nashville estimates the proposed law would cost it more than $100,000. With the rising cost of insurance and fuel, could motorcoach operators in Tennessee afford another financial burden?

Neese noted that a recent article in the New England Journal of Medicine reported that American Heart Association figures show that 80 percent of all heart attacks occur in the home, but that home access to an automated electronic defibrillator had not significantly improved overall survival, when compared with reliance on conventional resuscitation methods (CPR).