It?s about the size of a small briefcase.

But when it comes to a life or death situation, a handheld defibrillator device can make a huge difference.

And they?re so simple to use, even a ten-year-old has managed to bring a cardiac arrest victim back from the brink using one.

So says cardiac expert Steve Jelfs, who has jetted over to Bermuda to trumpet the benefits of Automated External Defibrillators (AEDs), a subject he reckons should be close to everyone?s heart as the battle against the ?world?s number one killer? rages on.

He raised awareness of AEDs during a presentation yesterday at the Bermuda Red Cross, a charity that helps companies secure the machines while ensuring staff get the right training to use them properly.

More than 100 Bermudians die of heart failure each year; more than half of these deaths are the result of sudden cardiac arrest.

The Red Cross estimates that it has helped put about 45 AED machines on the Island, although the exact number in use in Bermuda remains unclear. This total of 45 includes two at the Airport, alongside others now in place at a host of major private companies.

But more than half of these now need to be replaced and upgraded, it emerged yesterday.

Fortunately, health and safety officials from a dozen organisations were on hand to watch the very latest technology given a trial run.

Before giving the demonstration, Mr. Jelfs, international clinical director with a company called Cardiac Science, told how more than 300,000 people in the US died of cardiac arrests each year.

?It?s the world?s number one killer,? he stated.

Before portable AEDs, which cost about 1,500 UK pounds and deliver an electric shock to re-start the heart, the only way of treating cardiac arrests was to wait for an ambulance or to receive treatment in hospital using equipment located there.

But he warned that a timely response was essential ? with patients suffering a ten percent deterioration in health every minute they had to wait.

?You have to get a defibrillator to them in two, three, four minutes otherwise they will die,? added UK-based Mr. Jelfs, a trained paramedic who worked for the British Red Cross for five years.

He said that if somebody collapsed in the street, their chances of survival would be very low, unless a defibrillator was to hand.

A wait of ten minutes for an ambulance leads to an average survival rate of ten percent.

However, a wait of about three minutes for a defibrillator in a public place, like a mall or an airport, led to an average survival rate of about 70 percent.

?People are dying all the time because we are not treating them quickly enough when they are in cardiac arrest,? said Mr. Jelfs.

?You can?t rely on ambulances all the time...they could be out on another call.?

A demonstration on a plastic dummy on the floor of Red Cross headquarters yesterday showed how the device talks the user through each step of the life-saving process, from putting pads on the patient?s chest before analysing the heart?s rhythm and delivering the vital zap of electric shock.

?It?s very, very simple to use,? said the cardiac expert. ?But at the end of the day, it saves lives.?

That message was echoed by Petra Spencer-Arscott, health management co-ordinator at Bermuda Red Cross.

She said that machines do not leave the charity until four people at the company taking it are trained to use them. Last year the charity trained 200 people to use AEDs, with a further 900 taught CPR.

Ferries, cruise ship terminals, museums and any places where large numbers gather would be perfect locations for more to be situated, she added.

She told . ?We want them in as many accessible places as possible.?

She also called for a consistent policy on duty free regarding AEDs. At the moment, some are exempt while others are not.

The prospect of more more life-saving defibrillator machines being put in public places across the Island was welcomed during a debate in Parliament last November.

New regulations paved the way for more to go in places such as the Airport, Government buildings and shopping centres.

The Government?s Chief Medical Officer, Dr. John Cann, yesterday said he was unable to provide immediate information on the number of defibrillator machines in public places, or how many had been introduced in recent months.

He said the aim of last year?s law change was to make them more available, and also to give legal protection to Good Samaritans that step in and use them.