Turnkey AED Program Management
- By David Fritzsche, Drew Myklegard
- Oct 01, 2005
Affording an automated system of checks and balances, such a program improves emergency response and also saves lives.
AUTOMATED external defibrillators are becoming increasingly common in workplaces and public facilities across the nation. They've been endorsed by several medical research studies and health care organizations, including OSHA and the American College of Occupational and Environmental Medicine.
Diligent employers have begun to consider AED deployment an important aspect of a comprehensive employee health and safety program, especially because sudden cardiac arrest (SCA) causes 13 percent of workplace fatalities, according to OSHA. Seventy-eight percent of 200 workplaces surveyed by ACOEM in 2003 said they had defibrillators on site, with the college estimating that fewer than 5 percent of companies had defibrillators in 1999. AEDs have shown a high degree of reliability in tests conducted by the Food and Drug Administration, and everyone naturally expects the devices to work properly after they are deployed in a workplace or public area. However, on rare occasions, an AED that is not maintained correctly may not function as intended in an emergency, and tragedy can result.
Recently, a man died of SCA in a major airport after batteries in two AEDs witnesses brought to aid him did not work properly. This incident called into question whether the AEDs were properly maintained and placed the management of the airport's AED program under intense public scrutiny.
"How can we prevent this situation from happening again?" is the question every person responsible for an AED program should be asking. The answer is a comprehensive AED management program that links all participants (manufacturer, distributor, medical director, customer, trainer, local EMS, etc.) in one, integrated effort.
The components of this "turnkey" approach to AED program management are:
1. A high-quality, easy-to-use AED.
2. Medical oversight and direction.
3. A Web-enabled tracking and maintenance system that is accessible by all program participants.
4. Standardized AED/CPR training and communication.
5. Continual program evaluation and improvement.
An integrated program of this nature provides an automated system of checks and balances that keeps program participants well-informed and accountable to each other.
Ninety percent of sudden cardiac arrest victims survive when defibrillated within a minute or two after arrest; only 5 percent live if defibrillation is delayed for more than 10 minutes. Unfortunately, the 5 percent outcome is common in many communities. Usually caused by ventricular fibrillation or ventricular tachycardia, SCA still claims the lives of more than 335,000 Americans each year, according to American Heart Association statistics. Studies show that these fatalities happen primarily because response time to out-of-hospital cardiac arrest often still exceeds 10 minutes. With each minute that passes after the cardiac event, the chance of survival decreases by 10 percent. Early defibrillation not only saves lives, but also often allows victims to return to work and a normal lifestyle by preventing brain or heart damage from a lack of oxygen.
Choosing the AED
The stark statistics about SCA point to the importance of having a fail-safe, easy-to-use AED on site to re-establish normal rhythm to the heart. Not only must the AED be readily available; it also must be accessed and successfully operated in less than three minutes. Even the fastest EMS team will be hard pressed to get to the side of a victim in less than five to 10 minutes, studies show. Employees or individuals responding with an on-site, public access device give the victim the best chance for survival--but they must be confident enough to act without delay! Waiting or running to ask for help because the AED has an intimidating design can be fatal.
When considering various AEDs, look for product features that will add speed, reliability, and confidence to your responder team. AEDs with voice prompts, for example, literally "talk" to the user during an emergency, giving audible instructions and confidence to those using it. Choosing an FDA-approved AED that's easy to see and find will add speed to the response because, in an alarming situation, what seems obvious under normal circumstances can be overlooked. Check into the device's reliability by investigating whether or not it has ever required a recall. Other factors to consider include self-testing capability, battery life, ruggedness of design, water and dust rating, and pediatric capability (if there's a reasonable chance the AED may be used on children).
The total number of AEDs deployed in a workplace or public area can make a big difference, too, especially because of the quick response time needed to save an SCA victim's life. That's why a lower-priced AED can add tremendous value and quality to your program. You now can buy a high-quality AED for about $1,500. Remember--the goal of your program is to have an AED attached to a SCA victim within three minutes of cardiac arrest. Your AED purchase should increase the odds of reaching that goal. Are the bells and whistles--such as an EKG screen and voice recording capability--offered by more expensive AEDs necessary? If you can purchase 15 AEDs instead of 10 for the same price, and if that means you'll have AEDs positioned to improve response time by a minute or two, buy the less-expensive models, assuming it reaches all quality standards. That decision can save a life.
This article originally appeared in the October 2005 issue of Occupational Health & Safety.