Cardiac Science AED

AED Mandates Continue to Rise

Oregon requires them for every business of 50,000 square feet or more where the public congregates if it has more than 50 visitors per day. Legislation may be introduced soon in Congress to mandate AEDs in all schools.

Becky Carney is lucky to be alive. The North Carolina state representative actually died of sudden cardiac arrest (SCA) caused by a heart arrhythmia. Carney was then revived by one of her colleagues who used an automated external defibrillator that was readily available in the North Carolina Statehouse.

Carney is like hundreds of thousands of people who survive SCA each year thanks to the increased prevalence of AEDs in the workplace. Little did she know the AED she and her colleagues helped install would later save her life.

The evidence is clear: AEDs increase the chance of surviving SCA by 70 percent. For that reason, AEDs are becoming more and more common in our daily travels and in the workplace. These small, portable devices save lives by delivering an electric shock to the heart in those crucial few minutes when someone experiences SCA. AEDs are lifesaving devices that can mean the difference between life and death for a victim of SCA.

The fact is that more than 365,000 people in North America die each year from SCA. Fewer than 5 percent of people who suffer SCA survive unless an AED is used to provide an electric shock to get the heart beating again. In some places where AEDs are deployed, survival rates from SCA are reported above 70 percent.

Because SCA is most effectively treated within the first few seconds or minutes of a sudden collapse, AEDs have the potential to save thousands of lives that could be lost if treatment is delayed until paramedics arrive on the scene of a cardiac arrest. The American Heart Association's Early Defibrillation movement aims to put AEDs in the hands of all first responders in places where people live, work, and play.

How does this portable device make such a difference? What are the laws in your state governing AEDs, and how do they affect you, your company, and the workplace?

AEDs Save Lives
Sudden cardiac arrest is different from a heart attack. A heart attack is caused by some sort of plumbing problem and is usually the result of heart disease. On the other hand, SCA can strike anyone at any time.

When a person experiences SCA, the heart's electrical impulses suddenly misfire. As a result, the heart "flutters" uncontrollably and cannot pump blood. When the heart cannot pump blood, the body is deprived of oxygen. For every minute the brain is deprived of oxygen, the likelihood of severe brain damage increases dramatically, which often results in death.

When sudden cardiac arrest happens, only an electric shock from an AED can get the heart back on track and beating normally again. That is how AEDs save lives.

Without an AED, more than 95 percent of SCA victims die before they reach a hospital. Having to wait for emergency medical services significantly reduces the chances of survival because it typically takes about nine minutes from the time 911 is called until emergency medical services personnel arrive with an AED. In larger cities this response time can be much longer, depending on traffic or crowded buildings. A victim has the best chance of survival if an AED is deployed within the first few minutes of experiencing SCA. That is why it is so crucial to have AEDs readily available.

I helped to start San Diego Project Heartbeat in 2001. Since that time, we have deployed more than 5,500 AEDs in San Diego and have saved 78 lives. In Nevada, AEDs installed in the casinos of Las Vegas have saved more than 250 people who suffered from SCA.

Recent Laws Mandate AEDs in Some Areas, Regulate in Others
The Federal Cardiac Arrest Survival Act (2000) provides AED users and acquirers with liability protection. All 50 U.S. states have specific AED laws and regulations. Most state laws require medical authorization, oversight, EMS notification, and/or AED registration. Also required is basic training as simple as CPR/AED courses for lay responders and for AED owners, including basic recordkeeping and tracking of AEDs.

Many state and local laws have gone to great lengths to encourage the placement of AEDs. While the specific requirements vary from state to state, none has regulations that are burdensome in a way that would prevent anyone desiring to install AEDs from doing so. In fact, AEDs have become so commonplace, the standard of care has now shifted creating a potential liability for organizations that do not have AEDs installed.

OSHA bulletin #3174, published in 2001, recommends AEDs, stating that "devices appropriately located in a business or workplace improves the survivability of people experiencing a cardiac crisis." OSHA bulletin #3185, published in 2003, states, "These devices have a proven track record of saving lives in public places as well as in the workplace. They can do the same for you and your employees. Please consider installing AEDs in your workplace."

Each state regulates AEDs differently. Forty-one states offer simple immunity protection. Twelve states require AEDs in public fitness facilities. Eighteen states require AEDs in public schools. Ten states require AEDs in public buildings. Twenty-eight states require training for AEDs, and 31 states require regular maintenance and testing. Thirty states require AEDs be registered with the local EMS agency, and 22 states require clinical use of an AED to be reported to the local EMS system.

Recent laws have made AEDs more common. Oregon earlier this year passed a law requiring AEDs at any business of 50,000 square feet or more where the public congregates, if it has more than 50 visitors per day. The state of Arizona passed a law that requires any state building constructed or renovated at a cost of at least $250,000 to be equipped with AEDs. In Pennsylvania, a law mandating AEDs in all hotels is winding its way through the legislative process. Several members of Congress are talking about introducing legislation in the next session of Congress to mandate AEDs in all schools and to expand the federal Good Samaritan law of 2000.

For a comprehensive list tracking AED laws, AED legislation, and Good Samaritan laws that have recently passed, visit

This article originally appeared in the December 2010 issue of Occupational Health & Safety.

About the Author

Jim Madaffer is a former San Diego City Councilmember, serving from 2000-2008 (leaving due to term limits). He held a number of leadership positions and helped found the San Diego Project Heartbeat, a public access defibrillation program. He is President of Madaffer Enterprises, a successful public policy and government relations consulting firm specializing in government and corporate relations, marketing, and technology innovation.

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