Built on a Solid Foundation

No matter whether the AED order is large or small, companies taking the plunge to deploy automated external defibrillators at their facilities are doing their homework, comparing available models, and making selections based on performance and reliability. Safety managers who are overseeing two recent deployments say their companies adopted AEDs proactively—not because of a fatality in their ranks—to build on a strong foundation of health and safety at their facilities.

Dustin Dier,medical services manager for The Shaw Group Inc., said the company has always had very strong employee participation in CPR training and first aid,and now the same is true with AED usage. Shaw (www.shaw grp.com) has about 27,000 employees who provide engineering, construction, maintenance, and other services from its headquarters in Baton Rouge, La., and offices on five continents.

Dier said Shaw phased in its AEDs starting in August 2007 with 70 defibrillators at about eight corporate facilities with the largest number of employees. Phase 2, from September to December 2007, involved 70 additional AEDs at 45 other corporate locations. The third phase, which will involve about 80 project sites, will follow after a committee decides the corporate side’s setup is operating effectively, he said.

Six months of research preceded Shaw’s deployment, with vendors brought in individually to make presentations. While the competing machines were similar, one manufacturer stood out because of its in-house maintenance program and some key features of its AED, including an excellent FDA record and the ability to check whether the unit’s pads are both in place and working properly. This winning vendor created a program with Shaw that checks the machines electronically for readiness; safety employees at each site also check them visually on a daily basis, Dier said.

‘We Like to Walk the Talk’
Brampton, Ontario (Canada)-based Brampton Brick Limited also spent six months on its research and evaluated 12 suppliers’ presentations, said Nick Bartzis, the company’s health and safety coordinator. This company’s deployment—seven AEDs to cover around 400 employees at six facilities in the Toronto, Canada area; Wixom, Mich.; and Terre Haute, Ind., where Brampton will open a brick manufacturing facility this fall—represents just a fraction of the Shaw program, but it was an important step for the company’s safety effort, Bartzis said.

Bartzis said Brampton’s facilities use lots of automation and have veteran, dedicated workforces with little turnover. “ The concern is that we have an aging workforce,” he said. “ Brampton Brick is committed to the health and safety of the workers, even their safety at home.We like to walk the talk.”

Brampton (www.bramptonbrick.com) initially installed an AED at its corporate headquarters. Management then asked why there were no AEDs at the rest of the company’s facilities and soon decided to take the program companywide, Bartzis said.

Employees at every facility have been trained on first aid, CPR, and AED use, and they are retrained every 90 days to ensure the material is fresh and retained by the employees, he said.

A guaranteed four-year battery, superb reliability, and the self-checks performed by the devices were the top considerations behind the company’s selection. Ease of use was important, as well,

“ With the unit, there is a very clear and loud, audible voice,” Bartzis explained. “It is so easy to understand that I actually had my six-year-old daughter listen to it, and she was able to apply the pads and follow the instructions.”

New Recommendation: Hands-Only CPR
The American Heart Association’s Emergency Cardiovascular Care Committee published a science advisory in the April issue of Circulation stating that bystanders who witness an adult’s sudden collapse should notify EMS and provide high-quality chest compressions, pushing hard and fast in the center of the chest. The committee recommends that a bystander not trained in CPR or who has been trained but is not confident of his or her ability to provided conventional CPR with rescue breaths should provide hands-only CPR.

Both the European Resuscitation Council and the Resuscitation Council (UK) support the advisory because they, like AHA, want to increase the rate of bystander CPR after out-of-hospital cardiac arrest. Listing several factors in favor of hands-only and against it, the Resuscitation Council (UK) noted that a controlled, randomized trial involving 4,400 bystanders utilizing phone-assisted conventional CPR or compression- only CPR will begin shortly and “may help to determine whether compression-only CPR should be adopted more widely.”

An important point made by the Resuscitation Council (UK) is that benefits of compression-only CPR over conventional CPR usually have been seen only when EMS response times are shorter than four minutes, but in most areas response times are longer,“and ventilation [rescue breathing] becomes increasingly important as the duration of cardiac arrest increases.”

This article originally appeared in the June 2008 issue of Occupational Health & Safety.

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