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Automated external defibrillators

By Matthew Marc Henry
June 4, 2009


In March and May, we discussed what “first aid” is, what you need to do to comply with regulations, and what composes a First Aid Kit. Now, let’s have a look at AEDs. This article presents considerations of liability, efficacy, and responsibility in AED placement in businesses.

The Bad News:
  • AEDs are Class 3 Medical Devices, are regulated by the FDA, and in all cases but one, a prescription is required for purchase of AEDs.
  • AED sales organizations in some cases lean on gimmicks and questionable promotions.
The Good News:
  • AEDs are safe and simple to use. In fact, one is so easy that the FDA has approved it for over-the-counter sale without a prescription.1 AEDs, Automated External Defibrillators are just that – AUTOMATED… shocks will not be administered unless necessary.
  • AEDs save lives. AED use in cardiac arrest raises survival rate 62%-98% over CPR alone.2
  • AEDs keep getting smaller, lighter, more advanced, and more affordable.
  • Good Samaritan laws in almost every state protect the business as well as the rescuer against civil or criminal liability in using an AED for rescue in the case of cardiac arrest. It is more likely that a business may be held liable for not having these simple-to-use devices handy in case of an emergency.
  • Insurance companies may now lower rates based upon availability of an AED in a commercial facility.
The Question:
  • Should you have an AED in your workplace?
The Answer:
  • YES. As more legislation is passed requiring AEDs in public places, such as restaurants, gyms and commercial buildings, the likelihood of being held liable for not having an AED available is rising. The rate of survival for cardiac arrest (America’s #1 killer) rises drastically with AED use. Automated External Defibrillators are easy to attain, easy to use, and convenient to place in your facility. If you do not already have AEDs at your workplace, the real question is: Why Not?
What to look for
Here are 15 recommendations:

1 — Brand Name: When considering life-saving devices, go with a major brand. Be sure you recognize the name of the manufacturer as an established company that has been around for years. Wouldn’t you rather pay a few dollars more for reliability?

2 — Value: Once you have determined which brand of AED you wish to purchase, talk to the seller — don’t just read a Web site. All major AED brands have a “Minimum Advertised Price” policy. This means that all legitimate online retailers must offer that AED at the minimum advertised price, or above. If you find the item for less — the company is violating policy. Look for real “Value Added” such as free CPR and AED training with purchase, or free shipping. Be sure to ask your provider if any rebates are currently available as well.

3 — Cost of Maintenance: Some AEDs come with cartridges that include battery and electrodes combined. This sounds great, but if one or the other goes out, you have to replace them together. Also be sure your AED comes with a battery guaranteed for at least four years of stand-by time.

4 — CPR Coaching: AEDs provide voice prompts for AED use; this is part of what makes them so easy to use. Be sure the make and model you select offers actual CPR steps in the voice prompts to assist those never trained in CPR or who may be rusty in their CPR skills.

5 — ECG / EKG: Electrocardiography (ECG or EKG) is the recording of the electrical activity of the heart over time via skin electrodes. Unless you and your staff are well trained in advanced lifesaving techniques, do not buy an AED with ECG display — it is pointless and will confuse or intimidate the rescuer.

6 — Readiness: AEDs are critical in lifesaving, but time is of the essence. Make sure the AED you choose powers up for shock fast enough. Some of the best Automated External Defibrillators power up and are ready to shock in as little as eight seconds after analyzing.

7 — Training: While AEDs are practically “Dummy-Proof,” CPR and AED training is required in many states when an AED is available at a facility, and is recommended for all organizations with AEDs. Find a reliable, affordable and entertaining national training organization to perform training at your workplace.

8 — Self-Testing: Make sure the AED you select tests itself regularly. Some AEDs only test readiness once a week, some only test battery or pads, not both. Be sure your AED tests the batteries and pads at least daily (not just if the pads are present, but if they are ready and in good condition to be used). Some even test hourly so you know they are always ready to go.

9 — Reliability: Know the track record of the manufacturer of the AED you choose. Some have had some repeated recall issues. Ask your AED seller for statistics.

10 — Vendor: Choose a vendor that has been in business a long time. You will want to know they will be around in a few years when you need replacement parts, additional accessories, or support.

11 — Quantity: Your AED should be available in a three-minute round trip from the cardiac arrest casualty. Take a walk, count the distances from furthermost points (round trip) and be sure to equip with enough Automated External Defibrillators to reach them in 1.5 minutes from any location at your facility. Most AED resellers and programs offer discounts for multiple units.

12 — Prescription: All Automated External Defibrillators but one require a prescription for placement according to the FDA.1 Your AED provider should offer to assist you in attaining a prescription at little or no cost if you are not able to procure one easily on your own.

13 — Pediatric Capability and Adaptability: Unless you can guarantee that you will never have a child on site, you should have pediatric capability in your AED. One AED currently available switches instantly from adult to pediatric mode with the insertion of a “pediatric key.” Also, consider language. If you have a workforce that speaks another language as their primary tongue, consider placing AEDs with voice prompts in that language as well as English. Some manufacturers offer AEDs in more than ten different languages.

14 — Extra Battery and Pads: Be sure to get extra batteries and pads when you buy your AED. Rather than paying express fees later, get an extra set when you purchase your AED(s). You may even save on shipping or get a discount.

15 — Funding: Grants are available to assist with funding AEDs. There are state-sponsored grants for AED placement, federal grants for rural AED placement, and even legitimate corporate-sponsored “Buy Down” grants that combine funds from manufacturers and private training and reseller groups to reduce the cost of the AEDs, accessories and prescriptions well below Minimum Advertised Price policies and retail pricing. These corporate buy down grants are available to businesses and individuals, not just volunteer groups and non-profit organizations. Try an online search for “AED Grant” to see what is available to you. Most are no more than a one-page application, and are approved in 1-2 weeks.



References

1. United States Food & Drug Administration http://www.fda.gov/bbs/topics/ANSWERS/2004/ ANS01314.html

2. Figures from American CPR Training, American Heart Association, and CPR and Emergency Cardiovascular Care



Now that you know what to look for in an Automated External Defibrillator… Watch the FREE online AED Demonstration Videos @ www.FirstAidVideo.com

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Matthew is a managing safety consultant for Express Companies, Inc. (dba FirstAidStore.com/AmericanCPR. com/AedGrant.com). He is a former EMT and has served on several Cal/OSHA Advisory Committees and the Associated General Contractors Safety Committee.

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