OSHA does not have standards specific to automated external defibrillators (AEDs), but health experts say workplaces are ideal settings for AEDs. Compared to other public environments, workplaces have a culture that includes an emphasis on human resources, risk management, safety, emergency response, and training.

About 2.4 million AEDs are available in public places, according to the Food and Drug Administration. Despite the fact that using an AED increases a victim’s sudden cardiac arrest (SCA) survival rate by 60 percent, numerous workplaces are hesitant to set up AED programs due to concern over liability, confusion caused by variances in local and state Good Samaritan laws, and a lack of coordination with medical oversight personnel and emergency medical services.

Liability protection

Good Samaritan laws make it more difficult to sue those involved with AED programs by protecting certain levels of misconduct from liability. The level of protection varies widely from state to state. According to legal experts, meaningful immunity law typically protects misconduct rising at least to the level of so-called “ordinary negligence.” According to USLegal.com, ordinary negligence “is the failure to act as a reasonably prudent person.”

According to one estimate, 43 state laws limit immunity protection only to AED use-related activities. AED program decisions and actions taken in advance of an SCA event are not always protected, such as how many AEDs to buy, where to place them, who can use them, and how training is conducted.

Voluntary guidelines

In 2000, the federal Cardiac Arrest Survival Act was signed into law, designed to expand the availability of AEDs. To support federal goals, the American College of Occupational and Environmental Medicine (ACOEM) issued guidance for the use of AEDs in occupational settings. ACOEM guidance calls for a qualified medical director to be assigned to manage all medical aspects of the AED program. This includes performing a case-by-case review each time an AED is used.

Other key aspects of ACOEM’s AED program guidance:

• The program must comply with the Cardiac Arrest Survival Act guidelines and other federal and state AED legislation. A single corporate policy covering sites in different states may not suffice, given the variance of state AED laws.
• A written summary of the AED program should be distributed to all emergency response personnel (safety, security, health care, management) at a worksite.
• The AED program should be a part of a more general plan for emergency responses.
• The AED component of the plan should include awareness and placement of AEDS to ensure timely access; a procedure for notification of suspected SCA events to occupational medical, train first aid responders, and bystanders;  bystander debriefing; and equipment review, service and replacement. Note: these are not all the components of a program.
• Coordination with local EMS should be part of an integrated plan.
• AEDs should be used by the first available bystander, trained or not. All designated first aid responders and health care users should receive training.

Reasons to deploy

About 10,000 SCA events occur while victims are on the job, according to OSHA. Today’s AEDs are easy to use. In one study, untrained 6th graders guided by voice, text and graphics prompts were shown to be able to use AEDs nearly as rapidly as trained paramedics. A published Chicago O’Hare Airport study documented that more than 60 percent of AED users who successfully saved SCA victims were untrained. Other examples have also been documented.