Safety Dispatch

AED – Automatic External Defibrillator

 

MIDDLE ROAD ATHLETIC ASSOCIATION LOCATIONS:

1.     Burchfield Elementary Fields – Concession Stand

2.     Farrell Field – Equipment Room

 

 

Using Automatic External Defibrillators to Save Lives

 

 

When a cardiac emergency strikes, a rapid response is critical to survival. Some educational institutions are making it easier for staff and students to act quickly by purchasing automated external defibrillators (AEDs). These battery-powered computerized devices can jump-start a stopped heart, as these examples show:

 

 

 

·                    A 16-year-old student fell ill at a New York school. She was having seizures, her pulse was weak, and she was turning blue. The school nurse administered CPR, while a student ran for the AED. After three shocks, the student began breathing, and the machine detected a slight pulse.

 

·                    A 13-year-old boy collapsed and went into cardiac arrest after being hit in the chest by a pitched ball during a summer baseball game. The coach and two parents, both doctors in the stands, ran to the boy to administer CPR, and another spectator called 911. The boy’s pulse was weak and his breathing slow when a police officer arrived with an AED. After one shock, the child’s heartbeat returned to normal.

 

AEDs are evident in airports and increasingly in other public venues. New York State requires them in public schools under legislation passed in 2002. Following are some points to consider as you evaluate whether your institution should purchase AEDs.

 

How Do AEDs Work?

AEDs use adhesive pads placed on a person’s torso to analyze heart rhythms, distinguishing abnormal from normal activity and indicating when to administer an electric shock to jolt a heart back to beating regularly. If no irregular rhythm is detected, the device will not deliver a shock. AEDs are lifelines for people suffering cardiac arrest, a condition in which the heart undergoes uncontrollable abnormal electrical activity, known as ventricular fibrillation. Ultimately, the heart stops beating, there is no blood flow, and the victim becomes unresponsive, collapses, and stops breathing normally. Early defibrillation restores the normal circulation of blood. Heart attacks and other conditions can cause ventricular fibrillation.

 

AEDs are about the size of a laptop computer and weigh approximately five pounds.  They range in price from $3,000 to $5,000 per unit.

 

Are AEDs Necessary?

More than 300,000 people suffer from cardiac arrest outside of a hospital each year, and only about five percent survive, according to the American Heart Association (AHA). The fatalities include 5,000 to 7,000 children, the National Center for Early Defibrillation says.   

 

The chances of survival can be greatly increased through the use of AED and CPR. CPR is important because it keeps oxygenated blood flowing to vital organs. The AHA estimates that the early use of AEDs could prevent 100,000 deaths per year. For the best chance of survival, the shock produced by an AED should be delivered within five minutes of a person’s cardiac arrest.  For every minute that goes by without defibrillation, a victim’s chance of survival decreases by 7 to 10 percent.

 

Who Can Use AEDs?        

AEDs are medical devices regulated by the Food and Drug Administration (FDA), which approves the sale of all models and specifies the need for training and conditions of use.  The devices have been designed to be both easy to use and difficult to misuse. They give step-by-step instructions through simple voice prompts and visual messages. The AHA describes them as being safe for use by anyone who has been trained to operate them.

 

Each AED is equipped with a memory database.  The information the device obtains on a cardiac victim, such as heart rhythms and the number of shocks, can later be converted into a medical report by emergency responders or medical staff personnel. 

AED training requirements vary from state to state. The AHA and American Red Cross (ARC) have developed several AED training courses for non-medical responders.  Basic courses run 3 ½ to 4 hours and incorporate adult-CPR training.  AED certification must be renewed every year for the ARC or every two years for the AHA. 

 

Because cardiac arrests often occur as a result of a rapid heart rate associated with physical activity, educational institutions that purchase AEDs should consider providing training to individuals working in health and recreation centers and athletic departments. However, before training any personnel, a school should research and develop a written policy regarding which personnel or volunteers should receive AED. Other candidates for training include staff and volunteers who work on special events, student leaders, and resident associates.  To keep users current, consider supplementing training with reviews during periodic emergency-response training and tabletop exercises throughout the year.  Regular training and reviews will help to make the emergency use of AEDs automatic and minimize the chance of any delay when AEDs are needed.

Where Should Defibrillators Be Kept?

AEDs should be placed in locations that can be reached quickly and easily because cardiac arrests can occur anywhere on campus, often at locations several minutes away from a defibrillator.

 

An evaluation of your campus’s risk factors can help you determine the right place for the AEDs.  Consider examining the institution’s previous year’s incident and injury reports, talking to your designated campus emergency responders, and discussing your emergency response plan with the local emergency response and law enforcement agencies.  Several institutions, such as the University of Arizona, have placed AEDs in public safety vehicles and trained the officers on their use. (Note that AEDs stored in vehicles may require special protection from extreme heat or cold.)

 

Minimizing the Liability Risks

Some companies have been held liable for not responding adequately to customers who suffered cardiac arrest.  There have been few reported court decisions relating to the availability or use of AEDs, and it remains debatable whether a school or college may be held liable if an AED could have prevented a student’s death but none was available on campus.  Analysts also question whether an institution could be found negligent if AEDs are located on campus but they were not used or were used incorrectly on a victim by untrained or inexperienced personnel or volunteers.

 

Laws in several states seek to limit the types and scope of negligence lawsuits permissible against individuals rendering emergency medical care, including Good Samaritan laws and a variety of immunity laws that may help reduce liability under certain circumstances.

 

A review of your state's laws will help determine whether it provides liability immunity protection.  One source for information on AED and Good Samaritan laws is the National Immunity/Good Samaritan Law Database of the National EMS Info Exchange, available online at http://naemt.org/nemsie/immunity.htm. 

 

To date, only a handful of legal cases have involved the use of AEDs by non-health-care professionals. Arguably, organizations that adopt AED programs may face a lower liability exposure than those that do not. If sudden cardiac arrest is untreated, the victim will die. As a general rule, an AED that is used properly can only help. 

 

Educational institutions can also help to insulate themselves from lawsuits by being careful to comply with state and federal laws governing the use of AEDs and the manufacturers’ instructions.  The National Center for Early Defibrillation (www.early-defib.org) offers a complete analysis of the FDA’s management of these medical devices as well as an overview of the federal and state laws surrounding their use.  The FDA website at www.fda.gov provides information on which AEDs have received agency approval.

 

It is never easy to place a price on a human life.  The purchase of AEDs for use on campus may, however, be easily translatable into saved lives.

 

Resources

 

Government and Industry

 

American Heart Association

www.americanheart.org

 The American Heart Association’s HeartSaver courses provide the skills to effectively assess and maintain life from the critical minutes immediately following an emergency until the arrival of emergency medical services personnel.  The Heartsaver FACTS course combines adult CPR and the use of an automated external defibrillator (AED) with basic first aid procedures.

 

American Red Cross

www.redcross.org/services/hss/courses/

The Red Cross will assist you in training your campus community in the use of AEDs at your site when it is convenient for you.  The Red Cross' Workplace Training will teach you the most vital skills needed to save the life of a sudden cardiac arrest victim.  Red Cross first aid, CPR and AED programs are available for any age and can be tailored to the needs of specific groups and individuals.

 

Early Defibrillation Law and Policy Center

www.edlpc.com

Information about the consulting services firm that provides services, information, and tools to help clients understand and implement AED programs that comply with regulatory requirements, manage legal liability risk, and encourage people to use life-saving portable defibrillators.

 

National Center for Early Defibrillation

www.early-defib.org

Comprehensive information on defibrillators, including federal and state legislation, a review of legal issues, sample training modules, product information, and a complete list of useful links.

 

U.S. Food and Drug Administration

www.fda.gov

The FDA is the federal regulatory agency responsible for ensuring that medical devices like AEDs are safe and effective. To achieve this goal, the FDA imposes device labeling requirements on AED manufacturers.

 

National EMS Information Exchange

http://naemt.org/nemsie/immunity.htm

The National Immunity/Good Samaritan Law database of the National EMS Info Exchange provides a summary of state legislation regarding the use of AEDs and good Samaritan laws.  The database is still under development, but the information is current and categorized by state.

 

Sample Campus Policies

 

Amherst University

http://www.amherst.edu/~ehs/health/DefibPolicy.htm

This comprehensive AED campus policy addresses safety precautions, placement, training requirements, and maintenance. 

 

Bowling Green University

http://www.bgsu.edu/offices/riskmgmt/AED_Policy.pdf

This policy includes a detailed post-incident report form for cardiac arrest.

 

Colorado State University

http://www.ehs.colostate.edu/Safety/AED.asp

CSU’s policy is comprehensive.  It includes a campus map where AEDs are located and an informative FAQ page.

 

Indiana University

http://www.indiana.edu/~riskmgmt/aed.htm

IU’s AED policy addresses the purchase, placement, and use of defibrillators. 

 

University of Texas El Paso

http://www.utep.edu/eh&s/Utep%20AED%20program.html

The University of Texas El Paso AED program includes a maintenance checklist, training schedule, and links to several health sites.

 

Articles

 

 “Automatic External Defibrillators and PAD Programs,” a white paper from the University Risk Management and Insurance Association (URMIA) that explains the benefits and costs of an AED program in order to make informed decisions or recommendations about campus AEDs. The paper is available to URMIA members online at www.urmia.org.

 

Connaughton, Daniel P., and John O. Spengler, “Automated External Defibrillators in Sport and Recreation Settings:  An Analysis of Immunity Provisions in State Legislation,” Journal of Legal Aspects of Sport, Winter 2001.

 

“Equip Your District Schools with Defibrillators to Increase Safety,” Practical Strategies for Maintaining Safe Schools, January 2004, LRP Publications.

 

“Legal Pointers of AED Programs,” Your School and the Law, February 11, 2004, LRP Publications.

 

Petersen, Karen F., “Legal Implications of Lay Use of Automatic External Defibrillators in Non-Hospital Settings,” Journal of Contemporary Health Law and Policy, Winter 2000.