About AEDs

   Stand Clear! We’ve all heard the shout as actors on TV apply paddles to a cardiac arrest victim’s chest. What this drama is re-enacting is defibrillation, which unfortunately most people think can only happen in an ambulance or hospital.

   PADL thinks this needs to change, because every day in our area three people die from sudden cardiac arrest and of that number, one could have been saved by early defibrillation.

   We’re not talking about the kind of defibrillation shown on TV. We’re talking about the kind that you can learn to do; the kind that can get to sudden cardiac arrest victim’s quickly enough to make a difference. We’re talking about AEDs, or automated external defibrillators.

   First, a little background: AEDs have been commercially available for the past ten years. Early units were large and expensive and hampered by regulatory issues. Designed for use by hospitals and ambulances, these devices never entered the public market.

   In the early 90s things began to change. The American Heart Association spoke out about getting defibrillation to sudden cardiac arrest victims as quickly as possible (within the first three minutes is optimal), and said that first responders (those who arrive first at an emergency) should be trained to defibrillate.

   Then in 1992, SurVivaLink Corporation brought out the first new generation AED–one that is lighter, less expensive and easier to use. The idea of early defibrillation was becoming a reality as other players like Laerdal, Heartstream, ZOLL Medical and Physio-Control all debuted new generation devices designed with public use in mind.

   These devices truly are automated–they take the decision making process out of the hands of rescuers and place it in an internal computer chip. They don’t use paddles but instead have patches called electrodes that are easily placed on the victim’s chest. And the voice saying Stand Clear is now the device’s, walking you through the rescue sequence.

   This is all good news for cardiac arrest victims! With proper training you can learn to use these simple devices and really make a difference. Contact PADL today for help in setting up a training program in your home, community or business.

PADL … Saving one life a day, every day for life.

Frequently Asked Questions

Please feel free to scan the entire list, or choose from one of these sub-categories:

AED QUESTIONS
Q: What is an AED?

       AED stands for Automated External Defibrillator. This is a device that automatically analyzes a cardiac arrest victim’s heart rhythm and makes a decision to defibrillate the patient.

Q: What is defibrillation?

       Defibrillation is the therapeutic delivery of an electric current to a patient’s chest wall that in turn passes through the heart, hopefully terminating lethal heart rhythms.

Q: Can I hurt a patient with the AED?

       The sudden cardiac arrest victim will die without rapid intervention. Used properly, the AED can only help.

Q: What if the AED shocks someone who isn’t in a cardiac arrest?

       The AED’s internal computer chip will not allow the device to shock unless it detects the presence of cardiac rhythms that require defibrillation.

Q: What if the device fails to work?

       If you maintain your device, a malfunction is very highly unlikely. However, if the device should fail to work, do CPR until help arrives and contact the device manufacturer as soon as possible after the event.

MEDICAL QUESTIONS

Q: What is sudden cardiac arrest?

       This is a condition where the heart stops beating suddenly and unexpectedly. Usually caused by a disturbance in the heart’s electrical system called ventricular fibrillation, the only definitive treatment is to render rapid defibrillation.

Q: What is ventricular fibrillation?

       The most common lethal rhythm leading to a sudden cardiac arrest, ventricular fibrillation causes the lower portion of the heart (the ventricles) to quiver uncontrollably. The heart cannot pump blood, and death quickly follows unless CPR and rapid defibrillation occurs.

Q: Who is at risk for sudden cardiac arrest?

       Sudden cardiac arrest is by nature unpredictable and can strike anyone at anytime. It is for this reason that the issue of public access defibrillation is so urgent—we are all at risk for this life threatening condition.

Q: So what is the difference between a heart attack and sudden cardiac arrest?

       A heart attack is due to a mechanical event—generally an obstruction of a coronary artery that leads to restricted blood flow to the heart. The portion of the heart deprived of blood (and its life giving oxygen) begins to die. Heart attack victims generally have warning signs, which may include pain or tightness in the chest, shortness of breath, nausea, vomiting, and profuse sweating. Depending on the severity of the attack (based on the location and extent of the heart muscle involved) the patient may be conscious or unconscious.

      A heart attack may lead to sudden cardiac arrest, in which case CPR and rapid defibrillation is necessary. (Call 911 immediately for anyone experiencing warning signs of a heart attack. Do not leave them alone or allow them to exert themselves while waiting for help to arrive.)

       A sudden cardiac arrest is due to an electrical event—the disturbance of the heart’s normal beating action. This occurs suddenly and without warning, completely and instantly shutting off all blood flow throughout the body. A sudden cardiac arrest can occur in those without previous heart disease; in young and healthy individuals; in just about anyone. The most common cardiac rhythm causing sudden cardiac arrest is ventricular fibrillation. The only treatment for this rhythm is rapid defibrillation; something that can be provided by those properly trained in the use of an AED.

Q: Doesn’t CPR save lives? Why is defibrillation needed?

       No, in most cases CPR isn’t enough to revive sudden cardiac arrest victims. CPR maintains a minimal blood flow and can bridge the time until defibrillation occurs. According to the American Heart Association the definitive treatment for sudden cardiac arrest is defibrillation, which explains why only three percent nationwide survive a sudden cardiac arrest when given CPR without rapid defibrillation.

Q: What about 911? Why can’t we just wait until they arrive?

       Emergency medical rescuers do a fantastic job and are true heroes in every sense of the word. But it is physically impossible in the majority of cases for them to arrive at the sides of sudden cardiac arrest victims quickly enough to render rapid, lifesaving defibrillation. The reason is this: for every minute that passes after a sudden cardiac arrest, the chance for survival drops by 10%. The average time it takes for 911 to arrive is 10-12 minutes. After doing the math it’s easy to see why public access defibrillation will help save the lives of many sudden cardiac arrest victims.

Q: Will all sudden cardiac arrest victims survive if they are rapidly defibrillated?

       No. Survival rates for sudden cardiac arrest depend on many factors, and survival is never guaranteed. Even so, rapid defibrillation gives the sudden cardiac arrest victim the best chance for survival currently available.

LIABILITY ISSUES

Q: I see that AEDs can save lives. But what about the liability issues? What if my business purchases an AED, and when used, it doesn’t save the patient?

       A good starting point when discussing liability issues and AED technology is the fact that the sudden cardiac arrest victim is dead unless rapid CPR and defibrillation successfully resuscitates them.

       CPR is performed thousands of times a year with a nationwide success rate of 3 percent; yet no one has ever been sued for performing CPR. AEDs raise the sudden cardiac arrest victim’s chances of survival to as high as 40 percent. The use of these devices doesn’t guarantee survival, but gives a chance where close to none previously existed.

       To withhold the use of an AED because of an unfounded fear of liability is to issue death warrants to thousands of Americans each year. In fact, medicolegal experts foresee a time in the near future when not having an AED program may bring lawsuits against businesses; this has already occurred to Busch Gardens Amusement Park and Lufthansa Airlines. A good article addressing the liability concerns of businesses is Defibrillators Enter the Business Marketplace by Richard A. Lazar. We recommend you read this article and print it out to educate others.

Q: What can businesses can do to reduce liability issues?

There are several things that can reduce risk and insure your AED program will run smoothly:

       Implement a responsible training and retraining plan. Using PADL approved training can help you do this. Although the AED is very intuitive and easy to use, responsible training includes CPR along with AED use. Each student should have ample time to practice skills and have all questions answered. Additionally, skill refreshers and retraining must be performed on a regular basis in accordance with your area’s regulations. (In California, lay persons must demonstrate skill competency every three months.)
       Purchase AEDs accompanied by an indemnification program. SurVivaLink devices come with a 6 million-dollar indemnification for each use of the device; Heartstream has recently instituted a similar program.
       Place devices centrally where they are easily reached and can reach most victims within a 2-3 minute window. PADL approved trainers perform a free logistic survey for businesses and produce a written report showing the best placement for devices, along with recommendations for the optimal number of devices to purchase.
       Promote Good Samaritan laws in your area. These laws protect individuals providing emergency care to those in need. Check out the National EMS Info Exchange website at http://www.naemt.org/ to see what Good Samaritan legislation exists in your state. (Nevada is a good example of a state with AED-friendly legislation.)

Q: What is medical direction?

    Medical direction is a concept endorsed by the American Heart Association and most medical experts. Put simply, it is physician involvement in lay AED programs. Most state laws require some form of medical direction, however PADL strongly recommends that all AED programs come under the auspices of a physician—preferably one with the knowledge and experience necessary to help administer AED programs (such as an emergency room physician or cardiologist). Medical direction is one way for businesses and individuals to reduce liability from their AED program. For more information about medical direction in your area, visit MedicalDirection.com.

TRAINING ISSUES
Q: Legally who can be trained to use an AED?

       In the US, laws vary from state to state regarding the use of AEDs. In California, the AED is a prescripted device, which means that those trained in its use must operate under a physician and his or her written orders. In Utah, anyone trained to American Heart Association standards may operate an AED. Florida is another AED-friendly state with regulations stating "an automatic external defibrillator may be used by any person for the purpose of saving the life of another person in cardiac arrest"—providing the rescuer has been trained in CPR and AED use.

       Some states say that professional emergency rescuers such as EMTs or paramedics may use AEDs, but do not expressly prohibit other users. In these cases, some businesses (such as Harrah’s Entertainment) have opted to institute training programs for on-site emergency response teams at the advice of corporate counsel, who’ve determined that such programs run by properly trained individuals under medical control on private property pose no liability risks. Check out our US Legislative Index for more information about your state’s laws regarding AED use.

Q: How long does AED training generally take?

       Most responsible training companies take from 3 ½ to 4 hours to teach lay persons to use the AED. The American Heart Association recommends a 3 ½ course, recognizing that full CPR training is needed to properly prepare students to use the AED.

Q: What should I look for in a training company?

   First, consider using PADL-approved training. When evaluating any training company, the following is important:

    Do they have a Medical Director? To reduce liability and get the best AED training, look for a company with an on-staff physician who oversees programs. (In such states as California, the AED is a prescripted device, so medical direction is absolutely necessary.)
    How long have they been doing training? Will they be there to offer continuing medical direction and support?
    Is full CPR training a part of the AED course? Even those who have taken CPR in the past need to learn how to integrate CPR with AED use.
    Is the training hands-on with ample scenarios and opportunities for students to practice their skills? Does the company bring enough CPR manikins to class (generally one manikin per two students is best) to allow all students plenty of CPR practice?
    Do they have experience administering AED training? Check references, calling to see what other businesses say about the training.
    Do you receive certification from the training? It is important to identify those trained in the use of AEDs at your place of business.
    Does the company have a schedule of skill refreshers and retraining? Does this comply with your local regulations?
    Do local EMS authorities endorse the training?
    Are training costs reasonable and in line with industry averages?
    Does the training company offer ongoing support and guarantees for services rendered?