Tuesday, May 8, 2012

Public Defibrillators - Are They Helpful?

There has been a push to put automated external defibrillators (AEDs) in many public spaces, particularly arenas, gyms, schools, and just about any place where there may be physical exertion, large gatherings, or many floors that may make it difficult for EMTs to reach a patient in a timely manner. Some businesses have also purchased AEDs for their employees or guests/visitors, but are these AEDs really any good?

I thought about this last summer when I was filling in as an occupational health nurse at a major organization. There was an AED in the medical office, along with a few other life-saving pieces of equipment. Interestingly, it's not a given that a nurse knows how to  use one of the AEDs, but when I took a CPR renewal course a few years ago, the EMT graciously took a few extra moments to show me one and how it worked.

As a nurse, I've done CPR many times and I've reacted in many emergencies, but how you react in a hospital situation, where you have back up all around you, and how you react in the outside world are really two different things. I learned this many years ago when I had to help give CPR to a person who had collapsed on the street on a Halloween night, as she was taking her son out trick-or-treating. I never found out if she survived. I doubt it.

I remember how ill at ease I felt. It was as if I had forgotten all my training. Doing CPR in the street was much more difficult than doing it in the hospital. I was shocked at how ill prepared I felt and I have never forgotten it. The event happened over 25 years ago - I was pregnant with my oldest child.

As I took over the medical office for several weeks, I double checked my area and I looked to see if the AED was charged. I had to check to see if the charge light was on and if it was, we were ok. But, it occurred to me to wonder if anyone is checking the AEDs that are placed in so many public places now. We have rules about checking fire extinguishers and alarms, but are there rules for AEDs. Last week, I learned, apparently not.

According to this article from CBC, Defibrillators in public buildings need more upkeep, there is a problem with not only batteries running out, but machines not functioning properly at all. If this is the case, then it might be best not to have them at all. In my opinion, it is more dangerous to believe you have life saving equipment on hand that doesn't work rather than none at all.

AEDs do have their place. Statistics show that if CPR and an AED are used within the first three minutes following the heart stopping, there is a 75% chance of survival. So, what to do? Do you have any solutions as to how to ensure the AEDs are maintained properly?

Add on info:

In 2010, the American Heart Association updated its CPR guidelines to a much simpler way of doing things. You can read about it here: New CPR Guidelines.


Mimi said...

We are planning on buying an AED at Sam's Club, they run around $900 (roughly) and are great to have at home. Originally we were going to get it because my dad was living with us and he had a serious heart condition, but he passed away 7 months ago... but my husband who is only 44 is at risk for a heart attack because he's overweight, high cholesterol and diabetic. I would hate to lose him at such a young age. Plus his father had a quadruple bi-pass before his 60th birthday. Coronary problems run in my hubby's family. I'd rather be on the safe side than have something tragic happen.

Marijke Vroomen-Durning said...

Hi Mimi. I didn't realize you could buy one just like that. I think you've got a great reason for buying one.

I am curious how will you ensure that your machine is always in ready-to-go mode? Is this something you had thought about or did my post twig this? Will you do something like check the batteries once a month or maybe change them when we put the clocks forward or back, as it is recommended you do with smoke detectors?

Anonymous said...

How timely this is! I received an email this morning from Joe Hage, the leader of LinkedIn.com Medical Devices Group, group who asked the question, "Is there a defibrillator in your office?"

He says he bets more than 90 percent who see that question answer "no." He cites statistics from the US Occupational Safety and Health Administration (OSHA) saying 13 percent of workplace fatalites were sudden cardiac arrest. He consulted AED and they've donated 10 of the devices to the Medical Devices Group. He provides a link (shortened in bit.ly) to the entry form people can use to have a chance to win one one of the 10 AEDs. As the group's leader, Joe is charged with the task of randomly selecting winners.(I will forward that email to you so you can decide if it's appropriate to share it with your blog fans.)

Another approach I wrote about in January came from the University of Arizona which is now teaching compression-only CPR (no mouth-to-mouth) for situations when there's no AED and nobody is willing or trained and able to provide conventional CPR. Their study showed that chest compression alone would save lives and bystanders were much more likely to step in and try to help if they could do that instead of conventional CPR.

I'm enjoying all the articles you post but this one was especially timely and important. Thank you!

Peggy Noonan (not the famous one) said...

Whoop - sorry about that last post. I didn't mean to be obscure ... "Anonymous" was Peggy Noonan (not the famous one) from http://altmedforyou.com and www.peggyjnoonan.com.

Marijke Vroomen-Durning said...

Thanks Peggy. Do you think it would be appropriate for you to send him a link to this? It's an important issue, I think. People get the machines, but what is their plan for maintenance?