For the past several years, the American Heart Association (AHA) has attributed 150,000-220,000 deaths to sudden cardiac arrest (SCA), a sudden and unexpected loss of heart function. This was enough to make SCA the leading cause of death in America[1].

However, new estimates attribute 456,000 deaths a year to SCA. Cardiac arrest can strike anyone. According to the AHA, as many as 50% of SCA victims have no prior indication of heart disease[3]. Moreover, OSHA estimates that 15% of workplace fatalities are caused by SCA. Of these victims, it is estimated that 40% could have been saved by defibrillation within 5 minutes[1].

Pair these statistics with recent automated external defibrillator (AED) endorsements coupled with guidelines from the American College of Occupational and Environmental Medicine (ACOEM) and Building Owners and Managers Association International (BOMA) and a letter from the Federal Office of Management and Budget encouraging OSHA to initiate regulations mandating AEDs in the workplace, and it is practical to expect that most organizations will be implementing AED programs[3].

Just the Facts

Cardiac arrest occurs when the electrical system of the heart malfunctions and the heart’s rhythm becomes irregular. During cardiac arrest, the victim loses consciousness, stops normal breathing and loses their pulse[2]. The most common cause of sudden cardiac arrest is ventricular fibrillation (VF), which is when the heart’s lower pumping chambers, or ventricles, fibrillate randomly[2]. During VF, the victim’s heart does not adequately pump blood throughout the body.

“The only treatment for VF is to shock the heart with an AED. CPR won’t do it alone,” says Dr. Stephen Schaal[2].

AEDs for Dummies

AEDs are the size of a laptop, weigh up to 7 pounds and cost approximately $1,200-$3,000. The AED has a built-in computer that assesses the victim’s heart rhythm to determine if he or she requires a shock. The AED then uses voice, lights or text-messaging prompts to guide the rescuer through the defibrillation process[2]. It’s as simple as A-E-D.

Jump-start your AED Program

The development of an AED Program is a responsible and appropriate way to manage sudden cardiac arrests. (See sidebar)

SIDEBAR: To Implement an Effective AED Program

STEP 1 - Set Goals:An AED Program Manager/Committee should develop and document policies and procedures that address how AEDs will be utilized throughout the organization, what criteria will be used to determine which facilities get AEDs and the time frame for implementation and training[3].

STEP 2 - Establish a Program:Conducting a site assessment is the first step in developing an AED Program. Site assessments should include a facility walk-through to determine how many AEDs are needed, where the AEDs should be located and how many trained workplace responders are needed.

According to the AHA, from the time a victim “drops” from sudden cardiac arrest to the time a workplace responder delivers a “shock,” every minute that passes reduces the victim's chance of survival by 7%-10%. Research shows an effective AED program with a three-minute “drop-to-shock” time will save the lives of three out of four sudden-cardiac-arrest victims[3]. Therefore, the number of AEDs needed in a facility should be based upon the three-minute "drop-to-shock" rule: Wherever an employee may be when he or she collapses, a workplace responder should have access to an AED and be able to deliver a life-saving shock within three minutes.

STEP 3 - Organize a First-Responder Team:Recruiting workplace responders and training them is truly what separates life-saving AED programs from those that simply place a unit on a wall and hope for the best[3]. The AED trainer should have practical experience and provide hands-on training in accordance with AHA guidelines.

STEP 4 - Liability Review:Good Samaritan laws enacted in all states release AED lay responders acting without “willful or wanton misconduct” from liability in helping victims[2]. You may actually carry more liability by not having an AED.

STEP 5 - Ongoing Management:Equipment maintenance includes inspecting and servicing AEDs based on the manufacturer’s suggested schedule.

That's a Wrap

It should be clear that buying an AED is not the end, but just the beginning of a life-saving program. Through the implementation of an effective AED Program, your organization can protect its workforce, lower liability and save lives. The impact is well worth the investment.IH