What it means to your business.

Every year about 415,000 people die from Sudden Cardiac Arrest (SCA). According to the American Red Cross, SCA claims another victim every minute of every day. A heart attack occurs when the arteries that supply blood to the heart become blocked. The flow of blood that carries oxygen to the heart is slowed or stopped. This is called sudden cardiac arrest or simply cardiac arrest. Most cardiac arrests are caused by an abnormal heart rhythm called Ventricular Fibrillation (VF). VF occurs when the heart’s electrical system malfunctions, causing a chaotic rhythm that prevents the heart from pumping oxygen to the victim’s brain and body3. In all cases of VF the patient will not be breathing nor will there be a palpable pulse or heartbeat. The patient will be unconscious, pale, or even cyanotic (bluish skin color).

Defibrillation is the only known therapy for VF3. Help needs to be given quickly—generally before the victim even gets to the hospital. Because VF is the primary cause, prompt resuscitation and prevention of recurrence of VF are necessary2. Defibrillation can increase survival rates dramatically if administered within the first few minutes2. With every minute a victim does not receive defibrillation following sudden cardiac arrest, the chances of survival decrease by 10 percent8. Statistics also show that early CPR and early defibrillation combined with early advanced care can result in long-term survival rates for witnessed VF, as high as 40 percent2.

Installing Automatic External Defibrillators (AEDs) in the workplace can be a wise investment and responsible choice for the health and safety of the company’s employees, customers and visitors8. This article will attempt to explain why AEDs should be included in company’s first aid kits. I will also discuss the benefits, in addition to the legal concerns of AEDs in the workplace. Lastly I will give some resourceful information on starting an AED program for a company’s emergency management program.

 

Benefits of AEDs in the Workplace

In this section I will discuss the benefits of having AEDs in the workplace. What are the benefits? Are there any? Or is it wise just to wait for professional medical assistance or to start lifesaving skills immediately? These are some of the questions that arise when companies or organizations weigh the pros and cons prior to starting an AED program. In addition there will be a short discussion on the risk factors of AEDs in the civilian workplace.

All employees are valuable to a company’s success. Government or civilian employers depend on their people daily to keep it running smoothly and efficiently. Depending on the company’s mission and location, you may see various medical emergencies that may occur. Some may include bites (human, animal, insect, etc), stings, falls, electrocution, diabetic emergencies, motor vehicle accidents, chest pain, blunt trauma, and violent criminal acts resulting in injury. All of these emergencies have one thing in common—a person can go into sudden cardiac arrest (SCA) from each of these. Once a person goes into SCA, help needs to be given quickly—generally before the victim even arrives at the hospital. Because VF is the primary cause of sudden cardiac arrest, prompt resuscitation and prevention of recurrence of VF are necessary. Defibrillation can increase survival rates dramatically if administered within the first few minutes2.

To further give a better perspective of VF, think of the heart wiggling “like a bag of prepared Jell-O”. It is a chaotic flutter. A fibrillating heart can’t pump blood, creating the risk of brain damage and death. Thus an electrical shock restores a heartbeat and circulation. But for the patient to survive neurologically intact, rescue must be swift.

AEDs are lifesavers. The benefits of AEDs are numerous. However in the early 1990’s AEDs were heavy, awkward to handle and maintenance-intensive. Also the early AEDs were not as reliable or easy to use. These factors made them impractical for many groups of emergency responders and limited their widespread deployment6. However in 1994, the American Heart Association challenged the medical device industry to develop a lightweight, low-cost, easy-to-use AED6. Many companies rose to the challenge. Today there are many excellent AEDs that are very easy to use, small and lightweight. Also today's AEDs are virtually maintenance free, durable and most of all they are highly reliable if used properly6. Current models have automated voice prompts and computerized analysis of the victim’s heart condition that directs the decision to shock7. These improvements make it possible for non-medical professionals to administer the same vital service without risking an accidental shock1. Historically, only trained medical professionals (Emergency Medical Technicians, Paramedics, and Nurses) were able to interpret the heart rhythm on manual defibrillator devices. However AEDs now eliminate the need for manual defibrillators for patients in sudden cardiac arrest.

A broad range of responders, including police officers, security guards, corporate safety officers, flight attendants and other citizens have all reported using AEDs successfully6. Today the new generation of AEDs are reliable, low-cost and easy to use. This makes treatment of SCA in the workplace a realistic goal. Non-medical operators of AEDs do not have to know how to diagnose cardiac arrhythmias. All commands or instructions to the rescuer are computer voice prompted in the English language. AEDs have proven to be exceptionally safe and effective6.

Successful companies with such programs already include Boeing, General Motors, General Mills, Dow Chemical Company, IBM, Honda of America, Gillette, Lucent Technologies, Home Depot, Smith Barney and many more6. The general public may have even seen AEDs in place on walls at their local airport. In fact, two years ago Congress passed into law requiring that all Federal buildings and Post Offices to have an AED program and have AEDs easily accessible in the workplace5.

AEDs potentially prevent thousands of unnecessary deaths and allow persons to return to full and active lives, including employment. Survivors have a good long-term prognosis — 83% are alive at one year and 57% at five years6.

Companies that adopt AED programs for their workplace can save lives, improve morale, avoid potentially costly lawsuits, jury awards and demonstrate to their workers, their clients and their communities that they care about the health and well-being of their employees6. However there are risks with the use of AEDs in the workplace. The potential for legal action is ever present. Initial training, upkeep and refresher training are a major concern. The next section will examine this issue and possibly mitigate any concern that a company may have prior to starting their own program.

Risk Factors of having AEDs in the Workplace

As with anything there are risk factors. This holds true with the use of AEDs in the workplace. There are some areas that need to be addressed before a company decides to purchase AEDs and start an AED program in conjunction with their First Aid program.

For $2000, an AED can be a lifesaver for the patient; however a company that fails to keep their employees trained or certified in the use of CPR and AED operations can face potential legal ramifications. This can spell doom for a company. Even a company that fails to provide CPR and AEDs for their employees can also face possible legal action. Either way you look at it a company can face legal issues. However there are ways to protect your self in event of a lawsuit. This is called prevention. By having an AED program a company can prevent being liable for negligence. A company that already has an AED program in place can prevent being liable for malpractice lawsuits by having an adequate and documented training program with physician oversight.

If the agencies’ employees are not prepared or well trained to handle cardiac arrest emergencies, their coworkers could be left untreated until an ambulance arrives, causing the victim’s condition to worsen. Even causing brain damage or death. This can lead to higher medical/worker’s compensation costs and lost productivity8. Currently many Emergency Medical Services (EMS) around the nation endorses AED programs for the workplace. The faster you can get treatment to a patient in SCA, the better chances the patient will survive. However the company has to have a good quality training program for their employees prior to them performing AED operations on a patient in SCA.

The Occupational Safety and Health Agency (OSHA) require that employers provide first aid and CPR training to employees in the absence of a nearby clinic or hospital8. There is not a specific number of how many employees that need to be trained on staff, it depends on your organizations size, type of operations and potential for emergency medical needs. At a minimum, each department or location should have a first responder available on each shift.

Adequate CPR and AED training courses with required refresher training are essential to a company’s successful emergency management plan. Employees or companies that are reluctant to start such programs because of liability issues such as malpractice or negligence should have little to fear8. Currently there are over 36 states that protect persons and companies from civil lawsuits. Good Samaritan Laws and legal principles such as sovereign immunity are designed to protect people performing their authorized duties6. Although these laws vary from state to state, authorized employees performing defibrillation to people experiencing sudden cardiac arrest in the workplace setting would generally be covered under these statutes. Even companies that offer AEDs to their employees can be protected from legal litigation in event of a lawsuit, just as long there is sufficient evidence of the following recommendations set by the American Heart Association:

·  Training was designated to rescuers to perform CPR and use an AED.

·  Having physician oversight to help ensure quality control.

·  Integrating with the local emergency medical services (EMS) system Using and maintaining AEDs according to the manufacturer’s specifications.

These recommendations of course will not prevent a lawsuit; however, they may prevent a company from losing a lawsuit! Moreover, companies that fail to provide CPR and AED operations in the workplace could face stiffer consequences from the legal system. The absence of an AED program may present a favorable advantage to the plaintiff’s attorneys, who can argue that the deceased would most likely have survived the SCA had the company utilized an AED. Considering the ready availability of improved AED technology, with reduced cost and simplified operation and maintenance, as well as the proven efficiency of timely defibrillation, these arguments may be difficult to successfully counter in a court of law6. In 1996, a popular amusement park was found negligent and forced to pay $500,000 in damages for failing to provide their employees with proper emergency medical care training and for not maintaining a defibrillator and other necessary emergency medical equipment6. In one other case, a popular airline carrier was also found negligent for failing to provide timely treatment for a patient suffering a cardiac arrest.

As mentioned before, lawsuits are unpreventable however winning a lawsuit is what really matters. If a company can cover all their bases when providing emergency medical services such as CPR and AED operations and proper training programs, winning a potential lawsuit is much greater then a company that does not offer such services.