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EMS Corner
Public access defibrillation
Vol. 26 Summer

Automated external defibrillators (AEDs) have been discussed since before the new millennium. So with a little more than 10 years of public access defibrillation (PAD) programs, it is time to test the waters and see how they work. Thus the article, "Public Access Defibrillation: Time to Access the Public, published in the Annals of Emergency Medicine

The editor’s capsule summary was to ask the public from 38 nations whether they know what AEDs are and would they be willing to use them. Basically, the public failed. Less than half of the people could recognize an AED or were willing to use one.

Of all the times I have written or published an article on AEDs, every single one of them started with, "Sudden cardiac arrest is a leading cause of death." This still remains to be true and the good news is we can do something about this problem—if bystanders are willing to help.

The study does not address the issue of how many of the AEDs out there are truly PAD programs. Having performed AED inspections, I have entered government buildings where the AED box was hanging proudly on the wall, but the AED itself was hidden in a closet for fear of someone tampering with it. It is imperative that businesses and industry see AED programs as a form of insurance. Insurance that provides appropriate treatment to a cardiac arrest event. People will be lost to cardiac events in the presence of AEDs, but those are the lesser of these events. Most of these events can be treated with AEDs.

Back to the study that asked, "If you were to see someone lying on the floor, not breathing and suspect cardiac arrest, what would you do?" The public failed across the globe. The study asked, "What is a defibrillator used for?" The public failed again. "Who do you think is allowed to use a defibrillator?" The public failed still again.

Demographics were ascertained from participants too. This was the only part of the questionnaire to receive a passing grade.

This study also investigated the knowledge and attitudes of the public towards AEDs. The public is the largest group of rescuers available. It was also accompanied by regular public announcements on television, printed material and training sessions.

Being prepared for an emergency medical event in the post millennium is paramount. It is time that OSHA grew some teeth and increased their gentle advisory to a standard of care in America. AEDs, like fire extinguishers, should be hanging on the wall. This idea was introduced in 1992 in the Industrial Fire World article "It Will Shock You Back To Life," and it still seems like a viable idea.

In the world where high survival rates are seen after cardiac arrest such as in casinos, this information suggest that we could double our cardiac survival rate. To someone whose mother or best friend was saved by an AED it seems simple to implement, but there is resistance. Training, implementation and follow-up can be costly, but compared to that of saving a life on the job site, it is mere pennies.

With a multitude of major disasters going down in the world, people need to prepare for action in a cardiac event. This responsibility should be tied to privileges such as driving or working. Some people may protest. "Don’t add another thing to my plate," they say. Unless of course their plate is now missing a loved one.



Copyright 2011 by the American College of Emergency Physicians


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