By Grainger Editorial Staff 2/27/23
Anyone who has watched scripted television medical dramas has likely seen use of a manual defibrillator. Paddles are placed on the chest of someone going through cardiac arrest, and after shouting “clear,” the acting doctor or EMT uses the paddles to deliver an electric shock designed to re-start the heart.
Technological advances have put that potentially life-saving method into the hands of real-life civilians through an automated external defibrillator (AED). These are lightweight, portable devices designed to be used by people with little or no training. Federal legislation in 2000 and 2002 significantly expanded their use in public settings and led to further state-level legislation, all designed to create wider adoption in public and private areas.
What should you know about looking for a new or replacement AED for your facility? Here are some of the key questions to consider:
Unlike the paddles of a manual defibrillator that are designed for use by healthcare professionals, portable AEDs use contact pads that stick to the chest of the person being treated. Though all AEDs use these pads, they operate in one of two modes and the distinction is important.
Once the pads are applied and the device is activated:
All the models come with adult-sized and an option for child-sized pads that offer different levels of stimulation. The American Heart Association recommends using the pediatric pads on children between ages 1-8, and adult pads on people older than 8. The organization also recommends manual defibrillation for anyone younger than 1.
Beyond the difference in operating modes, many AEDs have a lot of similar characteristics. In addition to doing most or all the work in delivering the shock, most models have extensive voice or video direction in placing the pads as well as in giving CPR. They are very light, between 3 and 7 lbs., and all models should be easy to carry. Some have cabinets that can be affixed to a wall for storing the AED in an easily accessible location.
Most AED models record data from each use. Some will allow users to connect the device to a personal computer via a USB cable, while some save the data on a removable memory card.
AEDs are typically powered by a lithium/manganese dioxide battery with a standby life between 4 to 7 years. The Mayo Clinic recommends replacing the batteries about every four years but check manufacturer's recommendations for specific model guidance. The contact pads also have an expiration date, typically 2 years. Check manufacturer recommendations for this as well.
OSHA does not require that companies keep AEDs in their facility, but the organization urges the practice. Devices are recommended to be placed where response can happen in 3 to 5 minutes, as well as locations such as:
The Food and Drug Administration (FDA) is the federal agency charged with approving AEDs that go to market. Beginning in February 2015, the FDA determined that due to product recalls and malfunction reports, these systems and their accessories required more oversight and so manufacturers were required to get pre-market approval (PMA) for their AED systems. That order was later extended to accessories, and by November 2022 manufacturers who didn’t apply for their PMA were prohibited from selling those accessories.
The FDA continues to monitor the products once they reach the market, reviewing design changes and performance reports.
Also, all 50 states have some form of a public access defibrillation (PAD) program law. Each law has different tenets, but according to the Centers for Disease Control (CDC), the broader aims include:
The American College of Occupational and Environmental Medicine published a position paper that it last reaffirmed in 2012, outlining guidance for bringing AED use into the workplace. Among the key recommendations:
The Society for Human Resource Management outlines a similar set of tips, adding in the need to communicate the program broadly. Newsletters, posters and safety meetings and larger team meetings each provide avenues to help all employees understand the program.
Q: When should you not use an AED?
A: While AEDs are designed to analyze heart rhythms to determine if a shock should or should not be delivered, the University of Missouri’s Environmental Health and Safety Department reminds people of instances where they may not want to use an AED. These include times when the victim is in contact with water; when they are lying on a conductive surface, such as a metal bench; or when they are close to flammable materials.E
Q: What potential liability is associated with using an AED?
A: According to the CDC, at least 48 states have a law that provides at least some liability or immunity protection for even untrained civilians who use an AED in good faith. Almost 40 states extend those protections to persons or entities who provide AED training. The public access defibrillation (PAD) law in the state or states where your company operates will spell out the protected classes and what that protection offers.
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The information contained in this article is intended for general information purposes only and is based on information available as of the initial date of publication. No representation is made that the information or references are complete or remain current. This article is not a substitute for review of current applicable government regulations, industry standards, or other standards specific to your business and/or activities and should not be construed as legal advice or opinion. Readers with specific questions should refer to the applicable standards or consult with an attorney.