This guest commentary comes from Harvard Reynolds, founder and principal for LIFEGUARD Medical Solutions of Nashville, TN.
For TFM‘s past coverage of this topic, see “Not Just Another Day At The Office,” from the archives.
Heart disease is the greatest killer of all Americans, taking the lives of an estimated 300,000 of our family members, friends and co-workers each year. Considering that the American Heart Association (AHA) recommends a shock to the heart from a defibrillator within three to five minutes after someone suffers a sudden cardiac arrest (SCA), the response time necessary to save a victim of SCA is extremely vital. Furthermore, as the ages and labor hours of our workforce continue to increase, so does the likelihood that cardiac arrests may occur in the workplace.
The most common form of SCA is ventricular fibrillation, or V-F. V-F occurs when the body’s electrical system short circuits, sending the heart into an abnormal, chaotic rhythm and disallowing the heart to pump blood and oxygen properly to vital organs and tissues. Medical science has learned that the best response to V-F is the timely surge of electricity sent through the body from a heart defibrillator. This electrical “shock” ideally restores the heart to a normal sinus rhythm and may save a person’s life, if administered within an adequate timeframe.
For every minute which passes without a shock from a defibrillator, the victim’s chance of survival decreases by as much as 10%. Certainly, after six or seven minutes without proper defibrillation therapy, the chance of survival is very slim. Furthermore, after only a few minutes without defibrillation, the lack of proper blood and oxygen flow can cause serious and permanent neurological damage—even if the victim happens to survive.
While many of our paramedics, EMTs, firefighters, and other professional responders carry portable heart defibrillators on their vehicles, many factors may contribute to their inability to reach a victim in time. Distance to a location, busy traffic conditions, and inclement weather are just a few of the obstacles our public safety personnel face when responding to a medical emergency. Fortunately, advances in medical technology, as well as support from governmental agencies, have allowed our corporate facilities the opportunity to become safer environments, while also offering protection from potential liability.
The modern day automated external defibrillator (AED) is designed to be safe and very easy to use by almost anyone. These AEDs use simple to understand voice prompts to guide a lay person through the entire rescue procedure for someone suffering a cardiac arrest.
Most importantly, an AED is specifically designed only to administer a shock to a patient in a cardiac arrest situation—the AED will not shock a patient who is not suffering a type of cardiac arrest. This technological “intelligence” is very important to understand, as the rescuer does not have to worry about accidentally or inadvertently shocking a patient who may not be experiencing a cardiac arrest.
For example, the patient may have lost consciousness due to a variety of causes other than a cardiac arrest, such as a heat stroke or an adverse medication reaction. When these symptoms occur, the AED will not allow the rescuer to shock the patient. In short, the AED makes the decision to shock the patient, not the rescuer.
Certainly, if a patient loses consciousness, the first reaction should be to call 9-1-1. Secondly, the rescuer must assume the cause for distress may be that the victim has suffered a cardiac arrest and retrieve the AED, if readily available. The timely and proper reaction to a cardiac arrest is vital to a patient’s survival; and a rescuer’s reaction procedure is predicated upon adequate training.
Receiving CPR certification should be a standard requirement for many, if not all, employees. This employee training is designed for almost anyone and is available to be taught onsite from non-profit agencies such as the American Heart Association as well as other private safety service companies.
Trial results published in an August 2004 publication of The New England Journal of Medicine reaffirm the American Heart Association’s position that a community based, comprehensive lay rescuer program that includes both cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) training can save more sudden cardiac arrest victims. The journal reports the results of a two-year trial comparing out of hospital cardiac arrest survival between community CPR programs with and without AEDs.
In programs with bystanders trained to call 9-1-1 and provide CPR without an AED, 15 out of 107 cardiac arrest victims survived to hospital discharge. In programs with lay rescuers trained and equipped to call 9-1-1 and deliver CPR plus use an AED, 30 of 128 cardiac arrest victims survived to hospital discharge.
“This multi-center study confirms the value of AED Programs in improving survival from sudden cardiac arrest,” said Joseph P. Ornato, M.D., lead author of the trial.
While the placement of a medical device in the hands of a lay responder is a technological breakthrough, many corporate officials remain fearful of the potential for litigation. Fortunately, our government agencies are aware of the importance of these AEDs in our workplace environments, and they have taken the necessary steps to ensure that an organization and its employees are better protected from liability under federal, state, and local “Good Samaritan” laws.
As Richard Lazar, Esq., a legal expert on emergency medical services topics who serves as an advisor to the National Center for Early Defibrillation, stated, “Legal liability fears should not deter those considering the purchase and use of AEDs. Organizations that carefully adopt and implement AED Programs will be at lowest risk of liability.”
To many, the most frightening aspect regarding sudden cardiac arrest is that it can happen to anyone at anytime. Man, woman, or child, we are all potential victims of SCA. For the safety of your employees, please consider implementing an AED Program into your workplace by investing in the purchase of an AED and CPR training. With the proper equipment and training available, you will raise the standard of care for your customers, guests, and employees at your facilities and maybe even save someone’s life one day.
If you have questions about this article, contact Reynolds at (866) 932-2331 or by e-mail at [email protected]