Automatic External Defibrillators:
The Shocking Truth

You and a co-worker are walking by the college fitness center and witness a 40-year-old man slumped on the floor by the treadmill. You kneel beside the man and find him unresponsive. You tell your co-worker to call 911 on the nearby telephone, and to grab the automatic external defibrillator (AED) next to it. The man is not breathing and has no pulse. You start CPR, and your co-worker hands you the AED. You attach the electrode pads for the device to the man and turn the AED on. The machine starts to give you loud verbal commands that you follow.

Could this scenario happen to you? Absolutely. This is a way to help save lives previously lost to sudden cardiac death. AEDs make the earliest possible defibrillation a reality, and the American Heart Association recommends placing these devices in areas where large numbers of people congregate, such as stadiums and gymnasiums.

About 250,000 deaths occur annually from sudden cardiac arrest. Most cardiac arrests are due to abnormal heart rhythms called arrhythmias. Ventricular fibrillation (VF) is the most common arrhythmia that causes cardiac arrest. VF is a condition in which the heart's electrical impulses suddenly become chaotic, often
without warning, causing the heart's pumping action to stop abruptly. Death can follow within minutes.

Defibrillation is the key to surviving a cardiac arrest. If used within minutes of the arrest, it can restore the heart's normal rhythm. But for each minute that passes without defibrillation, the chance of survival decreases by about 10 percent. In the past, the ability to defibrillate rested solely in the hands of emergency medical workers. Today a new generation of AEDs makes it possible for trained lay rescuers to operate them. The new AEDs are effective, lightweight,
low maintenance, easy to use and relatively inexpensive (about $3,000 each). AEDs are also quite fail-safe. Placing the electrode pads on the victim enables the AED to sense the heart rhythm and make appropriate voice prompts. Even if the rescuer is overzealous and presses the shock button without an appropriate voice prompt, defibrillation attempts will not happen.

What about the legal ramifications of providing AEDs at our facilities? Arizona's AED bill (ARS Title 36, Chapter 21.1) was approved by the governor in 1999 and provides legal liability protection for the trained responder, the instructor, the supervisory physician, the premise owner, and the AED acquirer. This liability protection requires physician oversight of the program, and that AED use is limited to properly trained responders, be maintained per manufacturer guidelines, and be integrated with the local Emergency Medical Services system. AEDs are viewed more like necessary safety equipment than just another type of medical equipment (fire extinguishers are a common analogy). The growing trend toward AED programs may eventually increase liability for facilities not prepared to respond appropriately to a cardiac emergency.

Cardiac arrest is a matter of life or death. It is strongly encouraged that all of the colleges and facilities within the Maricopa County Community College District establish AED programs. After all, the shocking truth is that it's the right thing to do.

Contact the District risk manager for assistance on implementing an AED program at your campus.

Published in the Spring 2001 Edition of In Brief