Public Access Defibrillators

[LifeLine]

Hello, I am just joined. I had some questions and thought I would ask the experts! I was a volunteer firefighter in southern MN, but now currently work as a consultant to help businesses and organizations set up public access defibrillators (PADs). I want to make PADs more community friendly and had some questions.

As many of you have read, public access defibrillators can help provide necessary treatment prior to EMS arrival. In the field do you see these working or do Good Samaritans just not know how to use them? Know where they are?

Does your department actively help in training of these defibrillators and do you know where every AED is in your community?

We see a lot of what is going on from inside the business or organization and I want to try to combine what we are doing to help assist local EMS thus increasing the chance of survival for the patient.

 

[Airwaygoddess]

Hi Jason! Welcome to the tribe, AHA is a pretty good resource for PAD info and ways to set up. Hope this helps!

 

[LifeLine]

Hi Jason! Welcome to the tribe, AHA is a pretty good resource for PAD info and ways to set up. Hope this helps!

Thanks! AHA is a great resource for setting up PAD, but my goal is to bridge the gap that I currently see with a business that has an AED and the rescuers that respond to the call.

We provide AEDs, certified AHA training and medical oversight to ensure quality control. Our clients are taken care of very well and have more training and medical oversight than many states require. The problem is, many states like Minnesota do not require the business or organization to contact their local EMS to report the placement of an AED nor do they require the owners of an AED to receive training.

Do you, as rescuers, see problems with public access to defibrillation that needs to be addressed? For instance, do you see any businesses or organizations that have an outdated AED with pre 2005 CPR guidelines, or an AED that the batteries or pads are expired and thus it does not work? Would you like to know who has an AED and are they trained?

My goal is to increase the number of AEDs in the community as well as increasing the number of people properly trained in CPR and the use of an AED, while informing the EMS community to provide the most information available that may assist in the increase of survival of a patient. This is why I decided to ask the EMS community here. We are going to implement a reporting program and I want to get opinions of EMS personal as to how we can make this work to its fullest extent.

 

[mdtaylor]

My interpretation is that there is no such thing as Public Access Defibrillators. The AEDs are placed in a place of business and certain employees of that business are trained to use that device. At that point those employees are no longer members of the general public but trained rescuers. Albeit not specifically certified by any particular state agency. But trained nonetheless.

The general public has NO medical direction and no training therefore has no business using an AED.

Those AEDs are not for public access, but for access by the trained individuals of the business wherein they are located. AEDs on every street corner... now there's public access AEDs!

 

[Ridryder911]

Actually, there are some (i.e Phoenix Airport) that are placed like Fire Extinguisher cases (one has to break a seal) to use, but anyone can.

There was a younger man that had sudden cardiac death, and a non-trained person ran over and applied it defib the man, thus terminating V-fib. In all practical purposes their easy to use with big pictures where to place the pads and only two buttons on them. One to analyze & the second to deliver the shock if directed to. A monkey could do it, if they could read.

R/r 911

 

[KEVD18]

i can personally say that, professionally, i dont care where the aed's in my service area are. i have the one off my truck that i personally inspected that morning. i know the pads are current, the guidlines are current, the batteries are charged and all the accoutrements are present. i also know that its compatible with my services monitors.

 

[reaper]

Our service is very big on PAD's. They do have them in areas all over the county. We do provide training on them, but they are there for public access.

Our 911 dispatch has a computer program that shows the location of all PAD's. If a call comes in for cardiac arrest, they can see if one is close and tell the caller where it is located.

To date, they have been used about 10 times, 8 have been saves.

KVED18,
That is just unprofessional to think that way. Early defib is shown to be beneficial in cardiac arrest. I would be thankful if someone took the time to use it on me.

Also, all of our AED's are compatible with our monitors. We can show up and plug the pads right into our monitor. This does save some time.

I think PAD's are a good thing and more communities should be working toward them.

 

[LifeLine]

The general public has NO medical direction and no training therefore has no business using an AED.

The ease of use of the AEDs out on the market coupled with how good kids are with electronics these days made for an interesting study.

http://circ.ahajournals.org/cgi/content/full/circulationaha;100/16/1703

Background—Survival after out-of-hospital cardiac arrest (OHCA) is strongly influenced by time to defibrillation. Wider availability of automated external defibrillators (AEDs) may decrease response times but only with increased lay use. Consequently, this study endeavored to improve our understanding of AED use in naive users by measuring times to shock and appropriateness of pad location. We chose sixth-grade students to simulate an extreme circumstance of unfamiliarity with the problem of OHCA and defibrillation. The children's AED use was then compared with that of professionals.

Methods and Results—With the use of a mock cardiac arrest scenario, AED use by 15 children was compared with that of 22 emergency medical technicians (EMTs) or paramedics. The primary end point was time from entry onto the cardiac arrest scene to delivery of the shock into simulated ventricular fibrillation. The secondary end point was appropriateness of pad placement. All subject performances were videotaped to assess safety of use and compliance with AED prompts to remain clear of the mannequin during shock delivery. Mean time to defibrillation was 90±14 seconds (range, 69 to 111 seconds) for the children and 67±10 seconds (range, 50 to 87 seconds) for the EMTs/paramedics (P<0.0001). Electrode pad placement was appropriate for all subjects. All remained clear of the "patient" during shock delivery.

Conclusions—During mock cardiac arrest, the speed of AED use by untrained children is only modestly slower than that of professionals. The difference between the groups is surprisingly small, considering the naïveté of the children as untutored first-time users. These findings suggest that widespread use of AEDs will require only modest training.

 

[LifeLine]

Our service is very big on PAD's. They do have them in areas all over the county. We do provide training on them, but they are there for public access.

Our 911 dispatch has a computer program that shows the location of all PAD's. If a call comes in for cardiac arrest, they can see if one is close and tell the caller where it is located.

To date, they have been used about 10 times, 8 have been saves.

Also, all of our AED's are compatible with our monitors. We can show up and plug the pads right into our monitor. This does save some time.

I think PAD's are a good thing and more communities should be working toward them.

This sounds like it is working well for your department. Did you place the AEDs or did you guide the businesses into which AED you would like them to place so it was compatible with your monitors?

I would be interested in learning more about the software the 911 dispatch has.

 

[Chimpie]

My interpretation is that there is no such thing as Public Access Defibrillators. The AEDs are placed in a place of business and certain employees of that business are trained to use that device. At that point those employees are no longer members of the general public but trained rescuers. Albeit not specifically certified by any particular state agency. But trained nonetheless.

The general public has NO medical direction and no training therefore has no business using an AED.

Those AEDs are not for public access, but for access by the trained individuals of the business wherein they are located. AEDs on every street corner... now there's public access AEDs!

Actually, there are some (i.e Phoenix Airport) that are placed like Fire Extinguisher cases (one has to break a seal) to use, but anyone can.

And let's not forget about malls, stadiums, most gov't buildings. Most are installed in cases that are recessed into the walls.

i can personally say that, professionally, i dont care where the aed's in my service area are. i have the one off my truck that i personally inspected that morning. i know the pads are current, the guidlines are current, the batteries are charged and all the accoutrements are present. i also know that its compatible with my services monitors.

Maybe I misread it, but Jason is talking about PADs that citizens can use prior to EMS arrival.

Our service is very big on PAD's. They do have them in areas all over the county. We do provide training on them, but they are there for public access.

Our 911 dispatch has a computer program that shows the location of all PAD's. If a call comes in for cardiac arrest, they can see if one is close and tell the caller where it is located.

To date, they have been used about 10 times, 8 have been saves.

Now that is neat, but had to be an administrative nightmare to set up.

Also, all of our AED's are compatible with our monitors. We can show up and plug the pads right into our monitor. This does save some time.

I think PAD's are a good thing and more communities should be working toward them.

Jason, pay attention to that right there. Get to know the EMS agencies that serve your territory. Know what they use. Saying that your equipment will work with theirs was a huge selling point when I used to sell PADs.

This sounds like it is working well for your department. Did you place the AEDs or did you guide the businesses into which AED you would like them to place so it was compatible with your monitors?

I would be interested in learning more about the software the 911 dispatch has.

Jason, the more information you can provide to the potential customer the better off you'll be as a sales person. I would steer away from doing any actual installations. Let them hire a contractor to do the work. You spend your time selling.

Now here's the best tip I can give you for you to be successful in this biz. Don't just sell them a unit and call them every year or two to renew their training. Develop a relationship with them. Tell them you or someone from your team :wink: will come out monthly to check the machine. Tell them you will monitor the expiration dates of the paddles and batteries and will let them know when it needs changing. Even if you know that the pads won't expire till next January, go there EVERY MONTH, say hi, check the unit over, let them know everything is okay and that you will see them next month. If you do this, when it comes time to renew their training they won't hesitate because you've developed that relationship with them.

Good luck and if you have any questions please feel free to contact me.

 

[JPINFV]

My interpretation is that there is no such thing as Public Access Defibrillators. The AEDs are placed in a place of business and certain employees of that business are trained to use that device. At that point those employees are no longer members of the general public but trained rescuers. Albeit not specifically certified by any particular state agency. But trained nonetheless.

The general public has NO medical direction and no training therefore has no business using an AED.

Those AEDs are not for public access, but for access by the trained individuals of the business wherein they are located. AEDs on every street corner... now there's public access AEDs!

Would you like a picture of the PAD in my school's student lounge? Also all of the security stations (points of entry to the building. 2 for the main building) have AEDs located in them. Furthermore, spread throughout the attached hospital are PADs. As stated earlier, they are positioned in alarmed boxes similar to how fire extinguishers are.

As far as "no training, no medical control," I honestly doubt that even the dumbest user is going to either screw it up (hell, it's AUTOMATIC, well, semi-automatic to be specific since you push a button to analyze and a button to shock.) or fail to call EMS when used.

 

[LifeLine]

As far as "no training, no medical control" Some states require training and medical oversight, if you are setting up a PAD program be sure to check your states AED legislation.

 

[reaper]

This sounds like it is working well for your department. Did you place the AEDs or did you guide the businesses into which AED you would like them to place so it was compatible with your monitors?

I would be interested in learning more about the software the 911 dispatch has.

Our service has actually purchased all the PAD's, through grants and fund raising. Not only in public places, but we have placed them in all SO cars as well.

The software is a map of the county. When the call comes in, that area of the map pops up. There are symbols on the map that shows where a PAD is housed and any directions for access to it.

It does work well. It takes a lot of work, but this is part of helping the community that you serve.

 

[Chimpie]

The software is a map of the county. When the call comes in, that area of the map pops up. There are symbols on the map that shows where a PAD is housed and any directions for access to it.

I guess you can add it to the same software used to map out fire hydrants and the like. Just thought of that.

 

[JPINFV]

Well, Google Maps can be used to tract a bunch of information like that. During the California Wild Fires last year, several of the news agencies were keeping tract/publishing fire statistics, evacuation zones, evacuation centers and the like using Google Maps. It was pretty interesting to see just how the data was being managed and passed on.

http://www.signonsandiego.com/firemap/

The San Diego Tribune's map is now more for historical data (acerage burned, pictures, and the such), but it had a wealth of information during the crisis posted on it.

 

[certguy]

My interpretation is that there is no such thing as Public Access Defibrillators. The AEDs are placed in a place of business and certain employees of that business are trained to use that device. At that point those employees are no longer members of the general public but trained rescuers. Albeit not specifically certified by any particular state agency. But trained nonetheless.

The general public has NO medical direction and no training therefore has no business using an AED.

Those AEDs are not for public access, but for access by the trained individuals of the business wherein they are located. AEDs on every street corner... now there's public access AEDs!

The simple facts are ; these are very easy to use , AHA and ARC both teach these skills to the general public , Even in a layperson's hands , PADS have saved lives . The machine walks you through the process . You can't always count on quick response times and the sooner the defib , the better chance of survival . We should support this program .