Does your BLS unit carry an AED?

MMiz

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So do they? What's their reasoning behind it?

I've seen both units with and without them in my county, usually depending on the company. While chances of an EMT-B using an AED are rare, I feel it is a great tool to have available.

How is it where you are?
 

lastcode

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You should not make assumptions that the chance of BLS using AEDs is rare. It is extremely common in rural areas. In my area even the cops use AEDs. The closest ALS takes 20 minutes after we call them and usually they are not available. My agency has been carrying AED for around 10 years. They are so simple I think that every city and town should have them placed strategicly for the public to use in emergencys.
 

MMiz

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Originally posted by lastcode@Feb 18 2004, 11:26 AM
You should not make assumptions that the chance of BLS using AEDs is rare. It is extremely common in rural areas. In my area even the cops use AEDs. The closest ALS takes 20 minutes after we call them and usually they are not available. My agency has been carrying AED for around 10 years. They are so simple I think that every city and town should have them placed strategicly for the public to use in emergencys.
The private company I work for also has AEDs. The one or two (out of 20 or so) BLS fire/EMT-B stations also have AEDs. In my city where there is a 5-8 minute response time for ALS, cops also carry AEDs.

It was just my experience that private companies did not carry AEDs. It is true that many private BLS trucks don't carry them, as it is another way to save money.

Good to know they're becoming more popular now though.
 

SafetyPro2

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We have them on both ambulances and use them frequently (worked 2 full arrests in the last 2-3 weeks). We're a BLS department, and the way our system is structured, we don't call for ALS (would take longer to get an ALS unit from another city than to scoop and go...hospital's only about 2 miles away).
 

MMiz

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Originally posted by SafetyPro@Mar 10 2004, 01:31 AM
We have them on both ambulances and use them frequently (worked 2 full arrests in the last 2-3 weeks). We're a BLS department, and the way our system is structured, we don't call for ALS (would take longer to get an ALS unit from another city than to scoop and go...hospital's only about 2 miles away).
That's really interesting. All of my partners have used the AEDs multiple times, and the more and more people I ask, Im finding BLS units with AED units are a lot more valuable that I originally thought.

Two arrests in the past month? What kind of area do you work? From the sound of things you're in a pretty populated area, especially with hospitals so close. If a call even comes in with a possibility of a code, our company dispatches a PFR (Paramedic First Responder in a Tahoe, a single medic without the drug box), a BLS unit with an AED, and an ALS unit. Usually the BLS unit has a 2-3 minute response time. The PFR also has a 2-3, and the ALS is required to be there under 5.

It's interesting to see how other companies / departments respond though.
 

SafetyPro2

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Around here, fire departments are the primary EMS agency. Probably 2/3 of the departments run rescue ambulances (RAs), while the rest run non-transport squads with a private company providing the transport. The private companies primarily do inter-facility transports or provide transport for the FDs, but don't respond as a primary provider (and most are BLS as well).

We support about 11,000 residents, and a large percentage are elderly. We really don't get that many full arrests outside of the skilled nursing facility (where many are DNR anyway), but this past month we did.

As I said, most departments are ALS...we're the only BLS department in the county (we're also the only volunteer department). Arcadia, our neighbor to the south and east, has three stations and runs two ALS RAs. Pasadena, to the west, runs 4 ALS RAs and two ALS engines. Their EMS call volume is high enough that it's impractical for them to respond outside their own jurisdiction, especially coupled with the current hospital crisis in L.A. County. It's not uncommon for an ALS unit to be out of service at the hospital for over an hour waiting for a bed for their patient...recently, 3 RA crews from two departments were out of service for close to three hours at the same hospital...a BC finally had to come in and have one crew take all three patients to put the other two RAs back in service.
 

lastcode

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AEDs are great. Our community of about 7000 is really pushing for them. We 2 of them in our small school, each of our ambulances has them, our cops have them, and we have them in a few places around town. The newest auto ones are so easy there really is no excuse for the avg person not being able to use them. They talk and tell you exactly what to do. They can be such lifesavers, but even in cities, it can take to long to get one to the scene.
 

SafetyPro2

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Aside from my FD activity, I'm a big supporter of workplace and public access AEDs as well. We had them at my last two jobs (newspaper and oil company), and I was the program coordinator for the oil company. I'm also a Red Cross instructor and have been planning on writing an article on workplace AEDs for Professional Safety journal (when I can find the time).
 

AngryGeek

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Early defib really is important. AEDs are great things and should be everywhere. Further, I don't think a vehicle should be able to be called an ambulance without an AED (or better). That includes BLS trucks that do nothing but transports. Any patient could potentially arrest into VF or VT.

Even if the station is a block from the scene, and the scene is only a block from the hospital, it will still take a few minutes to get them into the ER. That's more than enough time for a saveable patient to become nonviable.

Now, I know the pertcentage of arrests that go into VF or a VT rhythm that an AED can shock isn't that high. However, the survival rate of patients in those rhythmes that get early defib IS high.

As far as my department goes, we use the same trucks for BLS and ALS. We have Physio-Control LifePak 12s. When you turn them on they start in AED mode but if an Intermediate or Medic is on scene they flip to manual mode easily. Unfortunately even the base model of the LifePak 12 is VERY expensive. I believe fully equiped (pacer, NIBP, Sp02, EtC02, 12-lead, etc.) is around $16,000 (ouch!).

Interesting side note: One of the largest EMS/Fire departments in the state uses LifePak 12s and recently got rid of all their hard paddles because even the paramedics prefer the quick-combo pads (for many reasons). Being able to stand far away from the patient while shocking is a good thing!
 

Chimpie

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I agree. We have two AEDs for our community, one with us in the squad, one inside the main building. I take it with me on ALL medical calls (sick calls, requests for BP checks, fallen out of bed, pendant presses, etc.) cause with the elderly you never know when things are going to go south.

We use the LifePak CR Plus. It's a pretty basic unit and serves our needs well.



Chimp
 

Alpha752

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I dont work on a squad (yet), but I do work for a major sporting venue, and we even have 4 AED's through out the building. During events we have paramedics and nurses on site with Lifepack 12's, but non event times, I take care of that. We have several officers (security) that are trained in AED use, but I am the only EMT on staff, so my boss put me in charge of making sure that they are ready to go at any time. I am also the first responder if I am on shift. Havnt had to use the AED yet, but I know that they are there, and its a comforting thought. EMS responce can be anywhere from 5 to 10 minutes depending on how busy they are (I work in Downtown Cleveland). Its good to know that I can take care of things for at least that long.

I strongly support AED's on all BLS trucks, in all public buildings, and in any building that holds over 100 people. As long as someone is trained to use it, it is an invaluable lifesaving tool.

Russ
 

MMiz

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AEDs are great. Our trucks carry the Medtronic Physio-Control LifePak 500. They're a basic unit that really works well in an EMS setting.

My personal favorite as a device for a community setting would be the ZOLL AED Plus. It's a single pad unit, walks you through each step out loud, has a CPR marker telling someone where to do CPR (it's on the single pad), and best of all, tells someone how to do CPR. It will tell you to speed up, slow down, push harder, and so on. It also records all the information for later analysis.

I don't see the Zoll being popular in EMS, but I think it's a great choice for those who haven't operated an AED before.
 

ResTech

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I agree with the majority of the above posts. AED's are critical when determining outcome and giving a patient the best chance of survival from cardiac arrest due to the nature of the illness making treatment so time dependent. In my area, we have a two-tiered response system where all FD/EMS station's are equipped as BLS ambulance providers and ALS comes from the two hospitals, one fire station that serves as a satellite station for the one hospital ALS unit, and another FD that just started their own ALS service.

So in my area AED's are onboard all ambulances and QRS (Quick Response Service) units and are usually first onscene prior to the ALS unit and EMT-B's start the initial treatment of all arrest patients. My department uses the LP500 as does most other stations. I do know of a few that use LP12's as AED's and also for the vital signs monitor capability.

The weird thing is that the Pennsylvania Department of Health does not mandate AED's for licensure. We have seperate AED program requirements for "AED provider services" and find it kinda weird that there is no mandate for AED.

I think the most important issue is the national standard of care for treatment of cardiac arrest patients. A BLS provider service that does not have the equipment to deliver the standard of care within their scope of practice is opening themselves up to potential litigation for not delivering the standard of care. I know I would be quite upset if an ambulance arrived at my home without the ability to defibrillate.

The majority of the police departments and three area shopping malls all have AED's which is awesome.
 

SafetyPro2

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On a related note, they're becoming more and more prevalent in industry. The conference I was just at was the American Society of Safety Engineers, which is primarily industrial occupational safety and health professionals. I counted at least a half-dozen or more AED vendors in the exhibit hall: ZOLL, MedTronic, Heartstream and several others.
 

TKO

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I have worked both rural and urban areas in Sask here and it all depends on the private operator if he wants to shell out the cash for them or not. If there is ALS, manual defibrillators are available in all the units but AED's are by choice. I personally don't agree with this especially if we are running a BLS car and ALS isn't available, my god, lay rescuer's have them in the mall and casinos. If I was the ambulance operator running that service I personally would be embarrassed having my crews show up on seen of a code and can't do a dam thing just because I didnt want to buy one. Too bad.
 

Chimpie

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I agree TKO. At around $2,000 (US$) you simply can't afford not to have one. Or two or three....

Chimp
 

cbdemt

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In my area (central IL) ALL ambulances carry the LIFEPAC 12. The majority of ambulances in this region run out of fire departments (many of which are volunteer). We are all trainied on the basic AED functions as well as 12 lead ECG. There is only one ALS service in the county, so having access to this is vital to our patients. I cant imagine not having access to one. Its quite expensive (starting at $4995.00), but well worth the price.



Take a look...
http://www.dixiemed.com/defibs/lifepak-12.html
 

MMiz

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Originally posted by cbdemt@Jun 16 2004, 02:45 PM
In my area (central IL) ALL ambulances carry the LIFEPAC 12. The majority of ambulances in this region run out of fire departments (many of which are volunteer). We are all trainied on the basic AED functions as well as 12 lead ECG. There is only one ALS service in the county, so having access to this is vital to our patients. I cant imagine not having access to one. Its quite expensive (starting at $4995.00), but well worth the price.



Take a look...
http://www.dixiemed.com/defibs/lifepak-12.html
Very interesting.

Our ALS and Paramedic First Responder (One medic in a Tahoe) carry the LifePak12. ALS is no more than 5 minutes away, and the farthest hospital would probably be 10-15 minutes coding.

I really think it all comes down to cost. As a private company, I dont think they can rationalize spending so much on a unit when ALS is so close. I also know the units we carry have the PulseOx, BP system, Vent monitor, and a few more add-ons.

As a basic are you trained to do EKGs? Do you have ACLS too?

very interesting, thanks for sharing.
 

citizencain20

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[/B]In rural northern wisconsin, we also carry S-AED's (LifePac) with built in 4 lead ECG. Although not every EMT-B is trained on how to read an ECG (everything treated as if AMI) It is very useful to the hospitol staff upon arrival. Also, with the recent homeland security grant funding now most polic vehicles even carry AED's.
 

ffemt8978

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No AED's, but we do carry biphasic defibrillators. (Way Cool!) B)

I was corrected today about this. All of our engines carry the Heartstream Biphasic AED's, in addition to the biphasic defibrillators carried on our ambulances.
 
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