Site assessment. A site assessment is a time for you to look at your facility and figure out the best possible location to place your AED(s). A three- to four-minute response time is crucial. Easy accessibility is what you are going for here.
Medical direction and oversight. This entails the direct involvement of a physician (or program director) to help with the development, tracking, and upkeep of written policies, procedures, protocols, certifications, and program upkeep requirements.
Responder certification. This comes from being trained in CPR and AED administration by a nationally accredited association (i.e., the American Heart Association).
EMS notification. EMS notification involves notifying the local EMS district in writing about the location of your AEDs.
Maintenance and upkeep. This part of the program involves the tracking and logging of AED maintenance checks, along with the tracking of responder certifications and monitoring of any regulatory changes that the laws may dictate.
Establishing program awareness and registration. You establish program awareness simply by notifying all possible employees of your AED program and that your facility does indeed have AEDs. Some cities have local ordinances that require a registration process of some type, which may or may not involve a minimal fee.
Many AED providers have the capability of providing an AED management program that takes care of most, if not all, of the requirements discussed above. A nominal fee is required in most cases but can be well worth it, especially if completing the requirements in house is not feasible. Again, if you are working with a reputable sales rep, he or she will be able to point you in the right directions.
Choosing the Right AED
In regard to number 6 above, I wanted to talk about it last. I am surprised that, while you can indeed find out a lot about AEDs on the Internet, nowhere have I found a list of general questions that every buyer should ask when meeting with his AED representative. All AEDs provide some type of shock therapy, but the similarities stop there. The “all AEDs are the same” attitude needs to be thrown out the window, and AEDs must be looked at very closely. Fortunately, the most important differences are right in front of you.
All AEDs differ, from the color to the design, durability, level of support, and cost of ownership. Your sales rep should have quick, honest answers about these features. If he or she spends more time talking about the competition than his or her own products, kindly escort him or her out of your office.
One important question should be at the forefront of your mind: “Who is this program being built around?” The majority of AED programs need to be built around infrequent lay responders. This is important because the chances of the responder’s never having been involved in a Sudden Cardiac Arrest (SCA) emergency are very high. Even if you are so fortunate as to have EMTs, paramedics, or doctors on staff, most of those wonderful, lifesaving people still fall into the infrequent lay responder category when it comes to administering high-quality CPR and defibrilliation.
An SCA event is a scary, unforeseen, frightening, shocking (no pun intended), adrenaline-rushed event. What a person learns through the videos in training is not exactly what happens during a live event: “Leisure Suit Larry” is not going to be lying all nice and pretty on his back, smiling without a bead of sweat on his forehead, with his shirt unbuttoned for you. Maximum support is needed and should be provided by the AED you are using. The less the responder has to quickly recall from training, the better.
Be cautious. Most AEDs provide heart rhythm analysis and shock therapy. Your AED needs to say more than “ATTACH ELECTRODE PADS” and “PRESS SHOCK BUTTON.” Some models do say a little more than that, such as “CALL 911,” but more support is still needed.
The Value of CPR Support
New technology has been out for a while, so do not settle on just any “shock box.” Make sure your AED provides some type of CPR support. Most AEDs do not, but finding one and paying a little extra for it is worth every penny. The chance of an infrequent lay responder performing adequate CPR in a live event is very low. Why? The answer is in the description of the person responding, the infrequent lay responder. This is one of the reasons the American Heart Association comes out with newer guidelines for CPR and AED administration every five to six years. These always stress the “push hard, push fast” principle by increasing the compression recommendation.
Why is having an AED with CPR support so important? Simple answer: Half the time an AED is used, no shock will be advised. However, every victim will need high-quality CPR to survive. In other words, there is about a 50 percent chance that when an AED is put on a victim, that AED will say something to the effect of, “NO SHOCK ADVISED” (or something similar). Thus, if your AED does not provide CPR support, that AED helps you only halfway through that frightening situation. Now, I do not know about you, hut if I need an AED to be used on me, I certainly don’t want it to help my Good Samaritan only halfway.
Questions to Aid Your Research
I will begin to wrap up this article with a simple list of questions that you can use when researching AEDs. As I said earlier, your sales rep should have quick answers to the following questions:
1. How much is the initial cost of the AED and related accessories?
2. What is the true cost of ownership of the AED? (That is, how much do replacement pads and batteries cost, and how often do I need to replace them?)
3. Can my AED be upgraded when newer CPR/AED guidelines are implemented? (Trust me, this will happen, and some AED manufacturers took nearly a year and a half to provide upgrade capabilities to their customers.)
4. Can my AED be upgraded on site, or do I have to send it in? What will be the approximate cost to upgrade?
5. What type of batteries does the AED use? (Are they available over the counter, or must they be purchased from the manufacturer?)
6. What type of pads does the AED use— a one-piece pad or two-piece pad?
7. How durable is the AED? What is the IP (ingress protection) rating of the device? (All AEDs get rated for protection again environmental elements, including water and dust. Some AEDs are classified as light-duty, indoor-use AEDs.)
8. How well does the AED replicate and remind me of what I learned in training?
9. Does the AED provide just audio prompts, or does it also provide clear, visual prompts as well? (Hint: An SCA event is not exactly a quiet situation.)
10. What type of support will the AED provide if no shock is advised?
11. What type of CPR support does the AED provide—none, minimal CPR prompting, or real-time CPR coaching/feedback?
These questions address critical factors that will help you decide which AED is right for you; also, don’t hesitate to perform some background research on the AED manufacturer. The right AED can and, in most cases, will make the difference between a successful rescue and an event full of confusion.
While this information all at once can seem overwhelming, it is imperative to understand the many steps that go into an AED program. A good sales rep will coach you through the different steps so that you feel comfortable and confident that your program is complete and compliant. Enjoy your AED program implementation. It is without a doubt a lifesaving program.
Chip Georges is National Sales Manager of St. Louis, Mo. based Marelly Products, a national provider of AED programs. He speaks at all types of safety conferences and conducts monthly webinars about AED programs, as well as being directly involved with client program implementation. He can be reached directly at 888-609-6599, ext. 3, or chipgeorges@marelly.com.
