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Public
Access Defibrillation
Public
access defibrillation (PAD) programs are based on the premise that the
first person on the scene of a cardiac arrest is in the best position of
saving a life IF the rescuer is equipped with an AED. It is a pretty heady
concept that you have more control over whether a person lives or dies
than the paramedic or EMT who is summoned, the emergency room physician,
or the cardiologist – all because of the speed with which a therapeutic
shock can be administered.
Three
airports around Chicago installed AEDs in their terminals several years
ago. The New England Journal of Medicine (pgs. 1242-47, 2002) recently
reported that the PAD AEDs were used on eighteen cardiac arrest victims in
a two year period. Eleven (61%) of the eighteen victims survived. It is
even more interesting that six of the eleven saves were accomplished by
people who had no training or experience with AEDs (three of the rescuers
were physicians, but they had never used an AED before). The airport
rescuers pulled the AEDs off the wall, hurried to the scene, followed the
prompts, and proceeded to save the lives of people who almost certainly
would have died. This is what PAD is all about. None of the rescuers woke
up in the morning thinking to themselves that they would try to save a
life that day and, in truth, most of them would probably rather have been
anywhere but in an airport rescuing a stranger. AED technology makes it
possible for even untrained people to save lives.
PAD
programs require AEDs to be placed near locations where people work or
gather. However, simply distributing AEDs is not enough. Successful
programs actively recruit and make it easy for as many people as possible
to acquire the skills and the confidence to use AEDs during emergencies.
The core of such group is made up of lay rescuers – those with minimal
first aid skills, a basic four-hour course covering CPR and AEDs, and a
fervent hope that they will never have to use the skills they learned in
class. However, they know that if they don’t do something and do it fast
the person in front of them who collapses in a movie line, a coworker, or
a parent watching his daughter’s soccer match, is probably going to die.
Others are motivated to learn the skills in case a loved one suffers
cardiac arrest.
AEDs, by
themselves do not a PAD program make. People, in the absence of AEDs, are
limited in how successful they can be. Both are required and only when
AEDs are available a few short minutes away from someone who collapses AND
there is one or more trained rescuers nearby can we begin to expect
increased survival rates. The more people trained and the more AEDs, the
greater the likelihood that someone attending the same concert as you
might save your life or the life of a loved one.
The flip
side of the people issue is the facility management’s acceptance of a PAD
program. There are some managers who are 100% behind AED programs but they
have a real problem with letting someone who is only visiting their
facility have access to the AEDs. This issue is best put to bed early by
informing management that they are protected from civil liability by Good
Samaritan laws (confirm this for your state) and that the more people that
can respond to cardiac emergencies, the better. It makes little sense to
have to wait for an employee of the facility or agency to show up if a
ready responder is close at hand. One of the large shopping malls in
Northeastern Pennsylvania has posted the following signs at each of their
entrances
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