In 2004, New York State Senator Joe Robach, working with Team AED, declared August "AED Awareness Month" in a resolution read on the Senate floor. The goal was to designate a month during which events and efforts could be dedicated to ensuring that communities understand that AEDs save lives and should be more broadly deployed than they are, as well as addressing questions about how to establish public access defibrillation (PAD) programs.
Essential Components to a Successful PAD Program
Just as everyone knows a car does not run on three wheels, PAD programs must have several components in place to be successful:
AEDs need to be available and accessible to the general public.
Citizens need to be trained to recognize the early signs of cardiac problems, to know when and how to use CPR, and to access and use an AED.
EMS providers must make lay providers feel that their contribution is a valued part of the chain of survival.
Acquiring an AED the Right Way
Acquiring an AED has become relatively easy, but that has not resulted in better deployment or increased accessibility of AEDs. Proper deployment of AEDs means more than just buying one on the Internet and placing it in a manager's office under the table. Additionally, staff should be trained, a response policy drafted and the device registered with the local EMS agency. Too often, well-intentioned lay people buy AEDs for public access without fulfilling all the requirements, and this could leave them in a tough spot if something were to go wrong. There should also be appropriate signage indicating where the AED is, whom to call in case it is used and what to do if there is a problem with it.
Two Minutes in Reach
Just like a fire extinguisher, an AED needs to be accessible at all times. It should not be sequestered in an office or under a counter, but rather in a wall cabinet-preferably an alarmed one so others can be informed when it is deployed-which has good visibility and easy access. Furthermore, these cabinets should be in places that people see every day-in the cafeteria, near the bathrooms or by the elevators, for example. Not only does it need to be a quick get in a pinch, but it also needs to be readily noticeable if the unit has failed-the indicator light visible and the alarm audible.
While there are no guidelines stating how far apart to space AEDs or how many should be in a building, consider that a person in V-fib is, practically speaking, holding his breath and has only four minutes until he starts losing brain cells. Rule of thumb: A lifesaving AED should be no more than two minutes away. That means if there are multiple floors, one per floor, unless it is a very small building. Proper deployment of an AED depends on response time, which is dependent on ready access.
Training a Reliable 10%
While some states mandate that someone at a PAD location be trained, we all know one person is never enough. A good guideline states that 10% of the permanent population at a location should be trained in CPR and the use of an AED. This allows for people to be in meetings, on holiday or otherwise unavailable, while at the same time allowing for an adequate number of responders so that at any given time you will get more than one trained person to respond to an event.
Perhaps the biggest change we can make as EMS providers is to help lay providers and PAD agencies feel their investment in equipment and training is appreciated. Why shouldn't a local volunteer fire department or ambulance service provide a CPR instructor to train responders for free? Maybe an EMS agency could help write grants to cover 50% of the cost of an AED? Perhaps an agency could work to develop response plans or help register a device once it is acquired and correctly deployed. Lay providers who are considering starting a PAD program often have many questions and need a resource to help them get the ball rolling. What better place to start than the local fire department or EMS agency?
AED Awareness Month Initiatives
One of the key initiatives of AED Awareness Month was to increase the number of trained responders in our region. This year, Monroe County Executive Maggie Brooks and the Livingston County Board of Supervisors, in conjunction with Team AED and the University of Rochester (NY) Medical Center Training Office, held a community CPR Day on August 13. Three area EMS agencies, West Webster Fire Department, Greece Volunteer Ambulance and Dansville Ambulance, hosted training sessions where citizens could learn adult CPR and AED operation at a greatly discounted cost. The feedback was tremendously positive. By having the training in their communities, it was easier for people to attend and also gave their local EMS agencies greater visibility.
If you would like to find how to get your EMS agency involved in promoting PAD programs in your area, e-mail me at SMustafa@TeamAED.com. The more we can do to facilitate proper AED deployment in our regions, the better off we all will be. After all, you might be helping to give someone a second chance at life. n