Heartstart

[Lupinus]

this kinda goes with some med kit threads but Ithink it warrents its own thread.

Has anyone seen these heart start home difibulators they have now?

Not sure about then for a bug out bag but as part of your dig in home kit do you think they would make a good addition?

[c_yeager]

I suppose if you have $1500 burning a hole in your pocket it might be reasonable way to spend it. Really I cant see justifying the expense unless you or a loved one has an existing heart condition. If there is someone with a heart condition around then it is quite possibly a worthwhile expense.

You can obtain training in the use of these devices from either the American Red Cross or the American Heart Association (go for CPR + AED). Technically the machines dont *require* training to operate (at least they advertise this) but one should really have basic life support skills to go along with it.

[SMLE]

Early difibrillation is one of the single most important factors in surviving a cardiac arrest. If you can afford one, get one. AND, get some REAL CPR training. American Heart Assc. is the best IMHO. Also, be aware that these devices also need some periodic maintainance, battery tests etc. Having one of these in a disaster situation where normal EMS service may be non-existant is especially important. An oxygen tank and equipment would also be good.

c_yeager said: "Really I cant see justifying the expense unless you or a loved one has an existing heart condition."

Sometimes you don't KNOW they have that heart condition until they hit the ground. I see an AED the same way I do my CCW. I'd rather have it and not need it, than need it and not have it.

[Lupinus]

yeah that is the one real drawback is their very high expense.

No one in my family currently has a heart condition but my family has a very long history of it. With a strong family history you never know. Maybe after they have been out for a few years the cost will go down.

[hso]

cyeager has the sense of it. AEDs are useful for coronaries due to cardiac arrest, but won't ultamately help someone suffering from a cornary blockage. Blockages can't be cleared with this type of equipment. Considering the expense I would spend the money on basics before covering this base. That said, we have one of the advanced models due to my wife's medical background (and that she picked a couple up at half price).;)

[c_yeager]

Sometimes you don't KNOW they have that heart condition until they hit the ground. I see an AED the same way I do my CCW. I'd rather have it and not need it, than need it and not have it.


Indeed.

Of course $1500 buys the sort of medical exam that would reveal the potential for such a condition, along with many others. This would be a wiser use of funds IMHO.

[Spot77]

How about a $50 pair of walking shoes as an alternative? Consistent exercise will go a long way to avoiding heart disease.


I'm afraid these home defribs are just another nail in the lazy Americans' coffin. As more doctors recommend these, and as insurance companies begin to pay for them, people will think accept this as a substitute for a healthy lifestyle.

Maybe not, who knows? Once I hit 50 I might think differently.

[hso]

Before anyone reads Spot77's post and says "Hell yeah!", you should do a little research (or maybe read all the posts) and avoid such a common misunderstanding of the nature of heart disease.

The risk of coronary blockages may be reduced with diet and exercise (and medication), but sudden cardiac arrest is an entirely different problem. It isn't a type of heart disease that exercise benifts. Considering that there are over 200,000 cases of sudden cardiac arrest a year an AED could be a valuable tool in the home medical chest if there are significant risk factors for sudden cardiac arrest in the family history.

[Father Knows Best]

Considering that there are over 200,000 cases of sudden cardiac arrest a year an AED could be a valuable tool in the home medical chest if there are significant risk factors for sudden cardiac arrest in the family history.

The key there is the "significant risk factors" part. I work for Medtronic -- the company that invented the cardiac pacemaker back in the late 1940s. We're also one of the leading manufacturers of automated external defibrillators, or AEDs. You've probably seen our LIFEPAK 500 AED in airports, schools and public buildings. We also sell thousands of AEDs and more sophisticated defibrillators every year to first responders (paramedics, fire departments, police departments, etc.).

There is no doubt that AEDs save lives. Sudden cardiac arrest kills 225,000 people a year in the U.S. Many of them have never had any prior history of heart trouble. While most are older, many are children. Studies have shown that if defibrillation is applied within two minutes, there is a very good chance of survival; if it isn't, death is almost certain. This is yet another instance where dialing 911 will not save you. Even when defibrillation from an AED saves a life, though, that person needs immediate medical attention at a well-equipped hospital. The AED is a stop-gap measure only. People who have had one arhytmic episode are at extremely high risk of another one. Most will get "ICDs", or "implantable cardio-defibrillators" placed inside their chests in a surgical procedure. The ICD is a device about the size of a cigarette pack, with an internal battery that can last 7-10 years. It becomes your own personal EKG machine and automatic defibrillator that goes everywhere you go, and monitors your heart 24/7, delivering a shock in as little as 0.05 seconds if you need it.

We'd love to sell more AEDs, but I'm not going to recommend that everyone run out and buy one. Your chances of needing one are well under 1 in a thousand. They cost around $2,000 each. That's a whole lot of money to spend on a very small risk. As a Medtronic employee, I can buy them for myself and my family at a substantial discount, but haven't done so because they simply aren't worth it for us.

An AED makes sense if you can either use it to benefit a large number of people (as is the case with AEDs in public buildings, schools, airports, etc.), or if you have a personal or family history that puts you at greater risk of cardiac arrest (such as a history of fainting or cardiac arhythmia).

To that last point, keep in mind also that AEDs are prescription medical devices. That means that you need a physician's order before you can buy one. If you think you need one and may qualify, talk to your doctor. If your doctor agrees, he will write you a prescription.

One last point -- I've long been an advocate of gun clubs getting AEDs. Gun clubs tend to be in remote areas, and have lots of members who are at higher risk than the general population, e.g., middle-aged men. They engage in activities such as competitions that can contribute to arhythmias requiring defibrillation. If you think your club is interested in getting an AED, shoot me a PM and I'll put you in touch with one of our local reps.

[Father Knows Best]

By the way, for more info on suddian cardiac arrest and AEDs, go to: http://www.aedhelp.com/

[chris in va]

How about a $50 pair of walking shoes as an alternative? Consistent exercise will go a long way to avoiding heart disease

Yeah well, I am in pretty good shape, 35 years old and exercise regularly. I also almost died due to a 95% coronary blockage. Angina saved my life.

Turns out most of it was hereditary. Check out some stats, many sudden death heart failures are happening to younger guys in decent physical condition. It's not just the big, fat, cholesterol-packing out of shape people any more...

[Lupinus]

How about a $50 pair of walking shoes as an alternative? Consistent exercise will go a long way to avoiding heart disease
As said in the previous post plenty of people who are young with no problems one day get one out of no where. My grandfather was a bull. Did he always watch what he ate? No. Did he work out? No he was a bull from hard work all his life. He was on his knees from a heart attack at 49 and died a few years ago at 60 from congestive heart failure. I knew a person who keeled over at forety dead from a heart attack that was in good condition. I knew a girl who was 19 who played tennis (and did so reguarly and was in great shape) she died from a sudden arrest. I also know a 75 year old that is rather large and portly and has been for most of his life and has no foresable health issues. Exorcise doesn't always have something to do with it. Helps sometimes but far from being a cure all.

Sometimes you are lucky (relativly anyway) and you end up on your knees clutching your chest and can get to a hospital. Sometimes you arn't so lucky and its on the floor passed out and no amount of cpr is going to help and the only thing that will is defibulation.

If you have a history of heart disease in your family I'd recomend one, even if you don't and can afford to keep it in your supplies it wouldn't be a bad idea. Only thing stopping me is the price tag right now. Hopefully in the future.

[secamp32]

She is young, in her late 30's with no prior cardiac history. Without warning she just keeled over at her desk. Luckly, we have 2 AEDs in the office. I had to zap her 5 times before she came back. It took EMS 15-20 minutes to arrive. She would have been dead without the AED. 3 weeks later she was back at work.

I recently met 2 other survivors of sudden cardiac arrest. They were relatively young men with no cardiac history, in good shape, that exercised regularly. Scary. It can happen to anyone.

[crucible]

Yes it can-it happened to me at the grand old age of 31 five years ago. ECG fine during the incident believe it or not, no family history, decent overall health, no definitive cause ever found either. Some coronary bloackage was found during the heart catherization, but not enough to slow blood flow as it occured in a very wide area (many walk around with similar, but simply don't know it). Treated via the shotgun approach: shoot at everything that could have caused it or may be a menacing factor in the future. (I was diagnosed with being a diabetic several months later...no explanation for that either save a screwy body chemistry following the MI. Thankfully, the pancreas needed to be "jumpstarted" for lack of a better term, and my levels today are almost normal.)

Not fun; I cannot recommend having a MI at all. No sirreee.

That said, minus an AED, if I could make a recommendation: keep full strength aspirin around always, and definatively in any kind of kit. If taken at the onset and even during an incident, it may just help save someone's life (unless alergic of course).

Chris

[ZenMasterJG]

It'd be great to have, but first i'd drop the bucks on a CPR and First aid class. I'm trained in CPR & First aid, and it's come in handy. Definatly important skills everyone should have (but entirely too few people do)

[Lupinus]

with what the heartstop helps with no amount of CPR will

[hso]

Aspirin helps with coronary blockages, but doesn't help with sudden cardiac arrest.

My wife was the medical director for a very large cleanup project at a DOE facility. Their AEDs were used 4 times in 5 years to save sudden cardiac arrest victems.

Father Knows Best, you might want to check your information on AEDs being prescription only. Airports and places of business don't get prescriptions to purchase AEDs and when we looked into it for our offices Phillips didn't require us to have any physician's prescription. It may be that insurance or other non-out of pocket payment support requries a physician's script.

Costs for pre-owned AEDs is far lower than for new.

[secamp32]

To that last point, keep in mind also that AEDs are prescription medical devices. That means that you need a physician's order before you can buy one. If you think you need one and may qualify, talk to your doctor. If your doctor agrees, he will write you a prescription.


I know you work for Medtronic but Philips has a model that is FDA approved to sell without a prescription, the Heartstart Home. http://www.medical.philips.com/main/products/resuscitation/industry/home/index.html
You can buy them at Amazon.com or Walgreens.com $1300

[Lupinus]

yeah they do and it is supposed ot be extremly easy to use and idiot proof.

I saw one demonstrated on a news channel (forget which one, was either local or foxnews). Shows you where to place the pads and supposidly it determines if a shock is needed and what voltage and does it on itself, all the person has to do is put the pads on and press the on button and the defibulator takes it from there.

When I can afford one it is something that will definatly be in my home med kit.

[c_yeager]

with what the heartstop helps with no amount of CPR will


You do realize that AEDs are integrated with the use of CPR, right? The one is a prerequisite for the other. If you had ever been trained to use an AED machine you would notice that there are times when the machine instructs the user to conduct CPR.

If one were to make a list of all the things that an AED can help with and another list with all the things that CPR can help with they would see that if one had to choose between the two that CPR would be the obvious choice. In fact the list of problems that are addressed with an AED is pretty narrow. Obviously the best choice is to have both, especially since CPR training is A) cheap and B) offers training in the use of AEDs, its pretty clear that its a good investment.

CPR also works if you dont happen to have you nifty $2000 piece of equipment on hand.

[goalie]

You do realize that AEDs are integrated with the use of CPR, right? The one is a prerequisite for the other. If you had ever been trained to use an AED machine you would notice that there are times when the machine instructs the user to conduct CPR.

If one were to make a list of all the things that an AED can help with and another list with all the things that CPR can help with they would see that if one had to choose between the two that CPR would be the obvious choice. In fact the list of problems that are addressed with an AED is pretty narrow. Obviously the best choice is to have both, especially since CPR training is A) cheap and B) offers training in the use of AEDs, its pretty clear that its a good investment.

CPR also works if you dont happen to have you nifty $2000 piece of equipment on hand.

You do realize that without an AED (or manual defibrillator in a hospital setting) CPR is pretty much an exercise in futility, right? CPR is an attempt to perfuse the brain and body until the heart resumes a normal (or at least perfusing) rythm again. It is very rare for CPR alone (in the absence of ACLS drug protocols and either shocking or external/transcutaneous pacing) to be successful. CPR does nothing to correct a lethal or absent cardiac rythm. Then again, asystole (absent cardiac rythm, or "flatline" if you will) rarely ends well, regardless of equipment or location.

Unlike the movies, in real life, you NEVER shock someone who is in asystole (flatline), as it actually makes the likelyhood of the patient resuming a perfusing rythm less than if you just give epi, atropine , do CPR and pray. An AED is useful for rapid treatment of someone in a lethal rythm such as V-fib, non-perfusing V-tach, torsades, and the like. It applies electricity to the heart and basically "resets" the electrical conduction system, which, hopefully, results in a regular, life-sustaining rythm starting up again instead of the lethal rythm that caused the code or collapse in the first place.

(FWIW, I am an RN, CCRN, and ACLS certified. I work as the code-team nurse/house circulating critical care nurse at night for a 600+ bed hospital in Minneapolis. I have shocked dozens of people in the last month alone, both in codes/cardiac arrest secondary to a lethal rythm, and to electively cardiovert patients out of rapid atrial rythms)

[goalie]

If one were to make a list of all the things that an AED can help with and another list with all the things that CPR can help with they would see that if one had to choose between the two that CPR would be the obvious choice. In fact the list of problems that are addressed with an AED is pretty narrow.

I got a few more minutes here at work, so I'll bite again.

AED can help with:

1. V-tach
2. V-fib
3. Torsades
4. Symptomatic A-fib with RVR

CPR can help with:

1. Perfusing the body and brain with O2 until a perfusing rythm is restored in the heart in the event of one of the 4 above rythms or asystole.
2. Acute respiratory distress. (you still need professional medical attention, and fast)

Neither and AED or CPR alone can help with:

1. Asytole (you need a pacer or resolution of underlying electrolyte imbalances)
2. Acute coronary blockage (you need bypass or the cath lab)

So, when comparing we find that the AED can "fix" at least 4 lethal arrythmias (and manual ones can also externally pace asystole as well with the right patches), while CPR can only attempt to maintain a minimal perfusion of oxygen to brain tissue until the underlying problem causing the arrest is rectified. CPR is a good thing, but an AED is a better thing if you have it. The odds are you won't need one, but then again, the odds are that most people won't need their carry weapon, but I sure don't see people saying it is stupid to spend a grand or two on a 1911 for a CCW because they could buy some self-defense training or karate classes for 50 bucks.....

[c_yeager]

So, when comparing we find that the AED can "fix" at least 4 lethal arrythmias (and manual ones can also externally pace asystole as well with the right patches), while CPR can only attempt to maintain a minimal perfusion of oxygen to brain tissue until the underlying problem causing the arrest is rectified. CPR is a good thing, but an AED is a better thing if you have it.

I want you to read back what you just read. An AED can "fix" 4 problems. CPR can keep a person alive during any circumstance in which circulation and/pr respiration is interrupted.

Tell me which one is going to be more usefull OUTSIDE of a hospital setting, you know, that place where you dont have a crash cart around the corner.

The odds are you won't need one, but then again, the odds are that most people won't need their carry weapon, but I sure don't see people saying it is stupid to spend a grand or two on a 1911 for a CCW because they could buy some self-defense training or karate classes for 50 bucks.....

I wouldnt have expected such a sloppy analogy from someone who actually went to school. If you would go back and read my post you would notice that I pointed out that AED training is available along with CPR, it isnt an either/or proposition. A more accurate analogy would be this: "It would be wiser to spend $500 on a gun and spend the rest on training and ammo than it would be to spend $2000 on a gun without any training and ammo." And THAT is a common sentiment around here.

You are actually suggesting that people deliberately limit their training and experience because they are more likely to need one thing than another. I on the other hand suggested that one obtain actual TRAINING so that they know what they are doing.

I am also ACLS certified btw and one would be pretty remiss if they attempted to represent ACLS as an all encompassing life saving technique. As you know it is a course that applies *only* to cardiac arrest. This is why your hospital (like every other hospital and nursing school in the nation) requires you to have a Health Care Provider/First Responder CPR card in addition to your ACLS certification in order to mantain your position. So why are you telling people that they dont need this training when every healthcare facility in the nation has come to the conclusion that it is complimentary with AED training?

[goalie]

I want you to read back what you just read. An AED can "fix" 4 problems. CPR can keep a person alive during any circumstance in which circulation and/pr respiration is interrupted.

Tell me which one is going to be more usefull OUTSIDE of a hospital setting, you know, that place where you dont have a crash cart around the corner.

The AED. All CPR does is keep someone (reasonably) perfused until someone can get to them and use an AED or manual defibrillator. And I never said it can keep someone alive, I said it can perfuse them (and not very well) until a perfusing rythm is restored. To sum it up, quite often the AED actually fixes the problem, while CPR trys to minimize brain damage until someone with an AED can fix the problem.

So why are you telling people that they dont need this training when every healthcare facility in the nation has come to the conclusion that it is complimentary with AED training?

I would ask you to quote specifically where I said people do not need CPR training. If you can't, then I would request that you STFU instead of putting words in my mouth. As it is, I recall typing this......

CPR is a good thing, but an AED is a better thing if you have it.

...hardly a statement that people should not be BLS certified. The fact is that if you have an arrest and someone who knows CPR is there immediately, your odds of surviving and having no brain damage are still exponentially lower than if you have an arrest and someone is there within 2 minutes with an AED, attaches the patches from an AED to you, and lets the AED do it's thing.

Is an AED worth the money? Apparantly not to you. Is an AED BETTER than CPR? Yes.

[goalie]

I am also ACLS certified btw and one would be pretty remiss if they attempted to represent ACLS as an all encompassing life saving technique.

If I may ask, where do you work? I want to know so I can avoid having myself of family members ever receive treatment there. I don't want people who think CPR is better than an AED anywhere near people I care about.

Since you didn't like my other analogy, I'll use this one: An AED is like having a shotgun when being attacked. It cannot solve every problem, but it can solve a lot of them. CPR is like having a sharp stick. It won't solve much of anything, but it may keep you around until the guy with the shotgun saves you.

FWIW, I work at Abbott Northwestern in Minneapolis.

[c_yeager]

I would ask you to quote specifically where I said people do not need CPR training. If you can't, then I would request that you STFU instead of putting words in my mouth. As it is, I recall typing this......

Perhaps if you moderated the amount of sponateous profanity that comes out of your mouth i would be inclined to read the rest of your post, as it is I stopped right here. Here is what you actually said btw:

You do realize that without an AED (or manual defibrillator in a hospital setting) CPR is pretty much an exercise in futility, right?

Im sure that you have all sorts of <edit>"valuable information"</edit> ;) to add, but im done reading your posts from here on out.

[hso]

Folks I don't want to take sides in a fight, but I spent several days researching the online literature on the effectivness of CPR in ensuring patient survival and found a growing body of research indicating that it was minimally effective in the assuring patient survival when applied outside of a hospital. While I didn't propose making any changes to company procedures this information didn't make anyone at my company very happy.

One of the other things my reading revealed was that many people are very passionate in their feelings about CPR, both supporting and discounting it.

In summary, the conventional wisdom that CPR is beneficial in the instance of a "heart attack" is under debate in the emergency medical literature.

[wingnutx]

They appear to be the exact same thing I use as an EMT.

Great to have if anyone in your family is at risk of a heart attack.

[goalie]

Perhaps if you moderated the amount of sponateous profanity that comes out of your mouth i would be inclined to read the rest of your post, as it is I stopped right here. Here is what you actually said btw:



Im sure that you have all sorts of <edit>"valuable information"</edit> ;) to add, but im done reading your posts from here on out.

Nice cop out, but I used the abbreviation "STFU" AFTER you lied about what I said. Getting mad that I used the abbreviation "STFU" in response to you lying about my stated position is a rather pathetic.

No problem though, I'm used to people running away from an argument once they realize they are wrong. It's par for the course.

Maybe, in the future, you should read what people say, check credentials, then do some research on your own before typing a response. It would almost eliminate the need to run away because you were not only wrong, but passionate and condescending while being wrong.

FWIW, I think the big disagreement was because you somehow got it into your head that I said CPR was worthless. I never said that, I said that CPR was good, but an AED was BETTER. Numerous studies on both in-hospital and out-of-hospital arrests support my position, and those studies have resulted in AEDs being distributed widely to police, and first responders almost everywhere.

I am sorry if you felt offended, but I do not appreciate someone using straw-man arguments against me. Responding to someone who attacks a position I never took gets old enough when debating antis, I really, really don't appreciate it here.

[Jeff White]

Member are reminded that they are at THEHIGHROAD.ORG and are expected to conduct themselves accordingly. Take the personal stuff to email or PMs.....Jeez, you'd think this was an AK vs M16 or .45 vs 9mm thread ;)

Jeff

[Lupinus]

Perhaps if you moderated the amount of sponateous profanity that comes out of your mouth i would be inclined to read the rest of your post, as it is I stopped right here. Here is what you actually said btw:



Im sure that you have all sorts of <edit>"valuable information"</edit> to add, but im done reading your posts from here on out.
Where was the spontainous profanity???

CPR is fine in some situation, but it is going to do nothing if the reason you have problems is a heartbeat that wont pump blood through extreamly off contraction

[goalie]

Member are reminded that they are at THEHIGHROAD.ORG and are expected to conduct themselves accordingly. Take the personal stuff to email or PMs.....Jeez, you'd think this was an AK vs M16 or .45 vs 9mm thread ;)

Jeff

I would respectfully reply that, in light of the documented and controlled studies available, this was akin to debating whether or not the .45 actually makes a bigger hole than a 9mm. There are facts out there. Ignoring those facts doesn't change that they exist. Getting mad at someone else for presenting those facts doesn't change the fact that a .45 is of bigger diameter than a 9mm.

[goalie]

Folks I don't want to take sides in a fight, but I spent several days researching the online literature on the effectivness of CPR in ensuring patient survival and found a growing body of research indicating that it was minimally effective in the assuring patient survival when applied outside of a hospital.

Did you happen to read the study where they reached the conclusion that, in the case of single-rescuer CPR, chest compressions WITHOUT rescue breathing was as effective as traditional CPR? I found it rather interesting.

[hso]

Goalie,

Yep, that shocked me (NO pun intended for the discussion), but the lack of oxygen transfer during rescue breathing and the residual oxygen content of the blood also surprised me.

I wonder if part of the reason ARC changed their training from CPR then get help to get help first even if it takes a couple of minutes was partially due to these studies.

I also found the study about chest with abdominal compressions being more effective than chest compressions alone interesting.

When I was first trained for wilderness first responder (many many years ago) we were taught to perform CPR until we gave out even if the chest was flayed. How things have changed.

Oh, we really don't like to cut on each other here with stuff like "STFU". It's hard enough to get into impassioned arguments about things that truely matter and not get pissed off so we try to pretend we're arguing in our maiden aunts parlor when we do it.

[Davo]

Now if someone offered me an AED, I would take it. For private use by a low risk group, the funds may be better spent elsewhere. Also the prices on these things are bound to go down over the next several years, keep that in mind. I think it should suffice to say the following
-AED's are life saving, but in many cases may be useless.
-The use of your funds to get a gym membership, and perhaps a simple rescue kit (with cpr suppies, and O2) may be the best way to go, unless you are a known high risk, or have plenty of extra funds. Get American Heart Association certified in CPR.
-spend a little time volunteering in an ED or even on an ambulance, to gain a little experience (THIS IS WHAT YOU NEED WHEN IT MATTERS MOST) with CPR.
Remember CPR always buys time regardless of the leathal cardiac rhythm.
Goalie impressive post but remember we are talking with guys who have no idea what "pulseless electrical activity" is, no need to get so complicated.

[goalie]

Goalie impressive post but remember we are talking with guys who have no idea what "pulseless electrical activity" is, no need to get so complicated.

Actually, the offended party claimed to be ACLS certified, so, yes, he should know what PEA is.

;)

[Dean C]

I believe in AED's.
I'm CPR/AED Certified.
I owe my lifestyle to AED's especially the LP500 and LP CR+.
I believe everybody should own a bunch of em'.
I too work for Medtronic ERS. (We make the AED's)
BTW, I'm an Engineer there.

dean

[SMLE]

From: owner-instructors@ashinstitute.org
[mailto:owner-instructors@ashinstitute.org] On Behalf Of Alert
Training Systems Sent: Tuesday, November 01, 2005 4:00 PM To: ASHI
Instructors Subject: [ASHI] Interesting News Article



The following article is from the October 10th issue of Lawyers
Weekly. I thought you might find it interesting....




New Wave Of Defibrillator Suits Arises

By Reni Gertner

A new wave of defibrillator litigation is starting to attack
businesses that have the devices but don't use them - or don't have
plans in place to make sure they are used properly in a time of need.

Automated external defibrillators (AEDs) are used to treat an
individual suffering sudden cardiac arrest whose heart is beating
irregularly.

In September 2004 the FDA approved the over-the-counter sale of
defibrillators, an action which some experts said would make it easier
for plaintiffs' attorneys to prove that businesses have a duty to have
a defibrillator on their premises and breach that duty if they fail to
do so.

In the wake of the FDA's decision, more and more establishments -
including ice rinks, schools and some retail businesses - have
gradually begun to purchase AEDs. According to Jamie Froman, director
of marketing for commercial AEDs for Philips Medical Systems in
Seattle, a significant number of AEDs have also been installed in
shopping malls. (Philips manufactures the HeartStart Home
Defibrillator, the only AED that has been approved for
over-the-counter use.)

Now a new breed of cases is being pursued against these entities when
the devices aren't used or aren't used properly.

In March, the family of a 17-year-old ice hockey player who collapsed
and died while playing at a San Jose, Calif. rink sued the city and
the team for wrongful death. The rink had a defibrillator, but
allegedly no one who knew how to use it was nearby when the incident
happened, and no one informed the EMTs who eventually arrived of its
presence.

And late last year, the parents of a 20-year-old University of
Pittsburgh student filed suit after their daughter suffered brain
damage because campus police didn't have a defibrillator on hand when
she suffered an irregular heart beat and lost consciousness during
class.

According to the complaint, Erica Lynn Pratt had no previous heart
problems, and although the university website indicates that all
campus police carry a defibrillator, the two officers who responded in
this case didn't have them and failed to perform chest compressions on
the student.

Richard Lazar, founder and CEO of AED Risk Insights, a Portland, Ore.,
company which provides risk management and legal information services
related to AEDs, believes this second wave of litigation has only just
begun.

"More than 90 percent of AED deployments are probably flawed," he said.

In Lazar's view, the key to avoiding these suits is to have a
well-developed plan for deploying an AED in the event of an emergency.

"Comprehensive AED programs - not just AEDs - are required to reduce
liability risks and improve the chances of saving lives," he said.

Litigation Risks

The first round of defibrillator suits took on businesses that weren't
equipped with defibrillators. A big target of that litigation
continues to be health clubs, which are required to have AEDs by an
increasing number of states.

"I think the standard of care is evolving more quickly with respect to
the health club industry," said Lazar. "Health clubs are now at an
increasing risk that they will be found liable" if they fail to deploy
an AED.

San Mateo, Calif., attorney Mike Danko, a partner with O'Reilly, Danko
& Yamane, agreed.

"It's evidence of negligence if you're not meeting the standard your
competition has set," said Danko, who recently brought a lawsuit on
behalf of a family whose son died of sudden cardiac arrest at a 24
Hour Fitness, Inc. club that didn't have an AED.

But businesses that have defibrillators can still expose themselves to
potential litigation in a number of ways, Lazar said.

First of all, problems arise if the devices and all of their
components aren't properly maintained.

Batteries typically expire within one to five years, and either have a
date written on them or make a chirping noise when they are depleted.
Electrodes have expiration dates written on their packages and last
anywhere from one to three years.

In April, a passenger died of a heart attack at the Philadelphia
International Airport after two AEDs failed because the batteries were
dead.

And even if the machines are in working order, a site that has an AED
could still be sued if the device isn't easily accessible, leading to
a longer response time. Lazar cited an example where a 14-year-old
student at a Rhode Island high school died of sudden cardiac arrest
during baseball practice because the only AED in the building was
locked in the school nurse's office - 1/5 of a mile from the baseball
field. This case caused schools across the state to begin buying
defibrillators.

Yet another litigation risk occurs when employees fail to use a device
either because they lack awareness of it or haven't been trained in
its use.

Although "an untrained person can use an AED within about 90 seconds,"
Lazar said, "training increases the comfort level" with using the
device and thus increases the likelihood that someone will do so when
needed.

While AEDs are widely regarded as easy to use, Lazar predicted there
could still be suits over using the devices improperly.

But Boston attorney Dean Nicastro of the firm Pierce & Mandell noted
that a suit based on the failure to use an AED would also require
proof that in a given instance, the business had a duty to use it.

Designing A Program

To avoid litigation, Lazar recommends that companies develop a
deployment program that "quickly brings together the sudden cardiac
arrest victim, an AED user and the AED."

A good program will have the following components:

· Short response time

Lazar suggested having enough AEDs present "to ensure one can be
retrieved and used within about four minutes anywhere at the site."

Further, businesses must have a method for communicating that the AED
is needed quickly enough for it to be useful. Lazar said this might
include the use of an intercom system or any other quick method of
contacting someone who can assist.

· Comprehensive policies

A business should have a policy that "authorizes any willing rescuer
to use an AED," Lazar said. "Restrictive policies that limit AED use
to only trained operators create a risk it won't be retrieved and used
when needed."

Although untrained persons should be authorized to use the device,
companies should also have seminars to train as many workers as
possible.

In addition, there should be procedures in place to check the device
frequently to ensure that the batteries and electrodes haven't
expired.

· Signs and accessibility

Clear signs are essential to inform people where AEDs are located,
Lazar noted.

In addition, an AED must be stored such that it can be "quickly
retrieved," rather than locked in an office or closet.

Questions or comments can be directed to the writer at:
reni.gertner@lawyersweeklycom



© 2005 Lawyers Weekly Inc., All Rights Reserved.

[History Nut]

I guess I will chime in on this subject. I would recommend the following priorities:

1)Get First Aid/EMT-I training and CPR with AED module
2)Get everyone that will be around you in a 'bug-out' situation trained(note that you can't defibrillate yourself!)
3)Assemble adequate First Aid equipment and supplies including Oxygen administration equipment and BVM(Bag-Valve-Mask resuscitator).
4)If you have money left over then get the AED

Why should you listen to me? You shouldn't! You should do your own research and only use postings on Internet boards for guidence in areas of research.

My background: over 10 years First Aid and CPR instruction for the Red Cross many years ago. 25 years as a Paramedic in Los Angeles with conservatively estimated over 25,000 emergency responses. I retired in 2003 so I am not up on the "latest" but I have probably seen more cardiac arrest situations than most on this board. That doesn't make me smarter/superior, just more worn out. I was skeptical of AEDs when they first came out but saw them work "as advertised" too often to not believe in them. The ones I observed in use were operated by Firefighter/EMT-I/Ds which is why I stress training first. However, the machines worked so well that I am confident that any one of you, if you followed the directions, could do what was necessary. The other side of that is that the machine will not let you make a mistake which was my original concern with them. I will stress that anybody that needed defibrillation also required extensive follow-up care by medical personnel. Still, that was better than the alternative.

The bottom line: AEDs are a tool like any other medical procedure/equipment and not an end in and of themselves. If you want one and can afford it, buy it instead of a new 'battle rifle'. You will be more likely to use the AED for its design purpose than the rifle(i.e.: a two way rifle range). Keep in mind that in a true war/SHTF/end-of-the-world situation, there are no cardiac arrest victims, only dead bodies.

[Texfire]

Getting back to the original question. In a SHTF scenario where you can assume no or little access to advanced medical care is an AED going to be effective and worth budgeting for in your medical supplies? I'm going to say no.

Not because effective CPR and early defibrillation aren't an important component of survial of a sudden cardiac arrest event, because they are, but because if you don't have access to cardiac drugs and advanced medical care then the survivability of a cardiac event is going to be very small.

Now in a non-SHTF scenario my answer changes. Anyone who has history of cardiac disease or family history of same should have one. Even in the best scenario, help is generally over 6 minutes away, and early defibrillation is most effective within 6 minutes.

[Davo]

When a salty old medic like History Nut talks, were all better off to listen.:)