AEDs - distribution, public access, awareness

[Vee]

Defibrillators (AEDs) - distribution, public access (incl 24/7), location, awareness. Worth more than a thought!

I read recently about a person's life being saved, after going into cardiac arrest while out running. Quick thinking good samaritans came to the person's aid, including one who grabbed a defibrillator (AED) from their workplace nearby. This, and quick action - CPR by bystanders, was credited with the person's full recovery.

The story mentioned awareness, eg need for a registry, app etc. to provide the locations of publicly available AEDs.
Eg. issues around location, public, 24/7 access.

Reducing the time it takes to locate an Automated External Defibrillator (AED) is key. If an AED is applied to a sudden cardiac arrest victim within the first minute of collapse, their chance of survival is 90%. For every minute that passes, their chance of survival drops 10%, leaving a 10 minute ‘window of opportunity’.

https://www.australiawidefirstaid.com.a ... res-defib/

Various ambulance groups and state governments have taken action in this space eg Tasmania (map, app).
http://ambulance.tas.gov.au/community_information/eadp

Ambulance Tasmania's Early Access to Defibrillation Program is designed to take advantage of the many publically-accessible AEDs across Tasmania.  If a cardiac arrest occurs within a few blocks of a registered machine, its owner will be alerted and, where possible, take their defibrillator to the scene to help the patient.

Shopping centres, gyms, sport clubs/venues, pools, airports, cinemas, schools, hospital foyers, libraries, airports, trains, offices, construction worksites etc are likely locations.

The key is to be quick as defibrillation is most effective within the first 3 minutes...

So. Where is it?
Location awareness including within venue/centre. shop, office etc (prime/obvious?), clear signage and ready access are critical.

First aid kits, fire extinguishers, emergency exits are part of OHSW routine. AEDs are relatively affordable for work/public sites. Awareness and location on site (no training required) should be part of OHSW practice.

AEDs on Australian worksites - comprehensive report.
http://etunsw.asn.au/LiteratureRetrieve.aspx?ID=125537

Hours of opening comes into play with public access. With OTR (and other service stations) and many gyms now being 24/7 operations, and early/late/longer hours for some chemists, supermarkets, these would be great locations for more widespread distribution of AEDs.

Increased community and personal awareness is important.

[ChillyPhilly]

Great post.

Hours of opening comes into play with public access. With OTR (and other service stations) and many gyms now being 24/7 operations, and early/late/longer hours for some chemists, supermarkets, these would be great locations for more widespread distribution of AEDs.

To further the discussion, should these places compulsorily start housing AEDs?

[rev]

You need to be trained to use an AED.
I'm trained because my work required me to get a senior first aid certificate.
The average person is not trained.

[Llessur2002]

You need to be trained to use an AED.
I'm trained because my work required me to get a senior first aid certificate.
The average person is not trained.

Not sure you absolutely do.

From Australian Defibrillators' website:

AED’s were designed to be used by non-medical people with little or no previous experience or instruction.

In a perfect world everyone should have CPR and AED training, however modern AEDs are designed to be used by any motivated bystander, regardless of training. The devices advise the user about how to apply the device and whether or not to administer a shock. Most of the time, the AED will advise the user with voice prompts to administer CPR, depending on the needs of the victim, however all AED’s have step by step instructions including, voice, text and now video coaching.

From the time that the event occurs to the time that medical help arrives is critical. The instructions from the AED are keeping you productive and giving the patient the very best chance of survival until help, which is on the way, has arrived.

This is the critical time when defibrillation is needed for the patient to survive.

Everything I've seen and heard about AEDs involves verbal or graphic instructions of every step of the process - if I was in cardiac arrest I'd be happy for anyone to give it a go if there was no-one trained in the vicinity.

Likewise if I was in a public building with an AED and someone else went into cardiac arrest then I'd most certainly give it a go if there was no trained person around.

[bits]

Most stores such as supermarkets have trained first aid staff which includes use of an AED.
I know Foodland Norwood has an AED with trained first aid staff.
I know Coles and Woolworths stores always have trained first aid staff on hand but I do not believe they typically have an AED.

We probably should make it compulsory for any store over x sqm to have trained first aid staff and an AED available.
Large stores have the financial capacity, staff levels and customer usage to make it reasonable that they should have one.

Service stations might struggle with staffing levels.
AED really requires 2 people, one performing CPR and another operating the AED.
CPR is regarded as more important than the AED.

They may have only a single staff member working late at night where it could be unsafe for them to even be able to offer CPR.
Enforcing that a service station has a unit might be a cost for a device that could very rarely be used.


Due to risk of someone without training shocking themselves or shocking the person giving CPR/others, I would say untrained users should avoid using the machines.
It is as simple as do not touch the patient while you deliver the shock, it will audibly say to not touch the patient but in the moment it could be easy for someone to not hear the message or not fully understand.
The AED user needs to tell the person giving CPR to stand clear also before they deliver the shock, the AED messages are pretty basic and do not really go in to detail about the importance of not pushing the button unless EVERYONE is clear.

You get fixated on the simple pressing of a button instead of fixated on if the CPR user knows and is clear.

Also things such as a water or conductive metal frames etc are other concerns untrained people may not consider.
You could end up endangering perfectly fit and healthy people with incorrect use of an AED.

They really are simple once you know the rules, but learning the rules with someone in front of you not beating correctly is not really a suitable time for a crash course in a potentially dangerous device.

[Llessur2002]

I would say untrained users should avoid using the machines

Absolutely that would be the best course of action. Would be great to see AEDs in pretty much every pubic building with a trained member of staff always present.

But, if you were in a building with an AED but no trained person to hand (or known to be immediately on their way) and it was suspected that someone was in cardiac arrest - would the best course of action be to do nothing, or give it a go? My understanding is that there's only a maximum 10 minute window to take action and the chance of survival decreases 10% per minute...

[bits]

Best action is get trained help(eg ring 000 or find someone) and perform CPR if you know how.
I would be more confident in someone taking instructions from 000 regarding the AED than the audio messages they play. Humans can interact much more intimately with each other and the instructions would likely be better understood.
The worst outcome would be for a fit and healthy person to become "incompatible with living" while attempting to assist someone else that already had a very low chance of survival.

You would be surprised just how many people are trained in first aid.

[Llessur2002]

Good advice - generally thought they were for public use based on some things I have seen on TV recently. But then I guess you shouldn't believe everything you see on TV...

[bits]

Good advice - generally thought they were for public use based on some things I have seen on TV recently. But then I guess you shouldn't believe everything you see on TV...

I think there is a lot of info that says that people should give it a crack. I just would hate for those trying to help to be harmed.

[monotonehell]

Good advice - generally thought they were for public use based on some things I have seen on TV recently. But then I guess you shouldn't believe everything you see on TV...

The worst thing TV teaches people is that CPR revives people. It does not. It's just a way to keep them on the edge of death until real help arrives.

[Llessur2002]

Good advice - generally thought they were for public use based on some things I have seen on TV recently. But then I guess you shouldn't believe everything you see on TV...

The worst thing TV teaches people is that CPR revives people. It does not. It's just a way to keep them on the edge of death until real help arrives.

Interestingly, my nan's sister (my great aunt maybe?) was kept on the edge of death by her daughter for about 10 minutes a few weeks back after a heart attack. She'd seen a basic guide to hands-only CPR on a TV advert back in the UK - this one in fact...



...and managed to keep her going until the ambos arrived 10 minutes later. A stent and a few days in hospital later and she's as right as rain.

Should be more public awareness of stuff like this IMO.

[rev]

Good advice - generally thought they were for public use based on some things I have seen on TV recently. But then I guess you shouldn't believe everything you see on TV...

The worst thing TV teaches people is that CPR revives people. It does not. It's just a way to keep them on the edge of death until real help arrives.

Interestingly, my nan's sister (my great aunt maybe?) was kept on the edge of death by her daughter for about 10 minutes a few weeks back after a heart attack. She'd seen a basic guide to hands-only CPR on a TV advert back in the UK - this one in fact...



...and managed to keep her going until the ambos arrived 10 minutes later. A stent and a few days in hospital later and she's as right as rain.

Should be more public awareness of stuff like this IMO.

The latest recommendations are for chest compressions only.
And while any cpr is better then nothing, you actually can do a bit of damage to someone if you don't do it right and in the right spot.

CPR should be taught in primary and high school.

[Vee]

Defibrillators wil be installed in Rundle Mall, Victoria Square ...

Emergency defibrillators are being installed in Adelaide's CBD as part of a $25,000 trial to save lives in the case of cardiac arrest.

People are being urged to use the machines, even if they are untrained, with the Heart Foundation saying they are "completely safe to use".

A number of defibrillators will be located in Rundle Mall and Victoria Square.
The City Council already has defibrillators for use by staff at Adelaide Aquatic Centre, the Town Hall, Central Market and its golf links.

Heart Foundation chief executive Imelda Lynch said the first few minutes of a heart attack were critical to a person's survival.
"If you defibrillate somebody who is having a cardiac arrest within the first five minutes you have a 90 per cent chance of success and survival rates," she said.

The machines come with recorded verbal instructions.
"You cannot hurt someone. In fact the worst thing you can do with this is not use it." Adelaide City Councillor Phil Martin said.
Previously, defibrillators have been kept on business premises, making them inaccessible outside of office hours.

As part of the trial, these defibrillators will be placed in more public locations.
"Sudden cardiac arrest happens at any time of the day or night, it's not restricted to office hours or shopping hours." Councillor Martin said.

ABC News:
http://www.abc.net.au/news/2017-02-14/d ... de/8269110

How does it work?

* Pads are placed on the patient's chest and a built-in computer checks the victim's heart rhythm.
* The device determines whether a shock is needed.
* Most devices have an automated voice to tell the rescuer the next step, eg. stand clear and press the device's shock button.

Hopefully, more accessible locations will be 24/7 access and as vandal proof as possible.