Across Canada, anywhere from 35,000 to 45,000 people die of sudden cardiac arrest (SCA) ever year, according to the Heart and Stroke Foundation.
In Toronto alone, emergency service personnel respond to more than 2,000 cardiac arrests annually, 16 to 20 per cent of which occur in public places, according to Cardiac Safe City, a program from Toronto’s emergency medical services.
The use of automatic external defibrillators (AEDs) in both public and private settings has been proven to save lives. In fact, stand-alone cardiopulmonary resuscitation (CPR) only helps to resuscitate a victim about five per cent of the time — with a combination of CPR and defibrillation, survival rates can reach as high as 75 per cent.
An AED is a small, portable unit used to identify abnormal cardiac rhythms and, when appropriate, deliver a shock that may correct abnormal electrical activity in the heart.
Shopping malls, office buildings or industrial sites can present major challenges for emergency medical crews, as SCA victims may be located several floors above or below street level. This delay in accessing a victim hinders the delivery of a lifesaving shock by crucial minutes.
In conjunction with CPR, the faster the AED is used, the higher the rate of survival. Survival rates can drop by up to 10 per cent for each minute AED use is delayed.
Although not mandatory, more and more employers are implementing AED programs in the workplace. For example, the City of Ottawa invested $1.9 million in a Public Access Defibrillation program, with about $600,000 allotted toward training all staff. The city went from a two per cent survival rate in 2001 to a 12.3 per cent survival rate today, according to the Sudden Cardiac Arrest Foundation.
In considering whether to implement an AED program, employers should consider:
What, how, where? What type of AED will be purchased? How many? Where will they be located? How will they be accessed and maintained? To answer these questions, an employer must take into account:
•the distance from the workplace to emergency medical services
•the number of workers in the workplace
•the number of visitors to the workplace
•the nature of the work.
In order to select the appropriate type of AED, it is important to discuss your needs with the AED provider or trainer. Health Canada has approved six devices in Canada for use.
In considering the number of AEDs that should be installed, a good rule of thumb is if you walk briskly 60 to 90 seconds in any direction, that would be the coverage of that particular AED machine, according to Terry Brown, Toronto-based president of SOS Emergency Response Technologies, during an interview with Canadian Safety Reporter (a sister publication of Canadian HR Reporter). That would be a round trip of a maximum of two to three minutes.
Who will be trained to use an AED? It’s very important to have a well-documented workplace policy outlining the roles and responsibilities of those involved in the program.
In Ontario, all recognized providers of both emergency and standard first aid programs are required to have their students use a defibrillator trainer. However, the orientation training may not go into the particular details of a workplace-specific program, such as requirements for retraining, unit maintenance, procedures following the use of an AED and program management. It is important that these items be discussed in detail with any potential supplier or training provider.
Workplaces considering implementing an AED program are also encouraged to discuss the advantages of stand-alone AED courses with their training provider and program administrator.
Although the Workplace Safety and Insurance Board recognizes the two workplace first aid courses, they do not currently set the standards for stand-alone AED programs, wilderness first aid, child first aid or any other training programs.
In Ontario, there is no official government source granting approval for AED training or that recognizes any particular provider. It is a buyer-beware market and employers looking to implement a program should do their due diligence.
Who will oversee the AED program? Although not mandatory, in some provinces the Heart and Stroke Foundation recommends all community and corporate AED programs be overseen by a physician or designated AED program co-ordinator. While medical oversight is a nice-to-have, it is not a requirement as using an AED is not a delegated medical act in Ontario.
How will EMS be contacted? The AED program policy should clearly define who and how to contact in the event of an SCA or other emergency.
How will the program be funded? Over the past few years, the cost of implementing an AED program has been significantly reduced.
Units can now be purchased for as little as $1,200 while replacement pads are between $70 and $100 dollars, and batteries can last between three to five years, with a replacement cost between $300 and $500.
Training costs will depend on the size of the workplace, number of trainees and frequency required by the medical director or program administrator.
There are many programs that offer support to organizations, communities and workplaces to assist with the implementation of an AED program. The Heart and Stroke Foundation or Cardiac Safe Cities will have more information in regards to funding.
How can the AED program be integrated with other heart health programs?
There is no question the wide use of AEDs will have a positive impact for all Canadians. All employers are encouraged to consider the advantages of implementing an AED program in the workplace and develop the appropriate policies and programs to ensure maximum success.
Steven Stone is manager, eConsulting, at the Public Services Health & Safety Association in Toronto, a non-profit association that works with public service sector employers and workers to reduce workplace risks and prevent occupational injuries and illness. For more information, visit www.pshsa.ca.
Can employers be sued if an AED is used improperly on a victim?
Employers may have concerns about liability if an AED is used improperly on a victim. But, to date, no one in Canada has ever been sued for using an AED.
This may be attributed to “Good Samaritan” laws that prevent individuals from being sued for trying to help. Every province and territory — except New Brunswick and Nunavut — has such laws. Ontario even has the Heart Defibrillator Civil Liability Act, 2006 (also known as the Chase McEachern Act) which protects individuals from liability for damages that may occur from their use of an AED to save someone’s life at the immediate scene of an emergency, unless damages are caused by gross negligence.
AEDs are also designed to reduce the risk of operator misuse. For example, a shock cannot be administered if the defibrillator does not detect a heart rhythm that needs defibrillating.
Source: Canadian Safety Reporter/www.safety-reporter.com