Utilization and Impact of AEDs in the Workplace: A Survey of Occupational Health Physicians

Barbara Toeppen-Sprigg, MD, MPH, Warner Hudson, MD, Doris L. Konicki, MHS, Colleen K. DiIorio, PhD, and Pamela J. Kennedy, BA

Abstract

Each year, approximately 1 million Americans die of cardiovascular disease. (1) Of these, between 300,000 to 400,000 die due to cardiac arrest, a sudden and unexpected loss of heart function. When cardiac arrest occurs outside of a hospital, survival rates are extremely low, in a range of 1 to 5 percent.

The most common cause of cardiac arrest is chaotic beating of the heart, also known as ventricular fibrillation. If an electric shock (defibrillation) is administered early enough, the heart can be restored to a normal rhythm resulting in survival rates approaching 50% and even as high as 90 percent, according to some studies. (2,3,4) However, the likelihood of survival without neurological problems decreases by about 10%, with each passing minute. (5)

The use of Automated External Defibrillators (AEDs) offers a cost-effective, safe method of providing electric shock to victims of out-of-the-hospital (OHCA) cardiac arrest. (6) Since AEDs were first introduced in 1979, (7) their cost has decreased significantly and their design has been improved, making them suitable for use by laypersons in public places.

As AED technology has advanced and its success in saving lives has been documented, discussion has increased regarding its use in the workplace. The American College of Occupational and Environmental Medicine (ACOEM) believes strongly that AEDs offer an important safety resource in the workplace and that their use should be aggressively promoted in order to reduce workplace fatalities. (8) ACOEM undertook a study in August 2003 to ascertain the utilization and impact of AEDs in the workplace. Based on this survey, those companies employing an AED program experienced a 66% favorable response rate when the AED was deployed.

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1. Technical Information bulletin (TIB) 01-12-17. U.S. Department of Labor, Occupational Safety and Health Administration.
2. Weaver WE, Copass MK, Bufi D, Ray R, Hallstrom AP, Cobb LA. Improved neurological recovery and survival after early defibrillation. Circulation. 1984;69:943-948.
3. Eisenberg MS, Cummins RO, Damon S, Larsen MP, Hearne TR. Survival rates from out-of-hospital cardiac arrest: recommendations for uniform definitions and ata to report. Ann Emerg Med.1990;19:1249-1259.
4. Weisfeldt ML, Becker LB. Resuscitation after cardiac arrest—a 3-phase time-sensitive model. JAMA. 2002;288:3035-3038.
5. The PAD Trial Investigators. The public access defibrillation (PAD) trial study design and rationale. Resuscitation. 2003;56:135-147.
6. Gundry JW, Comess KA, DeRook FA, Jorgenson D, Bardy GH. Comparison of Naïve Sixth-Grade Children with Trained Professionals in the Use of an Automated External Defibrillator. Circulation. 1998;97:1315-1320.
7. Diak AW, Welborn WS, Rullman RG, Walter CW, Wayne MA. An automatic cardiac resuscitator for emergency treatment of cardiac arrest. Med Instrumentation. 1979;13:78-83.
8. ACOEM Guidelines for Automated External Defibrillators in the Workplace .