• How does an AED work?
• What are the liabilities incurred by setting up AEDs in our facility, or by not having AEDs on location?
• Do I Need Malpractice Insurance?
• What States Have The Good Samaritan Law?
• What Is The Cost To Purchase And Maintain An AED?
• What is the difference between Monophasic and Biphasic AEDs?
• Why do we need Medical Direction?
• Why is an AED protocol necessary?
• Do I Need A Prescription?
• How Do We Implement An AED Program?
• Where is the ideal location for an AED?
• What Public Places Have AEDs?
• Why Public Access to Defibrillators?
• Why Can't We Just Call 911?
• What Additional Training Is Required?
• Where Can We Get Education Resources and Materials?

How Does An AED Work?
The Automated External Defibrillator is a microprocessor controlled and verbally automated device that is able to detect and analyze a person's heart rhythm through electrodes on the victim's chest. The computer inside determines whether or not the person's heart is in a condition called "Ventricular Fibrillation". The condition mentioned occurs during Sudden Cardiac Arrest (SCA). SCA is when the largest chambers of the heart quiver and blood is not pumped through the body. Eventually, the heart stops unless an AED delivers an electrical current to the heart. The shock is the only definitive treatment for this condition and can return the heart back into a normal beating heart rhythm. No accidental shocks are given because the machine can detect normal heart rhythms and will verbally advise the operator that no shock is advised. If the victim has no pulse, CPR should be started immediately. The device gives voice automated prompts to guide the operator through whole process.
By allowing the automated external defibrillator to do the analysis and advise you when a shock is needed, the user only has to be responsible for pushing the button. Therefore, in the event of Sudden Cardiac Arrest, after first making sure that the victim is not breathing and there is no pulse, simply apply the device and leave it in the hands of the AED to make the decision to give the therapy. If defibrillation is not needed, the AED will advise the user, and CPR may begin immediately.

What are the liabilities incurred by setting up AEDs in our facility, or by not having AEDs on location?
The risk of liability is minimal because of the Good Samaritan laws that every state has passed. Additionally, the Cardiac Arrest Survival Act, which was passed by Congress and signed by President Clinton in 2000, provides AED users and acquirers with protection from liability. This will help make AEDs the standard of care for Sudden Cardiac Arrest. With proper training and the AEDs easy-to-use design the risk of misuse is low

Do I Need Malpractice Insurance?
All 50 states have passed Good Samaritan laws that cover properly trained AED users against liability. As of the date of this writing, there have been no lawsuits filed against persons acting in good faith assisting a person who had collapsed, by applying an AED.

What States Have The Good Samaritan Law?
All 50 states provide immunity to laypeople who administrate an AED:

What Is The Cost To Purchase And Maintain An AED?
An AED costs about the same as a computer. With its warranty and five-year battery, an AED offers a very low cost of ownership through the life of the AED. You can expect to pay about $2000-$3000

Most external defibrillators currently use monphasic waveforms, either damped sinusoidal (MDS) or truncated exponential (MTE) monophasic waveforms. Monophasic waveforms are the conventional waveforms used for defibrillation with an AED. The 1992 guidelines recommended an initial 200-J (joule) shock with increases in energy levels to either 200 or 300 and then to 360-J for subsequent shocks (JAMA. 1992;268:2211-2).
During the past two decades, biphasic waveform defibrillation has been examined in experimental and clinical settings. Biphasic waveforms deliver both a positive and a negative current that together result in successful defibrillation with less delivered energy than monophasic waveforms. However, in a recent multicenter, randomized clinical study[*] comparing the difference between biphasic and monophasic waveform shock delivery, there was no statistical differences in survival.
*Atkins D, Bossaert LL, Hazinski MF, Kerber RE, Mancini MB, Ornato JP, Peberdy MA, Quan L, Tang W, Timerman S, Weisfeldt ML, White RD. Automated external defibrillation/public access defibrillation. Ann Emerg Med. April 2001;37:S60-S67.

Why do we need Medical Direction?
It is recommended that a physician be assigned as the medical director for your AED program.

Why is an AED protocol necessary?
It is important that an AED protocol is established for your program. We recommend that each protocol must include indications for AED use, contraindications, procedures for its use, reporting procedures, maintenance, and quality assurance procedures.

Do I Need A Prescription?
A written doctor's prescription is legally required for the use of an AED. The law does not allow a prescription to be valid after one year. Additional prescriptions may be purchased annually at $500 per year use. Note: After one year, user assumes all legal liability regarding possession of a medically controlled device without a doctor's order.

How Do We Implement An AED Program?
The first step is to work with the principal people within your establishment. It is also important to involve people such as a medical director, occupational nurse, human resources director, security director, or a safety/CPR training coordinator in program planning. Factors to take into account when instigating an AED program are:
1. Facility security
2. Location
3. Size of facility
4. Number of employees and visitors

Where is the ideal location for an AED?
The AED should placed in a visible and easily accessible location where a five-minute response time can be achieved. The AEDs convenient carrying case allows for easy mobility and the available wall mount accessory allows for stationary placement. Listed are recommended areas for AED placement:
· In a medical clinic (if available).
· In a reception or common area
· Near a fire extinguisher.
· With a safety response team member.
· With a security officer.
· On board a corporate jet
· Football stadium

What Public Places Have AEDs?
At O'Hare Airport in Chicago and DFW in Dallas, the AED stations are hanging on the walls spaced within one minutes' walking distance for public access to defibrillators. Since O'Hare Airport is putting the AED in the hands of the general public, AEDs are evolving into a standard of safety, not unlike fire extinguishers. You may see them in doctors offices, dentist offices, schools, golf courses, or stadiums such as the United Center in Chicago

Why Public Access to Defibrillators?
"The placement of AEDs in the hands of large numbers of people trained in their use may be the key intervantion to increase the survival chances of out-of-hospital cardiac arrest patients . . . " (JAMA. 1992;268:2291.) Without warning, sudden cardiac arrest (SCA) can afflict anyone, anytime. SCA kills 350,000 people in the U.S. alone each year. The evidence is well defined that the chance of surviving a cardiac arrest declines by approximately 10% for each minute without defibrillation. Beyond 12 minutes, the chance of survival is 2% to 5%.
In its publication, Guidelines 2004 for CPR and Emergency Cardiac Care, the American Heart Association recommends defibrillation within five minutes for emergency response outside the hospital. Recently published studies in the New England Journal of Medicine further support the recommendation with results that show 74 percent survival rates for victims defibrillated within three minutes.

Why Can't We Just Call 911?
Realistically, there is a very good chance emergency medical services (EMS) cannot respond fast enough to save someone in cardiac arrest, particularly in congested urban areas, high-rise buildings, large facilities or in rural areas. In fact, the national average response time is 10-12 minutes, so even the best EMS responders could have difficulty arriving in time. Besides traffic, consider the time needed to make it through building security and all the way to a victim.

What Additional Training Is Required?
Regulation on the use of AEDs is common, and minimum training requirements vary from state to state. In many cases, a simple course including CPR and AED training is all that is required. The National Safety Council® and other training organizations, such as the American Red Cross, also offer training programs.

Where Can We Get Education Resources and Materials?
We can provide seamless AED training throughout the United States. Our large physician instructor network have all had orientation to the FirstSave AED and have been approved to provide quality education to our customers.
We provide American Heart Association training textbooks and materials that are used to provide the educational tools necessary for increasing public access defibrillation.