Automated external defibrillators (AEDs) have become a common sight in public places over the past 20 years, but many businesses have been slow to introduce them into the workplace. Although there is no legal requirement to provide a defibrillator for the health and safety of employees or visitors to the premises, an AED is a relatively small investment that could one day save a life.
Sudden cardiac arrest -- the facts
Sudden cardiac arrest (SCA) is a leading cause of death in western Europe, and in the UK there are an estimated 60,000 cases every year. In England, the ambulance service attempts resuscitation in around 30,000 of these, but less than one person in ten survives if the condition occurs out of hospital (bit.ly/2nUf6gm).
The good news is that survival rates improve dramatically with early intervention and the European Resuscitation Council states that CPR can double or quadruple a person's chance of survival if it is started immediately.
But that's only half the story.
Most SCAs occur because of a problem developing in the heart that results in an abnormality in its electrical rhythm. Technically referred to as ventricular fibrillation, the electrical impulses that normally control the heart become chaotic and uncoordinated. This could be caused by many issues, including muscle damage, as in a heart attack, or accidental electrocution. The heart stops beating normally and blood stops circulating around the body. It can happen to people of any age, at any time.
To return the heart to its normal rhythm, the patient requires defibrillation -- an electric shock that will stun the heart muscle and restore the pumping function. Using a defibrillator within three minutes of a cardiac arrest can improve a person's chance of survival by as much as 70%. However, survival rates fall by 10% for every minute the patient goes without defibrillation.
Armed with the knowledge that it's a race against time, it's clear that having employees trained to deliver CPR and with ready access to an AED can save lives.
Does my business need an AED?
In an ideal world, everyone would live, study and work within minutes of defibrillator treatment. In reality, an AED represents a financial investment in the equipment, its upkeep and training on its use. Therefore, businesses want to be confident that the purchase is warranted.
Enter the risk assessment.
If your organisation has a large number of employees or customers visiting a site each day, this will increase the risk of an SCA. UK supermarket chain Morrisons has 11 million customers walking through its doors every week and has installed defibrillators in 494 stores. Quick-thinking staff have already saved the lives of 21 people by using the devices (see box below).
Morrisons rescue remedy
The lives of 21 people have been saved since Morrisons installed nearly 500 defibrillators in its UK stores in 2017.
As part of the £500,000 initiative funded by the retailer's charitable arm, Morrisons Foundation, more than 2,300 employees attended familiarisation sessions on using the kit and giving CPR. The sessions, run by St John Ambulance volunteers, gave staff the confidence and knowledge of what to do if someone sustained a cardiac arrest.
The Morrisons store in Blackburn, Lancashire, is among the 494 to install a defibrillator and one where a life has already been saved. When a customer collapsed in an aisle, the store first aider and her team used the machine to give shocks that restarted the heart and resuscitated him.
The supermarket chain was one of the winners in the Workplace Hero category at St John Ambulance's Everyday Heroes Awards 2018. The awards celebrate those who have bravely stepped forward in the moments that matter, saving lives with first aid or having a positive effect on community health through volunteering.
Also consider whether there is a higher risk of SCA at your place of business -- for example, gyms or health clubs have an elevated risk of cardiac arrest and in some countries and US states it is compulsory to have an AED onsite. British car retailer Pendragon has bought more than 200 defibrillators for its dealerships and centres after being advised by manufacturers that an AED should be provided for the safe servicing of electrical vehicles.
When time is of the essence, the case for having a defibrillator on site can be critical. For rural businesses, ambulance response times can be much longer, which shortens the survival chances of a stricken employee or customer.
Most organisations will know where their nearest defibrillator is as part of their first aid strategy, but it should be well researched to ensure it is indeed a viable solution. For instance, is the AED available on days and times when your staff and customers are on site? Also consider how long it would take to retrieve the AED on foot. It may only be a five-minute walk away, but the round journey will be double that, by which time the chances of patient survival could have diminished significantly. If it's not accessible, businesses should consider investing in their own equipment.
Train and maintain to save lives
Modern AEDs provide audible instructions and some even give visual prompts to help the user. The AED analyses the heart's electrical activity and will charge itself to deliver a shock if required, making it particularly simple to operate.
Although anyone can use an AED without formal training, best outcomes are achieved when rescuers receive training in first aid to recognise the symptoms of SCA and perform CPR since these elements are essential in incidences of cardiac arrest. CPR maintains oxygen supply to the brain and other organs to make it more likely that the heart can be re-started by defibrillation. Training doesn't take long and it is important that staff are familiar with what to do because every minute wasted can have a significant impact.
As well as ensuring enough staff are trained to use the AED, businesses should also ensure the device is always visible, available and ready to use. This is normally very simple and involves little more than replacing the battery when required, keeping pads in stock and replacing them after use.
Become part of a heart restart network
As well as providing life-saving equipment for staff, visitors and customers, businesses can use their AED to be part of something much greater -- creating resilience in their community. The unit can be registered with the local ambulance service so that dispatchers can direct callers faced with an SCA to their nearest device.
The AED can also be fitted in an external place where the public can access it 24/7, thus adding to the safety of the area, supporting emergency services and helping to prevent unnecessary deaths.
A public service
Purchasing and registering the equipment as a public access defibrillator (PAD) with the ambulance service not only helps to make the workplace safer, but also helps the community and enhances the organisation's corporate social responsibility. A PAD is a defibrillator that is available for use by the public.
Defibrillators cost between £800 and £1,500 plus VAT. Wall brackets and cabinets will also be needed to store the units in a safe but accessible place. The defibrillator conducts self-checks to make sure it is 'rescue ready' should it be required for a cardiac arrest. However, manufacturers will advise how often an employee, such as a first aider, should check the unit too.