By R. Bruce Wright, CPCU
Back in April of 2003, the edition of RE-marks posted for that quarter included an article on Automatic External Defibrillators, sub-titled “A primer for RECs.” At that time, as we visited utilities that participate in our program, we had started to hear from our contacts that they were looking into these devices, or were interested in learning more about them. In the article we published then, Dean Wisecarver covered a number of frequently asked questions about AEDs and provided some links to sites with additional information. If you missed that article, or want to review it, you can navigate to it using the "Archive" button above.
Way back then (Less than a year ago!), we had discovered that only about 75% of the co-ops we visited had any real awareness of AEDs, and only 25% had really done any investigation into them. Public awareness was much lower than that, and only a small fraction of the general public had even heard of AEDs. My, how quickly things can change!
In November of 2003 the results of an early study hit the national press. Newspapers across the country covered the story of a research study sponsored by the National Heart, Lung and Blood Institute and reported at a meeting of the American Heart Association. This study, led by Doctor Joseph Ornato of Virginia Commonwealth University in Richmond, VA, found that placing Automatic External Defibrillators in public places such as airports, office buildings and shopping malls appears to greatly increase the chances of survival for victims of heart problems. The study covered 1,500 defibrillators in 993 sports facilities, shopping centers, entertainment sites, community centers, office buildings, factories, apartment buildings, transportation centers and schools in 24 cities. During the study there were 292 resuscitations attempted with 44 survivors, of whom 15 were saved with CPR only and 29 with AEDs. Those numbers show that there were almost twice as many survivors when AEDs were used! While this is a small sample and may not be statistically valid, the observed improvement to the rate of survival is so dramatic that it is certain to lead to further efforts to promote public access to these devices. 
In a front page story, USA Today reported that of the nearly 250,000 Americans who die outside of hospitals of cardiac arrest each year, as many as 76,000 may be victims of the ventricular fibrillation that AEDs are designed to correct. Medical professionals estimate that a victim needs care within the first 6 minutes after being stricken. Without prompt attention, 95% of these victims die before they can be transported to a medical facility. It is clear that Doctor Ornato’s study has shown that AEDs can be very effective in saving lives. Another interesting aspect of the report was that nearly 2/3s of the victims in the study were active at the time of their cardiac event and 76% were seen “going down.” This would suggest that in the majority of cases, timely intervention would be possible if AEDs and trained users were available nearby.
So, what’s the lesson here? Often when this subject comes up in the course of our visits, we are asked, “When will AEDs be required by OSHA?” If I may be so bold as to say so, in our opinion that is not the right question. For one thing, our crystal ball is no better than yours, and we don’t really have a good way to predict when a regulation may be implemented. One thing we do know, however, is that studies like the one discussed here are providing proof that AEDs work - that AEDs can save lives. This effectiveness should be the driving factor in your decision, and not the OSHA rules. Of course, when OSHA makes rules, you will have to follow them, but that is not the real reason to look at AEDs now.
As more evidence comes in supporting the effectiveness of AEDs it is reasonable to expect that they will become an addition to the tools of usual and customary emergency equipment, and a part of the “standard of care” expected. Since we expect that everone reading this is in the electric distribution, transmission or generation business, a business in which the chances of an accident caused fibrillation are higher than average, then it would be a prudent, proactive safety step to make plans to acquire AEDs and training for your workers.
Yes, they are still costly devices, but the costs have dropped dramatically as they have become more common. Back in April, we reported that average costs were $2,500 or so, and ranged up to $5,000. Recently, we visited a G&T that had purchased a number of high quality (Phillips Electronics) AEDS for about $1,600.00 each! At that figure, almost anyone reading this article can afford to get one or more of these potentially lifesaving devices.
We think that the time is approaching when employees, customers and the general public will expect that businesses like yours will have AEDs available for emergency use. The fact is that AEDs work. Further studies will certainly further refine our statistical understanding of the number of lives they can be expected to save, but there is no longer any question that they are effective tools that can be used successfully with only a bit of basic training. Why wait for OSHA to insist that you provide them? Whenever that day comes, there will be a “mad rush” to comply, which will only increase the chances of supply-side delays and hasty decisions. Making your move now may help you avoid that situation.