Careful Planning Required
An AED program consists of much more than buying an AED and making it accessible. A good program has widespread support, both internal (within your club, school, organization or business), and external (in the lay, medical and EMS communities) and is based on sound principles and careful planning.
Determining Need
One of the first steps is to determine whether your facility needs the protection an AED offers.
Generally, the need for an AED program is determined by:
Number of people: How many people use your facility, whether it be a school, athletic facility (baseball diamond, soccer field, hockey rink etc.), or business (shopping mall, etc.)?
Distance from EMS: How long would it take for emergency medical services to reach your facility in the event of a cardiac emergency? How large, complex, or security-intensive is your facility (i.e. how long will it take EMS to reach the victim once they are on your property)?
Specifically, you should find out the answers to the following questions:
Does your area have enhanced 911 coverage allowing emergency dispatchers to locate cell phone callers (according to the National Emergency Number Association (NENA), wireless callers make roughly one-third of all 911 calls)?
Are 911 dispatchers [1] trained to give instructions on CPR and AED use over the phone?
Approximately how many adults and students in the local community have had CPR training [2]?
What is the survival rate for SCA in your community?
Does your community have AEDs and, if so, where are they located? (You can usually obtain this information from the local fire department or EMS provider).
Are responders trained to deliver the first shock within 60 seconds of their arrival?
Are your community's first-responder vehicles (ambulances, police cars, fire department vehicles) equipped with AEDs? Who else might be a good candidate to receive an AED? What is their average response time? Does it exceed five minutes for more than 10% of responses?
Are there "high traffic" areas where people gather? Are there locations that could be considered high risk or difficult to access?
How much training has the local Emergency Medical Services (EMS) [1] provider and other emergency response personnel (Emergency Medical Technician [1], Paramedics) received in the use of AEDs?
Do emergency personnel provide Advanced Cardiac Life Support (ACLS) [3]?
Once you understand the current readiness of your community, you can develop the parameters of your defibrillation program. Based on the "optimal" response-time goal of three to five minutes or less, you can then determine the number of AEDs that you need and where they should be placed.
Worst Case Scenario
In determining need, it is essential to consider the worst case scenario.
Consider the following hypothetical situation: Your soccer club plays on a complex of fields on the outskirts of your town. It may be only five minutes from the nearest fire station, but think of how long it might take for paramedics to arrive if a player, referee, or parent went into Sudden Cardiac Arrest (SCA) [4] on a Saturday afternoon when four soccer games were being played on four different fields at the complex, when the parking lot was crowded with cars entering and leaving all the time, when traffic on the surrounding roads was heavy with people out running errands, and when the only ambulance was out on another call.
Far fetched? Maybe, but cardiac accidents tend not to happen when things are going right - only when everything seems to be going wrong, such as occurred in the case of 13-year old Emile Gadjev of Atlanta, Georgia, who died from SCA when, due to a series of errors, paramedics did not arrive until 12 minutes after he collapsed. Remember, the chances of surviving SCA are reduced 7 to 10% for every minute between collapse and defibrillation, which is the most important link in the cardiac chain of survival.
Research Essential
In determining need, you should also consider:
What similarly situated facilities have done: How have other schools, youth sports programs, or facilities like yours handled the issue of AEDs? You don't need to follow their lead, but it will give you some idea of whether you are on the right track.
Historical data: If you know of a case or two where people suffered cardiac arrest (or something like it) chances are that similar incidents will occur in the future. Of course, if the ambulance always arrives within a minute or two, maybe medical help will always be close at hand. The chances of reviving a person in cardiac arrest go down dramatically with each minute following collapse.
If you would like assistance with this process, please e-mail MomsTeam by clicking here [5] or call our toll-free 800 number, 1-800-474-5201.
Links:
[1] https://www.momsteam.com/node/387
[2] https://www.momsteam.com/node/298
[3] https://www.momsteam.com/node/354
[4] https://www.momsteam.com/alpha/features/cardiac_awareness_center/what_is_sudden_cardiac_arrest.shtml
[5] mailto:AED@momsteam.com
[6] https://www.momsteam.com/good-samaritan-laws-protect-aed-users
[7] https://www.momsteam.com/health-safety/cardiac-safety/automatic-external-defibrillators-aeds/onsite-placement-of-an-aed-is-critical
[8] https://www.momsteam.com/health-safety/cardiac-safety/automatic-external-defibrillators-aeds/starting-a-community-based-aed-program