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This article is intended to provide an overview of automated external defibrillator (AED) devices in response to the recent Club Industry article covering a case in which a lack of AED training allegedly led to the death of a club member. AEDs should be used as part of a formal, comprehensive safety program. A number of resources are listed below that can help with guidelines for establishing an AED safety program and training for employees. Because members and guests in a health club can suddenly experience cardiac arrest while exercising, AEDs are vitally important for health club operators to include in their safety programs.
Improving Survival from Sudden Cardiac Arrest
According to the United States Department of Labor’s Occupational Health & Safety Administration (OHSA), 220,000 people are victims of sudden cardiac arrest each year. Waiting for the arrival of emergency medical personnel results in only a 5 to 7 percent survival rate. Studies show that defibrillation provided within 3 to 5 minutes have shown up to a 60 percent survival rate.
Sudden Cardiac Arrest
The most common cause of sudden cardiac arrest is ventricular tachycardia (v-tach), a disruption of the normal heartbeat that can cause the heart to be unable to pump adequate blood through the body. This condition can deteriorate quickly into ventricular fibrillation (v-fib). Without medical attention, the person will collapse, lose consciousness, become unresponsive and die. The victim may have no warning and no history of heart conditions. A heart that has gone into ventricular fibrillation may only be restored to a normal rhythm by means of an electric shock.
Automated External Defibrillators (AED)
An automated external defibrillator is a device designed to analyze the heart rhythm and deliver an electronic shock to victims of ventricular defibrillation. The cost for an AED device is between $1,200 and $3,000. An AED is compact, lightweight, portable, battery-operated and easy to use. Select AEDs based on the most current recommendations of the American Heart Association are available in the Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. The AED units should be installed throughout the facility to ensure response within 3 to 5 minutes.
Formal Safety Programs
AEDs should be used as part of a formal safety program that ensures proper use and follow-up. Key elements of a program for fitness facilities include but are not limited to the following:
- Develop a written AED program.
- Designate an on-site coordinator.
- Expected AED users should maintain current CPR certifications.
- Expected AED users should complete a four-hour course on the device.
- All staff are informed of the location of the AED units in the facility.
- Post the list of AED-trained staff with each unit.
- Each AED should be maintained and tested regularly and in accordance with the manufacturer’s specifications.
- Document all elements of the safety program, including training, regular testing and maintenance of the AED units.
Guidelines for developing such programs are available through a number of resources, including:
- U.S. Department of Health & Human Services, Public Access to Defibrillation Guidelines
- State laws on cardiac arrest and defibrillators
- National Conference of State Legislatures and the American College of Occupational and Environmental Medicine, AEDs in the Occupational Setting
The staff of fitness facilities can be easily and affordably trained to recognize sudden cardiac arrest, notify EMS personnel, perform cardiopulmonary resuscitation, provide early defibrillation with an AED, care for the victim until the EMS personnel arrive and inform the EMS responder of the care provided. This training is imperative and should be a written part of the safety program.
Training resources include:
- OHSA www.osha.gov
- American Heart Association
- American Red Cross
- Federal Occupational Health
- National Center for Early Defibrillation
- National Safety Counsel
Good Samaritan Protection
The Cardiac Arrest Survival Act of 2000 required the Department of Health & Human Services to promote public access to defibrillation programs in federal and other public buildings. The act also extended Good Samaritan protections to AED users and the acquirers of the devices in any states without such immunities. Most states, however, have also passed legislation addressing the use of AEDs. Although there is variation across the states, the legislation commonly includes immunity for rescuers, acquirers and enablers. Some states do require current CPR certification and a four-hour AED training course for coverage under Good Samaritan laws. Fitness facilities should consult local regulation before initiating an AED program.
AEDs Save Lives
Developing and maintaining an effective AED program is a significant step in managing the risk of sudden cardiac arrest in fitness facilities. The American Heart Association posts success stories in which AEDs have saved the lives of people in public places. They can do the same in the fitness industry.
Jennifer Urmston Lowe has been with Sports & Fitness Insurance (SFIC) as a licensed insurance agent insuring health clubs and fitness centers since 1998. Lowe helped her father, John Urmston, found the IHRSA Insurance Program for Property and Casualty Insurance in 1999. She has functioned as SFIC’s national account manager since then. Lowe is a founding member of the advisory board of the Association of Fitness Studios. Prior to joining SFIC, she was the general manager of two personal training fitness centers and three corporate wellness centers in the Charlotte, North Carolina, market. Lowe has a bachelor's of science in business administration from the University of North Carolina at Chapel Hill.