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July 03, 2020  
FORUMS: Read-Only

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Topic Title: New Automated External Defibrillator Poised to Jump-Start Commercial Market Adoption
Created On: 08/22/2002 04:36 PM
 
 02/25/2003 08:33 AM

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69036903

there is a ny state tax credit available for purchase of AED's . is there any other available or how about federal? or reimbursement from either liability insurers or through prescription from health insurers
 08/30/2002 04:54 PM

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barabas

Well this covers alot of things except motivation on behalf of the company in question to initiate these programs- To be completely cynical tehre is still going to be some cost associated to teh company to train these employees- why would a company have incentive to do so? do they get a tax break? THeres always been 'accessible" CPR training but its likely your local cashier doesn't know it nor your local company necessarily provide it- though I don't know about security guards and their companies... Still for the purposes of this forums yes it does seem a smart way to handle the issue of more publicly accessible defibrillators
 08/27/2002 09:51 PM

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Psyche2569

You know, that is an interesting point to discuss, the legal liability, and the placement of the AED in public places. Perhaps we've been looking at the wrong side of the equation, having an AED as available as a fire extinguisher... After reading your post I thought of another possibility. Assume a public location wished to have an AED available for emergencies, say a large public mall or grocery store. When considering the Chain of Life proposed in the AHA Guidelines for BLS and ALS, it certainly does seem like a positive change to have a defibrillator available within a minute's reach. Now the consideration of protecting those who grab and use that device. How about his idea. One thing in common at any public setting such as this are personnel responsible for tending to the general public. This can be cashiers, stockers, management personnel, and even security. Now, assume one such place wished to have an AED available. I believe this is possible as follows: The company in request should apply for the use of an AED at their facility, and as part of this application, they should have members of their staff, be it security guards, managers, or whoever, who is both trained and certified by the American Heart Association in the use of an AED, and who have demonstrated to personnel to be selected by the state's board of health that they are indeed proficient in it's use. They should also agree that they will become liable for the equipment, and use of the equipment, most important of which is making sure it is only made available to certified and approved personnel. Now you have solved the problem of necessary training, legal liability, and Medical Control through the State Board of Health. While this would mean a lot of changes made on the legislative end of medicine, there can be no argument that having an AED available in the hands of certified and skilled persons within literally 3 minutes of collapse can be. I know this is a broad, and very touchy issue, and that there are many other considerations that we haven't thought of, but those are best left to the politicians to sort out. When this scenerio is thought out, it does become plausible and workable, and provides an additional security to the public, to know that even in the middle of a crowded mall, if trouble should arise, help could be just a moment away. Thank you for bringing up this thought provoking issue, it really makes me re-evaluate the validity of the AED as a highly valuable medical tool, in the right hands. I hope that something I provided here brings to light possibilities to facilitate near future changes. Also, the Good Samaritan Clause, yes, I think it should factor in. If an approved, properly trained and skilled employee authorized by their company performs in good faith and with reasonable standard of care their actions, then certainly the Good Samaritan Clause should play in this. However, the company should be willing to be responsible if a finding of gross negligence or less than standard care is provided. This would motivate the company wishing to have the AED to constantly evaluate the skills of those they approve to use the device, ensuring that standard of care is kept high. Write back, let me know what you think...
 08/27/2002 06:14 PM

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barabas

Ouch? so how is/would the use foo these defibrillators and their misuse be covered under liability laws- Would this be covered by Good Samaritan Laws? OTOH you may be right and this may indeed be a mistake, but would it be too hard to train people properly to check for artifacts? and then still provide the defibrillators in publicly accessible spots? Or is this just another bad idea?
 08/27/2002 05:16 AM

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Psyche2569

Being an Emergency Medical Technician at the Basic and Intermediate level, I have had some experience with the new Automated External Defibrillators. This being because at these levels we cannot use manual defibrillators. While I would never discount their invaluable place in the field, I do have mixed feelings about them. While they are great for providing early defibrillation to a patient in need, they depend heavily on what the leads show the monitor. This can be a good thing and a bad thing. The good side is the ability of even a layperson to use it, since it reads the rhythm, determines if a shock is necessary, and sets it's own power setting, and delivers the shock. However, this could be bad too. Imagine the patient being moved around, or a nearby source of 60 cycle hum, or any other factor that can create something called artifact in the leads. Artifact is literally garbage in the rhythm caused by a multitude of factors, among them shivering, movement, movement of the wires, and movement of the AED itself. I have had an AED misinterpret this artifact for a lethal Ventricular Fibrillation, and started to charge for a shock. In reality this patient had a normal sinus rhythm, and a strong, steady pulse of about 70. I had to shut off the machine and pull the cables. Imagine what could have happened if I had allowed it to shock. So I say again, these are great things, but I still believe that they shouldn't be allowed to be used by the general public. Perhaps designing an AED with a type of key device, simple and cheap, and those who pass an AHA certification on it's useage be issued one of these keys, so that even though they're readily available at your local mall, only someone with one of these key devices could turn on and operate the machine. I know this sounds rash, and cold, but in the greater scheme, it's got to be a safer method...
 08/22/2002 04:36 PM

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barabas

Wow looking at the articles on this site makes you think ther'll be defibrillators everywhere in a year or two- Next time on bad action movies we'lll be seeing the hero smash a glass panel (normally used for holding fireaxes and extinguishers) and pulling a defibrillator...
     
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