Through an automated system of checks and balances, a full-service AED management program enhances emergency response and saves lives
By Dave Fritzsche and Drew Myklegard
By February 26, 2006, each Florida dental office was required to have an automated external defibrillator (AED) due to a new rule implemented by the Florida Board of Dentistry. This requirement - likely to be echoed by other states - continues a trend toward better and quicker access to these lifesaving devices. AEDs resuscitate victims of sudden cardiac arrest (SCA), a condition that kills more than 400,000 Americans each year - more than breast cancer, AIDS, prostate cancer, house fires, handguns, and traffic accidents combined.
Since the American Dental Association’s Council on Scientific Affairs encouraged the purchase of AEDs for dental offices in 2002, these devices have become more commonplace, especially as they become more affordable. Also, with Good Samaritan laws providing liability immunity to rescuers in 49 of 50 states and the District of Columbia, AEDs are increasingly viewed by communities as a required standard of care - especially for patients in dental or medical offices. Trends show that liability risk may be incurred by not having an AED ready, with lawsuits having been filed after events in which AEDs were not available or ready to save a SCA victim in a public area.
Having an AED in a dental office will improve the speed of response, which is often the difference between life and death. Experts estimate that 70 percent of SCA victims survive when defibrillated within a minute or two after arrest, while only 5 percent live if defibrillation is delayed for more than 10 minutes. Studies show that these fatalities happen primarily because response time to out-of-hospital cardiac arrest often still exceeds 10 minutes. With each minute that passes, the chance of survival decreases by 10 percent.
Organizing an effective AED program for a dental office can improve response time and lessen the chance of error. A new concept in the AED industry - a comprehensive AED management program - links all participants (manufacturer, distributor, medical director, dental office, trainer, local EMS, etc.) in one, integrated effort. The components of this “turnkey” approach to AED program management are:
- A high-quality, easy-to-use AED.
- Medical oversight and direction.
- Web-enabled tracking and maintenance.
- Standardized AED/CPR training and communication.
- Continual program evaluation and improvement.
Through these five components, a turnkey AED management program provides an automated system of checks and balances that keeps program participants well-informed and accountable to each other.
A high-quality, easy-to-use AED
Because SCA victims must be treated quickly - within a few minutes - having an AED at your dental office gives you the best chance of saving a life. Victims receiving defibrillation within the first few minutes after arrest have a 70 percent survival rate; for those receiving aid after 10 minutes, the survival rate is 5 percent. The goal of an AED program must be to deliver defibrillation to a SCA victim within three minutes of cardiac arrest. Studies show that even the fastest EMS team will be hard-pressed to get to the side of a victim in less than five to 10 minutes. Properly trained individuals in your office responding with an on-site device can come to the aid of a victim faster - but they must be confident enough to act without delay!
A physician must prescribe a prescription for a dental office AED program, as required by federal law. The physician’s duties also include consultation on who is trained, how the training is conducted, and how the program is tracked and maintained.
Look for AED product features that will add speed, reliability, and confidence to your office’s team. Some AEDs, for example, literally “talk” to the user during an emergency, giving audible instructions and confidence to those using it. Consider purchasing a brightly colored AED that’s easy to see and find. In a situation when every moment counts, you don’t want to have a difficult time finding your AED. The total number of AEDs deployed in a dental practice - especially if you have more than one location - can make a big difference, too. That’s why a lower-priced AED can add tremendous value and quality to your program. A high-quality AED can be purchased for less than $1,500. Purchasing more AEDs for your budget means you’ll have the lifesaving devices better positioned to improve response time. That enhanced availability can save a life.
Medical oversight and direction
A prescription for your dental office program must be provided by a physician, as required by federal law. The physician serves as your medical director and makes sure the program’s policies and procedures meet all federal and state regulations. This is important because state laws regarding training, liability, and other issues vary. A turnkey AED management program can provide a physician with experience implementing public access AED programs and treating emergency cases of SCA. His or her duties include consultation on who is trained, how the training is conducted, and how the program is tracked and maintained. The doctor also provides assistance in determining where the AED or AEDs are placed. Medical directors can supervise a site survey that measures response times with a stopwatch and accounts for physical barriers such as locked doors, elevators, and stairways.
Web-enabled tracking and maintenance
Tracking the working condition and maintenance of AEDs can quickly become a complex series of tasks, especially with devices in more than one location and with the manager of the AED program juggling many responsibilities. A Web-enabled program keeps program participants well-informed and accountable to one another. The program’s software places all vital program information online, including the location of the AEDs, maintenance checklists, and training information. Automatic e-mails remind program managers to do timely maintenance and training. Reminders become increasingly urgent as deadlines approach and, if they are missed, delinquent reports are listed (along with those responsible for them). This system of checks and balances generally results in excellent maintenance compliance, reducing the potential of an unsuccessful response and liability if an emergency occurs.
Standardized AED/CPR training and communication
Trained volunteer responders significantly improved the survival rates of SCA victims, according to the results of a recent research study of public access defibrillator programs published in the New England Journal of Medicine. A University of Washington study showed that the average sixth grader can successfully operate an AED. Therefore, an effective AED/CPR training program will turn dental office employees into an effective and confident team of potential lifesavers. Organizations are generally held liable for negligence in a SCA event when AEDs are not available or do not work, or when employees do not know about the availability of AEDs. These situations can be avoided through a proactive, top-to-bottom program involving training and communication about AEDs, CPR, and SCA to all employees. To decide how many employees to train in AED and CPR response, you should weigh several factors, including the prevalence of SCA risk factors in your dental office and your budget.
Continual program evaluation and improvement
After each use of an AED in an emergency situation, you should make sure the used AED’s pads and batteries, as well as other used supplies (CPR mask, razor, scissors, gloves, etc.), are replaced. Soon after the event, the medical director will schedule a briefing with the individuals who participated in and witnessed the response. Participants review the event in detail during this discussion with an eye toward optimal performance of the AED and the response teams. Your office team should meet periodically to discuss how the program can be improved, even if no emergency responses are needed. Response team drills conducted with local EMS also help to fine-tune the effectiveness of your program.
Preparation saves lives
Multiple studies have clearly established early defibrillation through AED use as the standard in pre-hospital care. Early defibrillation is the critical link in the American Heart Association chain of survival and the only hope for most victims of SCA. The American Dental Association, the American Red Cross, the American Safety and Health Institute, and the National Safety Council are among the many health organizations endorsing AEDs in dental and medical offices, workplaces, and public areas.
A turnkey AED management program can help ensure that your dental office will successfully respond to a cardiac event. Through high-quality AEDs, Web-enabled tracking and maintenance, responder training, and continual improvement, your program will achieve its intended, positive result - the saving of lives.
David Fritzsche is a vice president of Defibtech (www.defibtech.com, 800-333-4248), which designs and manufactures FDA-approved AEDs and related accessories. Headquartered in Guilford, Conn., Defibtech markets its products worldwide through its network of distribution partners. Drew Myklegard is the president of STATPADS, LLC (www.statpads.com, 866-STATPADS), which designs and implements public access defibrillator programs for dental and medical offices, employers and public facilities. Defibtech and STATPADS have partnered to develop Defibtech MD (www.defibtechMD.com, 800-378-9772), a full-service AED management program.
