Portable Defibrillator

[BigClive]

Not enough!

Can you think of any other trade that carries such a high electrocution risk? It should be a legal requirement to have AEDs on all live-work crews.

[shepsta]

I've been pushing for AED's for our Line crews for a while now.
Were they really invented to save lives of lineman? And where do you find that info?
Our management really does'nt feel there is a need, however they do have them at there corporate headquarters.

[BigClive]

To quote...

In 1899, Prevost and Batelli made the crucial discovery that large voltages applied across the heart could stop ventricular fibrillation in animals. Various other scientists studied further the effects of electricity on the heart during the early nineteenth century.

During the 1920s and 1930s, research in this field was supported by the power companies because electric shock induced ventricular fibrillation killed many power utility line workers. Hooker, William B. Kouwenhoven, and Orthello Langworthy produced one of the first successes of this research. In 1933, they published the results of an experiment, which demonstrated that an internally applied alternating current could be used to produce a counter shock that reversed ventricle fibrillation in dogs.

In 1947, Dr. Claude Beck reported the first successful human defibrillation. During a surgery, Beck saw his patient experiencing a ventricular fibrillation. He applied a 60 Hz alternating current and was able to stabilize the heartbeat. The patient lived and the defibrillator was born. In 1954, Kouwenhoven and William Milnor demonstrated the first closed chest defibrillation on a dog. This work involved the application of electrodes to the chest wall to deliver the necessary electric counter shock. In 1956, Paul Zoll used the ideas learned from Kouwenhoven and performed the first successful external defibrillation of a human.

[old lineman]

To quote...

In 1899, Prevost and Batelli made the crucial discovery that large voltages applied across the heart could stop ventricular fibrillation in animals. Various other scientists studied further the effects of electricity on the heart during the early nineteenth century.

During the 1920s and 1930s, research in this field was supported by the power companies because electric shock induced ventricular fibrillation killed many power utility line workers. Hooker, William B. Kouwenhoven, and Orthello Langworthy produced one of the first successes of this research. In 1933, they published the results of an experiment, which demonstrated that an internally applied alternating current could be used to produce a counter shock that reversed ventricle fibrillation in dogs.

In 1947, Dr. Claude Beck reported the first successful human defibrillation. During a surgery, Beck saw his patient experiencing a ventricular fibrillation. He applied a 60 Hz alternating current and was able to stabilize the heartbeat. The patient lived and the defibrillator was born. In 1954, Kouwenhoven and William Milnor demonstrated the first closed chest defibrillation on a dog. This work involved the application of electrodes to the chest wall to deliver the necessary electric counter shock. In 1956, Paul Zoll used the ideas learned from Kouwenhoven and performed the first successful external defibrillation of a human.

Interesting that according to my information CPR was discovered because so many linemen were dying from electrical contacts.
CPR was the end result of extensive research at The John Hopkins Hospital in Baltimore, Maryland in 1952. That's after AED's were discovered. I guess they never thought that they would be so small and idiot proof.
Perhaps it's a case of the left hand not knowing what the right hand was doing and then again I'm sure that the doctors aware of the problem thought that AED'S were to complex for the layman.
That was probably true when they first were developed, however, they sure have solved that problem now.
Another stumbling block probably was size, and likely cost. Mass production and computerized systems have solved these issues as well.
There's no more excuses.
The Old lineman

[BigClive]

Interesting that according to my information CPR was discovered because so many linemen were dying from electrical contacts.

I think it was while the development of AEDs was being worked on with the aid of Power Company support that they inadvertently discovered that when the pads were applied to a dog it's blood pressure changed with the pressure. That was effectively how they discovered that applying pressure to a chest could be used to pump the blood through the body, and was the dawn of CPR.

[CPOPE]

Avoiding legalities and OSHA Technical Bulletin re:AEDs
“Every workplace should have them and people trained to use them.
They are clearly life savers. “
Wade Sikora, CIH
Director Accreditation and Quality Assurance at Building Performance Institute Inc.

Join us for the latest OSHA Technical Bulletin and AED acquirer state law information! We are happy to provide this 15 minute quick webinar review to help you avoid any legalities.

Copy this link to register for September 29, 2010 11:30AM CST webinar! ONLY 15 minutes in length. Must register; limited seating. Or, email at: [email protected]

http://www.freebinar.com/AccountMana...IID=EA55DE8880

Technical Information Bulletin U.S. Department of Labor
Occupational Safety and Health Administration
Cardiac Arrest and Automated External Defibrillators (AEDs)

TIB 01-12-17
The Occupational Safety and Health Administration’s (OSHA’s) Directorate of Science, Technology and Medicine issues Technical Information Bulletins (TIBs) to provide information about occupational hazards and/or to provide information about noteworthy, innovative, or specialized procedures, practices, and research that relate to occupational safety and health. These bulletins are not standards or regulations and they create no independent legal obligations. They are advisory in nature, informational in content, and are intended to assist employers in providing a safe and healthful workplace.

Further information about this bulletin may be obtained by contacting OSHA’s Directorate of Science, Technology and Medicine at 202-693-2093.

Purpose
1. To inform employers about the use of automated external defibrillators (AEDs), a life-saving technology, in the treatment of cardiac arrest at work.
2. To provide an information resource to aid in decision-making about these devices at individual worksites.

Background
Sixty-one million Americans have cardiovascular disease, resulting in approximately 1 million deaths per year. One-third of these deaths (300,000-400,000) are due to cardiac arrest, the sudden and unexpected loss of heart function. Survival rates for out-of-hospital cardiac arrest are only 1 to 5 percent. Most often cardiac arrest is due to chaotic beating of the heart (ventricular fibrillation), which can be restored to a normal rhythm if treated early with electric shock (defibrillation). Treatment of witnessed ventricular fibrillation with immediate defibrillation can result in greater than 90 percent survival. With each minute of delay in defibrillation, nearly 10 percent fewer survive, so that at 10 minutes, survival is dismal. In June 1999, Chicago’s O’Hare and Midway Airports installed automated external defibrillators (AEDs) to respond in 1 minute to cardiac arrest. In the first 10 months, 14 cardiac arrests occurred, and 9 of the 14 victims (64 percent) survived.

Description of Hazard
In 1999 and 2000, 815 out of 6,339 (13 percent) workplace fatalities reported to OSHA were due to sudden cardiac arrest. Work factors that may aggravate or contribute to cardiovascular disease are carbon monoxide, carbon disulfide, halogenated hydrocarbons, smoking, extreme heat or cold, stress, and shift work. Electrical hazards may produce cardiac arrest (ventricular fibrillation). Exposure to noise, lead, or arsenic may produce high blood pressure, increasing the risk for heart disease.

AED Use
Use of automated external defibrillators began in the 1970s, enhancing the ability of emergency medical service personnel to treat cardiac arrest. Defibrillation is just one part of the treatment which also includes calling for emergency medical service assistance, cardiopulmonary resuscitation, and for the administration of medications and other life support measures. Early defibrillation, however, is the most critical of all the steps because it is definitive therapy for ventricular fibrillation.

AEDs cost between $3,000 and $4,500 plus the expense of maintenance and instruction. The past decade has seen advances in miniaturization and improvement in their reliability and safety. The AED is lightweight, runs on rechargeable batteries, analyzes the heart rhythm, and automatically indicates when to shock. These developments have markedly reduced response time and minimized the need for training. In a study of mock cardiac arrest, the mean time to defibrillation was 67 seconds for trained emergency service technicians while only 90 seconds for untrained sixth-grade students, indicating that even the untrained can use these devices successfully.

Many communities have trained first responders (police and firefighters) to use AEDs. Recognizing the need for faster response, the American Heart Association (AHA) has proposed public access defibrillation (PAD), a program that places AEDs close to the victim (in public places) and uses trained lay personnel for defibrillation. Specifically, the program should be designed to reduce the time to defibrillation to no more than 3-5 minutes. Using this program, a study of cardiac arrest in casinos found that defibrillation by a trained security officer within the first 3 minutes produced a 74 percent survival rate whereas defibrillation more than 3 minutes after collapse had 49 percent survival rate. Another study assessing survival for airline passengers with cardiac arrest found that 92% responded to defibrillation, while 40% survived to go home. In both instances, cardiac arrest victims could be readily observed and treatment initiated almost immediately.

Research on AEDs is ongoing. To determine if trained lay persons are as effective as trained emergency medical service personnel, the National Heart, Lung, and Blood Institute of the National Institutes of Health initiated a study in August 2000 that will be completed in 2003. The study will also look at whether it is realistic and cost-effective to train a large number of people to use these devices.

The Department of Health and Human Services and the General Service Administration published Guidelines for Public Access Defibrillation Programs in Federal Facilities following passage of Public Law 106-505 November 13, 2000, the Public Health Improvement Act . The Act authorized placement of AEDs in federal buildings and provided immunity from civil liability for anyone using an AED in a federal building. Several states have adopted legislation that allows a layperson to use an AED and provides legal immunity for proper use.

The American College of Occupational and Environmental Medicine, the professional association representing occupational physicians, has issued guidelines for establishing and managing a workplace AED program.

Conclusions
The sooner defibrillation is started, the more likely the victim will survive. The optimum time for defibrillation is 3 to 5 minutes after the onset of the cardiac arrest. The AED is a safe, effective, easily learned method of treating victims of cardiac arrest.

Recommendations
About 400 workplace deaths from cardiac arrest are reported to OSHA annually. Assuming an average time to defibrillation of 5 minutes would produce a 40 percent survival rate, 160 lives per year could be saved. Employers should consider use of AEDs at their worksites to reduce the time to defibrillation with the goal of improving survival.

[BigClive]

If OSHA actually did their job properly instead of making up random fatuous regulations they'd be forcing power companies to provide a suitable AED on each truck. (And on all construction and factory sites too!)

Then again, if they ever do the price will suddenly shoot up because it's a "requirement" to have one and the greedy sales motivated "instant AED experts" will move in like vultures. It would be nice if OSHA did that and also talked to the manufacturers about capping the end price so that it avoided the whole vulture thing.

[thrasher]

Clive:
Much of the cynicism about OSHA in the US is because it often appears the only purpose of new regulations is so manufacturers can sell more stuff. If OSHA was truly interested in safety the would kick 95% of the rule writers into the field as inspectors. If you read the accident reports on this site and others then tell me the last time you saw an accident where someone hadn't already broken an existing rule. The only ones I can think of are a man cutting out on a pole or a traffic accident.
Actually the Highway Department in Virginia is worse, every four years they come out with new signage requirements for lane closures, so we have to throw out all our existing signs and buy new ones. And the last time around they changed the requirements on our vest as well.
And before you ask all of of our crews carry an AED on the Lead Linemans truck for each crew, and they have for sveral years.

[BigClive]

The major manufacturers supply ruggedised versions. Usually supplied in a decent protective case. The electronics are nothing special. Just run of the mill electronics you might find in the trucks radio or sat-nav gear.

A real issue is ensuring that the battery packs and perhaps pads are replaced on a routine basis whether the units get used or not. Also making sure that the guys do actually report a use in case they try to cover up an incident and then put the covers back on the used pads. It would be terrible to find that the unit had been neglected when it was really needed.