Page 50 - Occupational Health & Safety, January/February 2019

DEFIBRILLATORS & CPR
AED Coverage Area: Going back to high school math, we use the formula Pi*r2, where r is a radius of 300 feet, to calculate that the maximum theoretical area an AED can cover is 283,000 square feet (equal to about five football fields). But because AEDs are most often not placed in open areas, we must also account for obstacles such as people, doors, hallways, stairs, elevators, escalators, physi- cal barriers and obstructions, AED storage methods, and similar constraints that reduce the effective area an AED can cover within the two-minute AED retrieval time. Let’s assume that obstacles re- duce the coverage area radius by half to 150 feet. This means, on average, an AED can cover about 70,650 square feet.
Calculating the AED Shortage: The factors described above serve as the foundation for quantifying the AED shortage. To calculate the breadth of this shortage, I also make the following assumptions:
■ It takes 395 AEDs to cover one square mile (27.9 million square feet per mile/70,650 square feet of AED coverage area).
■ There are an estimated 88,000 non-residential, urbanized square miles in the United States.
■ AEDs must provide coverage horizontally and vertically (e.g., in multi-story buildings).
■ AEDs are often placed in locations that limit their effective range or add to response time (e.g., where AEDs are not permitted to be removed from the AED owner’s location even if an SCA event
is nearby at a different location, or the worst case, AEDs are placed in a locked cabinet).
Putting all this together, we can now estimate our need to be more than 30 million AEDs to cover the 70 percent of the popula- tion found in the non-residential, urbanized areas of the United States. We’ll need at least 10 million more to cover the non-urban- ized areas and remaining 30 percent of the population. (For those who care to dig into the math, take a look at The AED Shortage post for more, http://www.readisys.com/the-aed-shortage/.)
An estimated 4.5 million AEDs have been sold in the United States since the 1990s (though not all remain in service, of course). This means we have only about 10 percent (perhaps less) of the total number of AEDs required if rapid defibrillation is going to be available to most people experiencing SCA. So you can see how this AED shortage may help explain why, in public settings, AEDs are used by bystanders a minuscule 2.1 percent to 3.7 percent of the time.
How to Fix the AED Shortage
The obvious reason for the AED shortage is the fact these life- saving devices are, with a few exceptions, not legally required at most locations. As a result, the vast majority of publicly accessible AEDs in the United States are there only because organizations vol- untarily chose to place them—decisions that should certainly be
MODEL AED LAW
An act to repeal \[insert statutory references\] and enact new provisions relating to the placement and use of automated external defibrillators (AEDs).
Section 1. Repeal and replacement of existing AED laws:
\[Insert statutory references\] are hereby repealed and replaced with the following:
Section 2: Definitions:
(a) “Automated external defibrillator” or “AED” means an automated external defibrillator approved for sale by the U.S.
Food and Drug Administration.
(b) “Person” means an individual, corporation, partnership, limited liability company, association, trust, unincorporated
organization, or other legal entity or organization, or a government or governmental body.
(c) “Public place” means an enclosed indoor or outdoor area capable of holding one hundred (100) or more people
and to which the public is invited or in which the public is permitted but does not include a private residence.
Section 3. Good Samaritan legal protections:
(a) The following persons are not subject to civil liability for damages arising out of any acts or omissions relating to the
placement and availability of automated external defibrillators absent gross negligence or willful or wanton misconduct: (i) Any person that acquires an AED;
(ii) Any person that owns, operates, manages or is otherwise responsible for the location where an AED is placed; (iii) Any person who retrieves or fails to retrieve an AED;
(iv) Any person who uses, attempts to use or fails to use an AED;
(v) Any person who was present at a location where an AED was used or not used;
(vi) Any physician or other authorized healthcare provider or person who issues a prescription for the purchase of an
AED or provides medical oversight services to a location where an AED is placed;
(vii) Any person that is involved with or responsible for the design, management or operation of an AED program; and (viii) Any person or entity that provides instruction in the use of an AED.
(b) The immunity described in paragraph (a) of this section applies regardless of where an AED is retrieved from or used. Section 4: Automated external defibrillators required; persons authorized to retrieve and use automated external
defibrillators:
(a) A person who owns, operates or manages a public place shall place functional AEDs in sufficient quantities to
ensure reasonable availability for use during perceived sudden cardiac arrest emergencies. (b) Any person is permitted to retrieve or use an AED.
44 Occupational Health & Safety | JANUARY/FEBRUARY 2019
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