we are a large multi-site company mainly office workers and are considering the introduction of defibrillators around the company buildings. Has any member undertaken (or decided not to) this recently or in the past based on a risk assessment and cost benefit analysis, and what lessons did they learn during the process and what would they do differently if they had the opportunity to do so?

My opinion is that where there is a higher than average risk arrhythmia then they should be considered eg Dr Surgery, Clinic, Care Home etc Consider this risk in your multi site offices, and then consider : - multi purchases of the defibs - multi trained people in the multi offices to use the equipment - multi refresher / familiarisation trainings in the multi offices - can you get the number of volunteers to be trained to use them Also I have had the experience of trained staff refusing to use the defib until the ambulance arrived - Each machine needs maintenance, calibration, checks etc - Will a trained person and the equipment be available at all times in these locations when occupied by staff, visitors or outside normal hours eg the cleaning staff. Defibs can be a benefit in the right circumstances, but be aware that costs and amount of resources needed to manage them once you have them. Steve

I have done this a few times. don't forget once casulty stops breathing you have an 80% chance of effective resus at second 1, this decreases by 10% every minute - at minute 8 __________________________ Also a defib ONLY works in some situations, the heart must be in fribulation, a specific rythum and so defib is NOT effective in all situations!! (however, it will tell you this) As you asked - a rough outline of assessments I have done:- 1st chemical plant (50 employees)- DEFIB provided - with o2 . Why - Cyanide gas on site so all first aiders trained in o2 and defib. Remote location - potential wait for ambulance + delay clearing security and access to zoned areas for emergency services. Concerns - Explosive atmospheres - our maths showed no explosion risk in zoned atmos (for our gases anyway, but still took gas meter which lived with the Defib) Checker plate floor - RA showed no risk to user only potential burns to casualty so authorised use (despite training advice indicating otherwise) (it was a long walk to non checker plate flooring and getting a non conductive mat to casualty would be the last thing you'd be thinking about) 2nd Chemical Plant (200 employees) - DEFIB provided - with o2 with site Emergency response team or (nurse). Why - Toxic gas on site (respiratory sensitiser) Remote location Large and ageing population of workers 3rd - Manufacturing site (500 people) - NO DEFIB Why - Large site, multiple defibs would be required to provide coverage, it would also be logistically difficult to get defib + first aider to all locations quicker than an ambulance! Next door to a hospital in centre of town (Ambulances arrive fast) I also recall a report that said if we replaced all fire extinguishers with defibs more lives would be saved. Not sure on the truth or origin of said report though :) I hope that helps - as said above it's all down to RA. Don't let service of equipment or training put you off, the are fool proof now and self check (just need a formal check once a week) also training can often be bolted onto FAW (I think). I have been an active first aider with St John for over 10 years - not need the defib yet - however!!!! O2 is a life saver!!!!!!!! Not sure why this isn't considered more?

Yes, donation to St John's or Order of Malta would be a better option.

Hi all - just been through this at two schools (one junior (400 kids + 120 staff), one senior (900 kids + 170 staff). A little girl (2 years old at the junior school (they have a baby unit and nursery)) has a condition where her heart could stop anytime. In consultation with the parents and to give the little girl as normal a school experience as possible the school bought a foolproof (as described by teh_boy) defrib (with training) at a cost of £1200. We then looked at the senior school and decided to provide 2. (The school site covers over 150 acres. The gymnasium is at one end of the site and the boarding houses at the other end) total cost with training £2400. After reading some of the posts above I started to think it may be a waste of money for the senior school. But our risk assessment and school nurse were convincing and the school governors cough up the loot. Rich

One reason that they don't have O2 available in public first aid scenario is that it is contraindicated in some conditions such as COAD and Emphysema, as such it is a medical drug, to be administered by competent medical personnel. As opposed to an AED which will self-determine cardiac rythyms and shock if indicated.