Hi all, I hear and read a lot of arguments for the introduction of defibs in workplaces. Lots of stories and pulling at heart strings. There's one on the IOSH main page right now. But none of them have actually specified what improval in survival rates they bring. I would have to base any decision to purchase them on whether they significantly improve the chances of the victim's survival, not just on numbers/demographics. I have had anecdotal feedback from two colleagues who have used them. Neither victime survived. Of course, this means NOTHING. Has anyone got any thoughts on this? Or even better, some data? Much appreciated :) Will

There really are a lot of studies, and it depends which one you read. Below is an example of one relevant to the UK. UK Defibrillation Programme A 2005 study of public defibrillators in England found that, of 177 witnessed cases of sudden cardiac arrest treated with AEDs, 44 people survived to hospital discharge – a survival rate of 25 percent. Whitfield R, et al. The Department of Health National Defibrillator Programme: analysis of downloads from 250 deployments of public access defibrillators. Resuscitation 2005;64:269-277. Phil

I would take the 25% chance as opposed to the other option; as I would hazard a guess that most other people on this forum would given the choice. If they save one life in your workplace does that not make the investment worthwhile? Stuart (with a site that does not have an AED yet but will do shortly)

My understanding is that a person who suffers Sudden Cardiac Arrest (SCA) has a limited amount of time during which the application of an AED can be of effective use and that the survivability aspects of SCA are reduced by 10% per minute after the event. I campaigned to have AED's positioned in our work place 5 years ago After an employee died from SAC (out of work, but we live in company compounds) and it was refused because of "Cultural/Legal" issues by the Prime Contractors legal department, Things are a bit different in the Middle East

Never an easy thing when your sending a body home

So achrn, I'm 2 and a half times more likely to survive a CA in a building with AED than without. Think I'll start asking around before I go in to any buildings.

Does it really matter what the survival rate is or is it more important than some people will survive if an AED is available. As someone who has survived the application of an AED on three occasions over a short period of time added to the fact that I am posting this more than a year after the events I am pleased that an AED was available regardless of how many might survive.

Surely the clue is in the name and an AED will only work if the heart is in fibrillation? LB

No brainer - if it saves one life its worth it. I would love to get one in my car the price being the limiting factor after watching this programme, (below) I think the UK is inadequately equipped to cope with the potential surge in CA's http://www.itv.com/news/...ight-how-to-save-a-life/

All this emotional 'if it saves one life...' is rather missing the point. I'm sure if we knew it was going to save a life then it would be worthwhile. The point is that in many situations it almost certainly will not be used, and even if it is used, it probably won't save a life. Here's a no-brainer for you: should you spend £2000 on equipment for the workplace that will almost certainly do no good whatsoever to anyone?

I think the designers of the Titanic considered a similar question!

Just a little correction John. The only difference between a fully automatic and semi automatic defib Is that with a semi auto the operator has to press the flashing red button to deliver the shock. With a fully auto AED, the shock is delivered automatically by the defib after a countdown without any operator pressing a shock button. On either model they will only deliver a shock if they detect VF or VT. If they detect any other rhythm they will not charge up, ie NSR, PEA, or Asystole. Only the fully manual defibs that healthcare professionals use can be overridden to shock any rhythm. Some models of AED will do this, but have an ECG display so that the practitioner can decide if a shock is required. They take considerable training and experience and are only used by ALS trained professionals. Phil

See the IOSH campaign worked.

What He said! ^^^^^^^^^^^^^^^^ Phil

"Person died at his desk with colleagues unable to do anything to assist. This was over 15 years ago before portable AED's were even available. Do we have one - absolutely - easiest decision I ever made" Unless the colleagues start immediate CPR until the AED arrives and is extracted from whatever it is in, it will be for nought.

But if you had 100 offices of five people would you spend £200,000 making sure they all had them? Yes if there are enough people at a site to raise the likelihood sufficiently, then one should probably be provided - I don't think anyone is arguing that no workplace should ever have one. The argument, such as it is, is whether every workplace should have one, and I am still of the opinion that the figures do not justify that approach for sites with small numbers of working-age people doing normal office-type tasks.

Comparing the presence of extinguishers with AEDs is not realistic. Extinguishers were mandated under past fire regimes as part of the Certification process and are still ubiquitous, despite our current ability and authority to assess risk and decide on our own controls. We are probably too afraid to decide that they are not needed, not likely to be used, over-provided, and take up valuable space. Provision of AEDs however does not have that historical imperative and the decisions on whether to have them available are much more likely to be risk/benefit based.

This can easily become an emotive subject, yet one for which few would have had, yet, any first hand experience. Achrn, when you go down, gripping your chest in crushing pain, and then arrest, shall we leave the defib in its box? And for others, do you really want to fund quite so many of these devices, to see them gather dust and possibly remain in their box because of a lack of training? Several here have mentioned the essentially idiot-proof design of this equipment. I guess that the real issue that big step, to get the device off the wall, rip open someone's shirt and take steps that may well shock them. And probably in front of a gathering crowd each offering their own 'help and advice' and generally flapping about to raise the level of tension felt by all. Assuming a defibrillator shock is really necessary, and whether successful or not, I imagine that for the average man in the street that will be a very bold and brave step to take. Without very specific training and occasional reinforcement of that training, I wonder how many would have the initiative, and perhaps the guts, to go ahead and give it a go? How many know what they are, and are for? Can I use it? What do I do? How will I know what to do? Am I allowed? And what if I get it wrong? Since so many will stand around uncertain about external chest compression, I wager that there will be many more leaving the defib safely in its box. Perhaps before too much costly investment in public defibs, we need to develop a scheme for awareness and training for al,l including workplace training, schools training etc, and frequent TV adverts to reach as many as possible. I suspect at present there will be more chance of a defib being available in a public space that there will be someone brave enough to give it a go.

That's exactly the sort of emotional nonsense that proves there's no good fact-based argument for them, frankly.

If you want emotive; I can do emotive. You can have an AED for every employee, if you want. Without someone, or someone[s], to start and continue CPR, they are as much use as a burp in a gale. Until the unit arrives and is attached, and then allowed to proceed with its analysis and work, the person doing the chest compressions is the thing needed above all. By all accounts, that person will still be doing the work until an ambulance/first responder arrives. They [AED} save some lives, not all. How many lives they save depends upon the definition of a life. Following the death of my father, which occurred shortly after I instructed the team to cease their efforts at resuscitation, following that same teams advice to me, my family was instructed in my definition of a life in case of my needing resuscitation. As I said previously, end of life planning. In case of a chronic illness which will result in your death, you will be offered it. **not arguing against, just arguing against the belief they save as many lives as you would be led to believe**