For information purposes, can one or more of you outline the pro's and con's (and perhaps your experiences?) of having defibrillators in the workplace. In essence as a company, we are a mixture of multi site Warehousing and Distribution and standard Office based activities on an approximately 50/50 basis and the use of defibrillators is currently being debated by our parent company. Many thanks in advance for your thoughts and comments. Mike

We deployed defibs throughout our organisation a couple of years ago, our experience has been - The only downside is cost - they're pretty expensive and you have to factor in adequate training. For that much money you could train a lot of first aiders, or implement other safety measures which might have more long term benefit. On the other hand, if your sites are remote and it would take a while to get an ambulance there, there is a very clear link between early defibrillation and survival chances (see the resuscitation council website). In calculating ambulance response times, think outside the box - it only needs a major motorway pile up (sadly not that rare an event) near your warehouse, and suddenly the nearest available ambulance could be miles away(and stuck in traffic). It's a difficult one to weigh up - the money could buy lots of other safety improvements, but IF someone has a heart attack, the defib is the only thing that's going to help them. Many ambulance services are putting effort into supporting organisations with installing defibs and training staff, so it could be worth contacting your locals as a first step? If you decide to go ahead, as well as training your first aiders, consider an awareness session for as many staff as you can get in - modern defibs are so easy to use that anyone who can look at pictures and follow spoken instructions can use them, and they won't deliver a shock unless one is needed, so it's impossible to make things worse.

Clive can you put a cost to these units as it seems to be the main issue for not having them in the first place. aslo i think it is important that buying the kit is not seen as the final step, ensuring that the need for the equipment is identified quickly by the first aider and that the kit then be brought to the causality as quick as possible and enough trained people to be confident on how to use it. i have come across a few occasions when life saving equipment has been purchased but then locked away so it doesn't get nicked or lost. There is need for a good fail safe procedure to make the equipment gives maximum benefit to someone who might need it. Phil

Iam sure that Clive is better equipped to answer this, I am just a Member and lack pips on my shoulder :) However to answer Bobs questions, Defibs work by DE-fibrillation. fibrillation = a undesirable heart rhythm that results in it failing to pump blood around the body. A defibrillation detects this irregular and precise pattern and delivers a shock to STOP the heart! (Note the movies are wrong :) ) Once stopped CPR becomes more effective and there is an increased chance of the heart returning to a normal rhythm (it is effectively rebooted) or CPR becoming effective until help arrives. As Clive points outs chance of success is at about 80% at 2 minutes with a drop of 10% / min, so 8 minutes = death. (That’s when the blue lights turn up!) Quick and prompt defibrillation and effective CPR is vital! So to get to the point, if a heart has stopped, or is another rhythm the defibrillator will not detect the correct rhythm and not administer a shock - it will advise to continue CPR if required. If used on a healthy live person (don't try this at home :) ) it will also not deliver a shock! Does that help?? So basically they are almost idiot proff and save lives!

teh-boy and others are prime examples of just how good this site can be The point of all these postings must be that de-fibs are OK but they need to be operated by competent people as many people/businesses have seen these bits of kit as the be-all and end all so reducing the competencies [stopped training first aiders etc] that are needed to operate them and 'advertised' to their staff etc that such kit can be used by anybody when that is not true

:) Thanks guys... I would have to agree, they are a tool and a very effective one at that, they will even tell you how to do CPR! but nothing beats training. There are also a number of other issues that must be considerd DSEAR - Falmmable atmospheres and risk of using o2 as well should be considerd Touching the casulty when a shock is delivered - the machine does warn. Debates go on about checker plate floors and water, it my understanding the biggest risk is burining the casulty by my St John trainer strongly disagreed. (My physics knowledge must be wrong :) ) Removal of jewlery and excess hair - but again biggest risk = burns (Burns or dead???) So to agree with the above use of a suitable trainer is essential (I don't mean to advertise but just look up :) ) However in my mind when using a defib the person is effectively dead! Not doing anything will mean they are still dead! Using a defib could save their life. Your choice.... P.S. keep asking questions I can answer please, unlike the NEBOSH examiners yeaterday! Unit C was hellish!

I am a long-time advocate of defib units in the appropriate circumstances. In my view the first points to consider are "what is the population demographics and do the environment/activitiies lead to an increased risk of cardiac problems. If sufficient numbers of people are "at risk" then the decision to provide defibs is made more clear. As to their operation, they are said to be idiot proof, only delivering a shock when fibrillation is detected. No hearbeat, no shock; normal heartbeat, no shock. As others have previously said, CPR may be needed until the heart is working properly or until proper medical care is available. Thus it is essential to have personnel trained in CPR alongside the idiot to use the defib unit. Whether there is any case for providing a defib unit in a typical warehouse/distribution premises I leave to those on the spot who will make the assessment and decision.

Many thanks to all for your valuable input, it is very much appreciated. Mike

Apologies for not getting back sooner! Having read all the posts, agree with them all, the units will only shock someone who's heart is in 'ventricular fibrillation' (VF), but in about 80% of cases when someone goes into cardiac arrest they will be in VF. We advocate that all staff should be trained to use the defib for those reasons previously listed, there are some small risks involved (being in contact with the patient at the time of shock, making sure the pads are properly applied, which will prevent any burns etc), but the most important reasons for training are the CPR element, CPR is a vital component of the casualty's survival and trying to take the surprise out of having to use one, as you can imagine the first time you need to use one could be quite a high stress situation, especially if you have never had chance to play with the defib first. As the units are so simple to use, the training session, including Primary survey, CPR, recovery position and use of the defib should only take about three hours. As for the cost, they vary depending on what units you buy, but start at just under £1k and go to just over £2k and most suppliers will offer discounts for multiple orders and can do a package that includes training. Some companies, especially those in more remote areas, have got some good PR out of the fact they have got defibs on site and make them available to the local community if needed during hours of business. I know these units these units will only be bought if there is an identified need for them and all the risks have been identified etc.. But you never know when you will need them, sudden cardiac arrest is just that, sudden and sometime there is no previous history, speaking as someone who has used one and seen how effective they can be, my advice is get them and hope they never have to be used, but if you do need to use them, then you are giving the casualty the best chance of survival, if nothing else it shows your staff that the management are looking after them. Clive

Well yes, but I think it depends how you measure success rate: Success rate (patients saved as a proportion of attempts made) probably = fairly low Success rate (patients saved by defib, compared to defib-suitable patients saved without a defib) probably = very big. They told us exactly this at our last refresher, and pointed out they were telling us so that if we used a defib and the patient didn't survive, we shouldn't think it was because we'd done anything wrong.

one more point on this... Once a patient has been successfully defibed, they won't get up and go home, they will be inherently unstable until paramedics (etc) can stabilise with drugs. Patients should be kept very still and not moved post successful defibrillation. I have never used a defib in anger but have unsuccessfully attempted to resus a 13 year old girl, very hard not to blame yourself even when the injuries are severe :(

Don't worry about it?!!!!! Hopefully that wasn't a response to the previous post, if so it was remarkably insensitive! I wonder what the 'motivation' for your post was?

the comment meant what it said. Several points, probably mentioned somewhere. If the victim has flat-lined then the defibrillator will not function. CPR needs to be started as soon as possible. Even if the victims heart restarts and he/she receives the best possible care during and after the event the survival rate is [basically] 50/50. and that's at 28 days. Just a comment or two.

Before portable defibs available, survival rate (1-year) 1:100 After, survival rate (1-year) 3:100 "The team found the one-year survival rate trebled to three in 100 patients" "And they concluded that if the response time for using defibrillators was shortened to within eight minutes, it would save the lives of 15 out of 100 people who collapse with cardiac arrest"

I agree there are no cons in having defibrillators available, they save lives! Hopefully one day they will be more common place in our society especially as current trends appear to show the UK population getting more obese and unfit. Always ensure that any training is undertaken by experienced competent providers as the regulation of reliable qualified trainers is lagging behind demand.