Betty Norman, BSN, MBA, CPHRM

According to an OSHA report, “Saving Sudden Cardiac Arrest Victims in the Workplace,” about 10,000 sudden cardiac arrests occur in the workplace annually. Waiting for the arrival of emergency medical system personnel can result in a lower survival rate.

Rapidly implementing what is known as the “chain of survival” model can help increase the chances of survival from sudden cardiac arrest. The steps in the chain include activation of emergency medical services by calling 9-1-1, starting cardiopulmonary resuscitation, using an automated external defibrillator and accessing appropriate care. Studies have shown a survival rate of as much as 60 percent with immediate defibrillation.

What to know about Automated External Defibrillators

An automated external defibrillator is a medical device designed to analyze the heart rhythm and deliver an electric shock to victims of ventricular fibrillation to restore the heart rhythm to normal. Ventricular fibrillation is the uncoordinated heart rhythm most often responsible for sudden cardiac arrest.

OSHA suggests that AEDs be placed in locations where:

  • Many people work closely together, such as office buildings

  • People gather, such as fitness centers, conference centers, and lunch rooms

  • Lightning strikes could take place, such as outdoor exercise areas or worksites

AED training courses usually last about three to four hours to allow adequate time for hands-on practice and to help increase user competence and confidence. AED training and related resources are offered through the American Heart Association, the American Red Cross, the National Safety Council and others. AED manufacturers and vendors also offer training resources.
AED training curricula vary, but generally emphasize:

  • A working knowledge of CPR

  • Safety for both victims and rescuers

  • Proper placement of electrodes

  • Delivering the first shock as quickly as possible, ideally within 60 seconds from time of arrival at the victim’s side

  • Plenty of hands-on practice, with one instructor and one AED or AED trainer for every four to six students

OSHA identifies sudden cardiac arrest as a leading cause of death in the workplace, as it is the cause of 15 percent of all workplace fatalities. By its very nature, SCA is completely unpredictable and can strike anyone at any time. Increased survival rates are the primary reason for installation of AEDs in workplaces and public places.

The American Heart Association has a publication “Implementing an AED Program” that can be helpful when considering adding these devices to your workplace.

This information on AEDs in the workplace focuses on management of SCA of staff members, volunteers or visitors. Remember the Centers for Medicare & Medicaid Services has specific regulations for management of SCA of residents.

For resident care policies, CMS requires that facility policy directs staff to initiate CPR “as appropriate.” Policy should indicate CPR is initiated for residents who have requested CPR in their advance directives, who have not formulated an advance directive, or who do not have a valid DNR order. In addition:

  • Nursing homes must provide basic life support, including initiation of CPR to such residents as defined above, until EMS arrives;

  • CPR certified staff must be available at all times to provide CPR when needed;

  • Facility-wide “no CPR” policies do not comply with a resident’s right to formulate an advance directive.

 Betty Norman, BSN, MBA, CPHRM, is the Risk Control Director at Glatfelter Healthcare Practice.