Defibrillator Debate Electrifies Industry
Since we last reported on automated external defibrillators (AEDs) in a Special Report that appeared in our March issue, several new developments have taken place. In the March 2002 issue of Medicine & Science in Sports & Exercise, the American College of Sports Medicine (ACSM) and the American Heart Association (AHA) released a Joint Position Statement addressing the purchase and use of AEDs in health and fitness facilities. This statement amplifies earlier recommendations made by the two organizations in 1998 and is in keeping with the YMCA of the USA’s guidelines released in a technical assistance paper on AEDs earlier this year.
The latest ACSM-AHA Joint Position Statement encourages all fitness facilities—especially those with “high memberships”—to make AEDs available to provide better emergency assistance for victims of sudden cardiac arrest. According to an ACSM press release dated March 5, 2002, the two organizations “strongly encourage AED training, presence of trained staff and placement of AEDs in facilities offering special programs to clinical populations.” The statement goes on to say it is “essential” that staff trained in cardiopulmonary resuscitation (CPR) be present during all hours of club operation and recommends having written emergency procedures and policies that designate CPR-trained staff as first responders.
“It’s a natural progression for ACSM to recommend AEDs for [fitness] facilities,” says Carl Foster, PhD, a member of the group who authored the new position statement. “A large number of individuals new to exercise begin their workouts in high-membership facilities, and possible heart problems may not have been assessed with the standard physical activity readiness questionnaire (PAR-Q). It’s important for them to have a measure of protection.”
Echoing the advice provided by Shirley Archer, JD, the author of the March Special Report commissioned by IDEA, the ACSM-AHA statement does acknowledge that emergency equipment alone cannot save lives. Rather, survival is dependent on following a chain of events: early recognition of cardiopulmonary arrest; early CPR; early defibrillation when indicated; and early advanced cardiac life support care. However, AEDs are vital in this chain because the survival rate for victims of sudden cardiac arrest decreases 7 to 10 percent with every minute that defibrillation is delayed, according to ACSM.
In another new development on this topic, legislation requiring health clubs to install AEDs has recently been introduced in three states. According to the International Health, Racquet and Sportsclub Association (IHRSA), New Jersey, Pennsylvania and Rhode Island have each put forth bills that would require one AED per fitness facility. Additionally, New Jersey is seeking to require that one person trained on the devices be on staff at all times. In recent years, AEDs have become standard emergency equipment for many other industries and are readily available on airplanes and in public venues such as shopping centers and gambling casinos.
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