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U.S. Department of Health and Human Services Exemplary Practice Citation Exemplary Practice Citation Application Automated External Defibrillator Program in Federal Workplace by Federal Occupational Health Item 2.3 Non-Occupational

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U.S. Department of Health and Human Services

Exemplary Practice Citation Exemplary Practice Citation Application

Automated External Defibrillator Program in Federal Workplace by Federal Occupational Health Item 2.3 Non-Occupational Illness Management

Federal Occupational Health

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Division of Clinical Services

FEDERAL OCCUPATIONAL HEALTH:

Part of the U.S. Department of Health and Human Services and a component of the

U. S. Public Health Service

Became fully reimbursable in 1984,

perating with no Congressional

i ti appropriations

Federal Occupational Health

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Division of Clinical Services

FOH’s Mission

To improve the To improve the health, safety, and productivity of the productivity of the federal workforce.

Federal Occupational Health

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Division of Clinical Services

FOH Automated External FOH Automated External Defibrillator (AED) Programs in Workplace Programs in Workplace

Commander John J. Perkner, DO, MSPH (USPHS) jperkner@psc.gov jp @p g

Federal Occupational Health

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Division of Clinical Services

AED PROGRAM HISTORY AED PROGRAM- HISTORY

Sudden Cardiac Arrest – responsible for 300 000 d th ( k l d th 300,000 deaths per year (workplace deaths prevalence unclear) American Heart Association - supports AEDs f S C as integral part of response to Sudden Cardiac Arrest in late 90’s ACOEM Position Statement on workplace p AEDs -2001

Federal Occupational Health

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Division of Clinical Services

FOH AED PROGRAM

 Need for Workplace AED Program assessed by p g y FOH 1999; pilot program started 1999-2000  FOH program has grown to over 4000 AEDs in k l i 100 i workplaces in over 100 sites

Federal Occupational Health

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Division of Clinical Services

Federal Support for AED Programs

Clinton Radio Address - May 2000 Cardiac Arrest Survival Act - November 2000 Cardiac Arrest Survival Act November 2000 DHHS Guidelines for Placement of AEDs in Federal Buildings - May 2001 g y OSHA Technical Bulletin FAA - Placement of AEDs in planes FAA - Placement of AEDs in planes Rural AED Grants

Federal Occupational Health

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Division of Clinical Services Federal Occupational Health

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Division of Clinical Services

Annual Deaths from The Odds Annual Deaths from Cardiovascular Disease – U.S.

All Other Sudden

350 000 590 000

All Other Cardiovascular Cardiac Arrest

350,000 590,000

Total Deaths 940 000

Federal Occupational Health

940,000

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Division of Clinical Services

SCA: Heart in Chaos Ventricular Fibrillation

Abnormal; irregular, very fast heart rhythm Heart can’t pump blood effectively Victim: Unconscious Unconscious  Not breathing spontaneously  No pulse  No pulse Only definitive treatment: Defibrillation

Federal Occupational Health

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Division of Clinical Services

“Chain of Survival” R id C di t d R Rapid, Coordinated Response Improves Outcome

Early Access Early CPR Early Defibrillation Early Advanced C

Federal Occupational Health

Care

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Division of Clinical Services

AED Components - Team Members AED Medical Director AED Program Specialists AED Administrative Team AED Administrative Team AED Site Coordinators AED Team Responders AED Team Responders

Federal Occupational Health

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Division of Clinical Services

AED Program Components Medical oversight Medical oversight CPR / AED training organization EAP contact / Critical Incident Stress Management g AED procurement Integrate with local EMS organization

Federal Occupational Health

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Division of Clinical Services

FOH AED Program Components

Medical Oversight

p

CPR / AED training organization Employee Assistance Program (EAP) contact / Critical Incident Stress Management services Integrate with local EMS organization

Federal Occupational Health

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Division of Clinical Services

FOH AED PROGRAM SITES

Federal Occupational Health

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Division of Clinical Services

FOH STATISTICS

Witnessed Sudden Witnessed Sudden Cardiac Arrest (less than 5% survival if no AED) 20 males 13 females Males 34 to 73 years of age a es 3

3 yea s o age

Females 37 to 72 years of age Average age of males = 54 Average age of males 54 Average age of females = 53 Save rate = 39%

Federal Occupational Health

Save rate 39%

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Division of Clinical Services

SCALABLE PROGRAM:

Single AED Program Multi-AED Complex sites

Federal Occupational Health

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Division of Clinical Services

Lessons Learned

Murphy’s law is true and MAGNIFIED in large, high profile programs Examples of errors: dead batteries, absent data cards, activation of teams, new l personnel Need management systems; motivated team team

Federal Occupational Health

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Division of Clinical Services

QUESTIONS

COST EFFECTIVE LIABILITY CONCERNS LOGISTICS LOGISTICS LONGTERM OUTCOMES

Federal Occupational Health