Penn State Intercom......March 28, 2002
Device becoming
prevalent in public locations
By Bill Campbell
Special to Intercom
It's
small and compact. It's easy to use. It's becoming more readily available.
And it saves lives. It's an automated external defibrillator (AED), and
it is making its presence felt throughout Penn State. 
"A number of units within the University have purchased AEDs for use in cardiac emergencies," Margaret Spear, director of University Health Services, said. "The devices do save lives if they are used quickly and properly."
AEDs are used to treat cardiac arrest, which occurs when the heart's normal electrical signals become erratic or "fibrillate," thus diminishing the heart's ability to pump blood effectively. To correct the problem, restoring proper heart rhythm in two to three minutes is crucial.
"Time is critical in a cardiac event," J. David Jones, director of Emergency Medical Services in University Health Services, said. "Survival is all about time. From the time you realize a patient is not breathing, has no pulse and is unconscious until defibrillation is done is critical. The quicker the patient gets defibrillation that is needed, the better are his or her chances for survival.
"Early intervention is the key to success. I have seen patients saved by use of a defibrillator. They are effective."
Here's how an AED works:
The operator opens the carrying case, plugs the cord of two pads into the machine and places the pads on the patient's chest. When the machine senses contact, it looks for the patient's electrocardiogram. If an abnormality is detected, the AED prompts the user to push a shock button, delivering a charge to the heart.
"In essence, the AED looks at the electrical activity in the heart," said Jones, who teaches advanced cardiac life support for the American Heart Association. "The machine automatically interprets the electrocardiogram. Based on that evaluation, the AED decides whether a shock of the heart rhythm is indicated. It is a pretty smart machine and is very effective.
"Before the emergence of AEDs, only emergency personnel and paramedics could defibrillate patients before they got to the hospital. Since these machines are safe and easy to operate, the lay public can use them. We recommend and encourage training in CPR and basic AED use."
AEDs are gaining wide acceptance across the country. They are standard equipment on many airlines and can be found in shopping malls, office buildings and fitness centers. On the University Park campus, Penn State Police has two units, Intercollegiate Athletics has five for use by athletic trainers, there is one at the Ice Pavilion and The Nittany Lion Inn, and two at The Penn Stater Conference Center Hotel. Emergency Medical Services has 13 units for use by its emergency medical technicians and paramedics. AEDs also can be found on a number of other campuses, including Altoona, Erie, Harrisburg, Mont Alto, Schuylkill, Wilkes-Barre and York.
Units currently placed at the University are approximately the size of a desk dictionary and weigh about four pounds. They range in cost from $1,500 to $3,000.
Penn State Police keeps one AED at department headquarters and the other in a patrol car. All Police Service Officers are certified as Red Cross emergency responders and, as such, are trained in cardio pulmonary resuscitation (CPR) and the use of AEDs.
"Fortunately, we have not had to use our units yet," said Police Services Officer John Torres, who is responsible for training in the department. "There was an instance where one might have been, but the ambulance arrived and the EMTs handled the patient. They have proved to be vital in many cases reported in the media and really can make a difference."
Torres noted that CPR is an important adjunct to AED units. And, if an AED is not available, he said, early CPR by someone trained in the procedure could be crucial until the arrival of emergency services. "Early CPR helps circulate oxygenated blood to all of the body's vital organs until defibrillation and advanced life support can be provided."
In light of increasing interest in AEDs, the University has established a policy for University units which choose to use an AED in Penn State facilities or vehicles. The policy, SY22, was developed jointly by the Office of Environmental Health and Safety and University Health Services.
Maurine Claver, director of Environmental Health and Safety, said it was designed to ensure proper training of users, appropriate medical oversight, and documentation and maintenance.
"We want to be certain that personnel are properly trained and that the devices are properly installed and posted so that members of the University community, visitors and others can use them when they need to," she added. "The first minutes in any cardiac situation are critical. AED operators can get to a patient quickly, often before the police or emergency medical technicians arrive."
Under the policy, which went into effect last July, the Office of Emergency Medical Services is responsible for assisting administrative units in making decisions on AED purchases, placement and use. Both EMS and Penn State Police offer training in CPR and AED use.
"While the AEDs are easy to operate," Jones said, "it is important in any cardiac situation to have someone trained in CPR available. There should be a commitment from a staff standpoint. In public areas, we need to be certain that, if someone from the general public uses the device, there is a trained staff member nearby. The machines at The Nittany Lion Inn and The Penn Stater, for example, are placed in cabinets. When the cabinet is opened, an alarm sounds and alerts a trained staff member."
None of the AEDs has been put to use since the policy was established, but Jones expects more to be purchased and placed in University facilities.
"In the future, the machines will be smaller, more reliable and, probably, less expensive," he said. "While cost will continue to be a major factor, there is no question that they work and save lives."
Bill Campbell can be reached at wjc1@psu.edu.