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Home > Topics > Cardiac Care
June 24, 2014
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EMS News in Focus
by Arthur Hsieh

Not having AEDs in big-box stores puts customers at undue risk

AEDs are just as essential as first aid kits, fire extinguishers, smoke alarms, emergency exits, sprinkler systems, and other safety equipment that costs far more and is used far less

By Arthur Hsieh

In what signals the end to a wrongful death lawsuit, the Supreme Court ruled that AEDs should not be required in California stores, saying "...it's an undue burden to require Target to obtain defibrillators and train staff to use them on the random chance that a customer suffers cardiac arrest."

Unless of course, that random chance involves you, or someone you know and love.

While large department stores such as Target, Walmart, Costco and hundreds of other businesses are private properties, the fact is that millions of Americans walk through the doors freely every day. And with that number of people is the undeniable chance that someone will have sudden cardiac arrest during a shopping excursion.

These stores all have first aid kits, fire extinguishers, smoke alarms, emergency exits, sprinkler systems, and other safety equipment that costs far more and is used far less.

Given the purchasing power of these businesses, you can't tell me that they couldn't purchase AEDs and have them installed for less than $1,000 apiece.

We know that time is not on the patients' side when they collapse in ventricular fibrillation. From the time of onset, to detection by nearby shoppers, to notification of staff, to activation of 911 and beginning CPR, these steps take time, even before the wheels of the closest emergency apparatus begin to roll. The AED has been shown to be essential to the reversal of VF and pulseless ventricular tachycardia.

Not making for-profit businesses responsible for providing AEDS, when they stock equipment and meet regulations for other life-safety situations, seems contradictory and out of synch with existing policies. 

About the author

EMS1 Editorial Advisor Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. Since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook author, has presented at conferences nationwide, and continues to provide patient care at an EMS service in Northern California. Contact Art at Art.Hsieh@ems1.com.
Comments
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Derrick Sims Derrick Sims Wednesday, June 25, 2014 12:22:03 AM I think we should remember that the only reason large retail stores have fire extinguishers, smoke alarms and sprinkler systems is that the law requires them to. The retailers primary aim is to make profits for its stakeholders, and that everything else reduces profit margin. Defibrillators benefit both staff and shoppers alike. Healthcare, unfortunately, is a poor secondary consideration in most peoples lives until the unthinkable happens. Make your own choice and shop where the stores have defibrillators, becase they choose to place health over profit margin.
Jon Levine Jon Levine Wednesday, June 25, 2014 2:20:39 PM Arthur there is a big difference between making a device available to the public and mandating additional training of staff and other regulatory weights. While I agree that "Big Box Stores" have large numbers of patrons and that there is a statistical chance of a cardiac event I don't see how a "for Profit" location mandates such treatment versus other locum with even higher populations and therefore "inherent" risk such as public transit ,entertainment sites, etc. I don't think a 1,000 cost is excessive but when you assign responsibility and training it can be considered onerous. If those interested in wider AED availability would restrain from pushing for mandates and push public education versus assignment of roles and responsibilities I personally believe that more organizations would be less afraid of litigious backlash and be willing to embrace the public good
Riley Hutchens Riley Hutchens Tuesday, July 01, 2014 2:49:35 PM Defibrillators should realistically not cost as much as they do. Look at the materials that it takes to create a defibrillator: plastic, majorly. I think that AEDs are still a fairly new concept, and Physio-Control and Zoll and whoever is making a nice buck off of them. As time moves on, I think we will see the price of them lower drastically.
Larry Zipper Larry Zipper Thursday, July 17, 2014 2:15:48 PM I don't see that it is a valid comparison to say that since establishments, of any size, have a fire extinguisher or smoke alarms, that is equivalent to carrying medical equipment such as a defibrillator. Those are mandated by fire laws which is entirely different from medical situations. I think it opens a huge can of worms to require AEDs. Just because an establishment has an AED, being private property, does it have to be made available to anyone who requests it? If it is publicly displayed I would bet with the low lifes out there it will be stolen in short order. If it is kept out of sight in an office then since the only people who know about it are employees what litigation will follow if it is not used because no one is trained? Under Good Samaritan laws nothing should occur but you know someone would try to get monetary gain from the situation. The law does not require anyone to provide medical assistance. An simple extrapolation of that would seem to be the law does not require any private individuals or company to carry medical equipment. An AED goes far beyond bandages in a first aid kit. I work for a private, not open to the public, as an ERT coordinator. We have an AED and have a trained team. But that does not REQUIRE us to advertise our AED or our training to anyone, nor does it require us to apply it if we chose not to outside, or even inside our company. Though we would. The keyword is require. I believe it makes sense in a mall to have an AED for the entire complex. It is likely security is probably trained in first aid so they would logically be the 'keepers'. But logic again should not imply required. It is a bad road to go down to require 'Good Samaritan' actions and goes against the actual law. This isn't an episode of Seinfeld where you get arrested because of a Reverse Good Samaritan law.

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