Webinar Series Starting In March

SUDDEN CARDIAC ARREST is the #1 killer in the US annually and an Automated External Defibrillator (AED) is the difference between life and death for these victims.  Every minute that goes by without using an AED results in a 10% less chance of survival!

You simply can’t wait for EMS or First Responder community teams to arrive!  National average EMS response is 8-10 minutes in urban areas.

OSHA highly recommends these devices in the workplace and there are many industry-specific, federal, state and local mandates for AEDs due to the death toll of Sudden Cardiac Arrest (SCA).  But, even if you are not mandated — you should consider purchasing one of these devices.  They take survival rates from SCA from 3-7% to over 65%! PLUS, if you can use a cell phone – YOU CAN USE AN AED!

So, are there any drawbacks to owning an AED?  Yes, if you do not maintain them or implement them according to your applicable AED acquirer laws in your city/county/state.  Think Safe knows these laws and is known for providing the legal protection and solutions our clients and dealers need.

Think Safe, in an effort to help our customers and dealers understand the legalities of defibrillator ownership, is sponsoring a webinar series on AED Programs: Avoiding Liability.

The webinar runs 3 times per day in March with speakers Paula Wickham or Greg Stebral, industry experts, providing key tips and resource materials for existing AED programs or those interested in selling AEDs or purchasing AEDs for their facility or workplace.

There is no fee.  There is no software to download. You just need an internet connection (no phone). All you have to do is go to:

http://www.thinksafewebinars.com/State-and-Local-AED-Acquirer-Laws.html

Once you fill out the form (we DO NOT SELL your information) you will be provided a screen that shows open webinars and you can click on and select any times / dates with open seats.

There are many dates/times to pick from this month- we know how hard it is to push a webinar into your busy schedule but…. you’ll find value from this webinar and we look forward to seeing you online.

Business AED Package

If you have any questions or want to schedule a specific time for this webinar please contact Paula Wickham at pwickham@think-safe.com or call our offices and ask for Paula or Greg, 319-377-5125.   Making Minutes Matter!

Automated External Defibrillators (AED)s: Pediatric & Infant Use

People who are familiar with AEDs and defibrillators know that both adult and pediatric pads had to be considered pre-2010 AHA science updates[separate pads are required to allow the AED to administer different shock dosage to the heart, lower for pediatric events of course].  Having both pads available creates extra costs as both have an expiry date and need replacement after 2 years usually. We often get asked, ” Do we really need pediatric pads?”

With the 2010 Emergency Cardiovascular Care (ECC) and American Heart Association (AHA) Guidelines Updates there comes new published science on the use of AEDs on infants and children. 

Former science [pre-2010 and post-2005] suggested not to use AEDs on infants and to use pediatric pads on children under 8 years of age or under 55 pounds.  Evidence of this from prior blogs or internet posts includes: http://www.wikihow.com/Use-a-Defibrillator, which contains old outdated information summarized below.

OLD INFORMATION: Do not put adult pads on a pediatric patient and vice versa! Pediatric pads are used on children who are ages 12 and under. [this is pre-2005 information]

NEW GUIDELINES INFORMATION: http://www.heart.org/idc/groups/heart-public/@wcm/@ecc/documents/downloadable/ucm_317350.pdf   clearly updates the guidelines to show that it is acceptable to use AEDs and even adult pads on pediatric patients, including infants.  The KEY is anterior and posterior placement.  For more details, see the information below pulled directly from the recent guidelines update.

AED Use in Children Now Includes Infants

2010 (New): For attempted defibrillation of children 1 to 8

years of age with an AED, the rescuer should use a pediatric

dose-attenuator system if one is available. If the rescuer

provides CPR to a child in cardiac arrest and does not have an

AED with a pediatric dose-attenuator system, the rescuer should

use a standard AED. For infants (<1 year of age), a manual

defibrillator is preferred. If a manual defibrillator is not available,

an AED with pediatric dose attenuation is desirable. If neither is

available, an AED without a dose attenuator may be used.

2005 (Old): For children 1 to 8 years of age, the rescuer

should use a pediatric dose-attenuator system if one is

available. If the rescuer provides CPR to a child in cardiac

arrest and does not have an AED with a pediatric attenuator

system, the rescuer should use a standard AED. There are

insufficient data to make a recommendation for or against the

use of AEDs for infants <1 year of age.

Why: The lowest energy dose for effective defibrillation in

infants and children is not known. The upper limit for safe

defibrillation is also not known, but doses >4 J/kg (as high

as 9 J/kg) have effectively defibrillated children and animal

models of pediatric arrest with no significant adverse effects.

Automated external defibrillators with relatively high-energy

doses have been used successfully in infants in cardiac arrest

with no clear adverse effects.

If you are a school or camp or childcare provider, what does this mean?  Until new science [in 2013 or after] is released you should consider looking at your current AED program.  Do you have pediatric pads currently?  Those will expire in 2 years or less – should you replace them?  In these economic times, there are many non-profits and schools who will not have adequate budgetary capacity and it may be a topic of consideration.  Due to the new science, strong consideration can be given to this — IF you can accommodate for proper AED use communication to responders or the public who would use the device with ADULT PADS on a child under 8 years or 55 pounds.

How do you accommodate?  A simple solution: a  sticker/decal set that can be attached to your AED case and responder supplies to remind responders on WHAT TO DO for pediatric events.  The set includes directions on where to find illustrations with 2010 instructions and how to apply the ADULT pads (complete with pictures) anterior [front] and posterior [back] for pediatric events and why.  Call 888-473-1777 for more technical information on this solution.

The reason for anterior and posterior placement, simply put, is to allow the pads to shock the heart WITHOUT the pads touching – the surface area of a pediatric victim’s chest is not large enough usually to allow normal ADULT pad placement.

Simple directions and illustrations and quick references on the AED, AED instruction manual or guides, AED policy and AED protocols and CPR/AED poster you keep at your facility all will help with communication of this simple change for pediatric vs. adult use.

The ONLY exception are customers who have Philips FRx (the ONLY model to allow switching of shock level with an Infant/Child Key inserted into the AED while using the SAME SET OF PADS).  Philips FRx models offer a wonderful solution for facilities that want to be able to accommodate pediatric or adult situations without a large CONSUMABLE cost from 2 yr disposable pads for each event.  The FRx is a more expensive model with a higher purchase price – however, IF you know you are going to be primarily using the device on pediatric patients, this model would be a leading device to consider.

We are here to help.  First Voice can provide a sticker/decal/ template set to easily show on your AED and responder supplies WHAT TO DO for pediatric events.  The set includes directions on where to find illustrations with 2010 instructions and how to apply the ADULT pads (complete with pictures) anterior [front] and posterior [back] for pediatric events and why.  Call 888-473-1777 or contact your dealer for First Voice products for more information – Part number PED-DECAL01.  Pricing is only $10.00 including shipping.  Please provide your AED brand so we can make sure to ship the right decal set.

School Mandates for AEDs slowed by economy

I recently read this article:  http://www.northjersey.com/news/health/111835889_Defibrillator_bill_stalled_over_funds.html

There are several very good points made in this article.

Of note is that these lifesaving devices can be purchased for $1000 or under and AED packages (cabinet, etc) are $1000 to $1500.  And, companies and facilities should want to purchase and maintain the devices under their own lead, not based upon being MANDATED to buy.

I know of several MANDATED customers (schools, fitness clubs, gyms, etc) where they – without hand holding and an easy database solution that is inexpensive – DID NOT hold up their end of the bargain historically due to the absence of an AED program Champion.    Pads expire, Batteries expire, devices go unchecked and management is crossing their fingers [and toes] that the device works when it is needed at their location (if it is even remembered to be used).

The key is that these devices save lives, they should not be mandated, they should be affordable and easy to maintain.  THEY SAVE LIVES and let’s not forget that Sudden Cardiac Arrest is the biggest killer annually in the U.S.

How can you fund an AED?  There are grants – email us for a copy of “THE FOUNDATION OF FUNDING AEDS” – FREE, COMPLIMENTARY and no strings attached!

EMAIL:   grants@think-safe.com (subject – COPY OF FOUNDATION OF FUNDING AEDS)

How can you make sure the AED is constantly in compliance and checked regularly for under $25 – 50/yr at your location?  info@firstvoice.us or check out this link:

http://www.firstvoice.us/Products/FirstVoiceAEDProgramManager/tabid/727/Default.aspx

It seems that the answer to placing the devices are not mandates but rather, proper funding and program solutions for the long term!   We can always be reached at  as well at the contact info below, and we are happy to give you our technical insights into accessible funding sources and cost reductions, where applicable!

Making Minutes Matter

Think Safe Blog /grants@think-safe.com (888.473.1777)

One Mom’s Story….

In May Think Safe received the following letter requesting assistance from a mom….. This is being reprinted with the permission of this mother in an effort to help others understand that Sudden Cardiac Arrest does affect children in the U.S. as well as adults.

Hello my name is Corinne Ruiz.

Olivia Ruiz' Last School Picture

April 22, 2004, my 14 year old daughter Olivia died from sudden cardiac arrest.  Olivia was on life support for ten days. After ten days, we were told that Olivia had no brain activity. We were left with a very painful decision to remove our daughter from the breathing machine.

April 22nd, it was six years since the death of my daughter. Not a day goes by that I don’t ask myself, “If only I had known about Long QT Syndrome/Sudden Cardiac Arrest and AEDs”. Maybe, just maybe Olivia would be alive today.

I and many other families who have lost children to Sudden Cardiac Arrest are now their voice. We are dedicated to protecting our youth from Sudden Cardiac Arrest (SCA) and preventable Sudden Cardiac Death (SCD). Unfortunately, where I live, xxx, very little is known about SCA in our youth.  I was quite surprised to find out that Olivia’s High School, xxx, didn’t have an AED on campus.

It’s time to make a difference, speak out, with the hope of saving others.  I plan on promoting SCA awareness in my community.  I have written letters to our community leaders to see if they have implemented community Public Access Defibrillation programs. I have contacted my local state representative, senators regarding the Josh Miller Hearts Act, which would provide a pool of grant money for school districts to use to purchase AED’s. If this passes, it would make mandating AED’s in [state xx] easier because it would offset a large portion of the start-up costs. I have written letters to our senators on behalf of the American Hearth Association supporting SB 1281.

I am a mom who is now left with:

• If only I had known that I had options..
• If only I had been told that there are screening tests or preventative treatments..
• If only I had known that my daughter looked normal but her heart wasn’t..
• If only I had known that an AED could give my daughter another chance..
• …then maybe I wouldn’t have lost my Olivia..

I hope after reading my story, you will find it in your heart to donate an AED to XX High School, in memory of my daughter, Olivia. I am not a politician nor am I an expert in the medical field, I am Olivia’s mom.  A mom who will not let her daughter’s death be in vain.

Thanking you in advance for your support.

Since that date, Corrine has been crucial in placing an AED at this school and is crucial in helping to place others in the surrounding area. Think Safe is proud to be of assistance in making this happen as well. We can provide funding solutions!

Each year 10,000 to 15,000 or more children die from Sudden Cardiac Arrest, just like Olivia – due to a fatal accident or undiagnosed medical condition.

For educational materials on SCA, grant or fund raising assistance or special school packages please contact the technical experts at Think Safe, 888-473-1777 or info@think-safe.com.  Let’s make schools an even safer place for our children!

Why do we need AEDs in camps or at schools?

June 2010

What is the scoop on AEDs and Sudden Cardiac Arrest?

We are talking about the nation’s leading killer; killing more people than strokes, AIDS and breast cancer in the US annually.  Each year, between 300,000 and 400,000 Americans experience sudden cardiac arrest (SCA) outside of a hospital.

About 10,000 to 20,000 are children!  SCA affects people of all ages!

On average in the U.S., just 6.4% of SCA victims survive. Cardiopulmonary resuscitation (CPR) and early defibrillation with an automated external defibrillator (AED) take chances of survival to over 65%. In fact, early defibrillation (within 2-4 minutes ideally) with CPR is the only way to restore the SCA victim’s heart rhythm to normal. For every minute that passes without CPR and defibrillation, the chances of survival decrease by around 10%. However, there are not enough AEDs to provide this life-saving treatment, resulting in lost opportunities to save more lives. Tragically, per a NIH study in 2007, 64% of Americans have never even seen an AED. AED PROGRAMS CAN AND DO IMPROVE SURVIVAL RATES. Communities with comprehensive AED programs that include training of anticipated rescuers in both CPR and AED use have achieved survival rates of 65 percent or higher.

How does this affect camps?  [American Camping Association**]

Illinois in 2009 passed an AED law for “recreational areas” that includes sports fields or recreational areas, affecting schools and camps.  Also, organizations that are involved in camping – such as the YMCAs, Boy Scouts or Girl Scouts have been placing AEDs in an increasing number of facilities and camps. This is setting an expectation to provide care amongst the population and camp attendees.  With AEDs becoming more readily available, the potential exists for increased litigation from not having an AED on premises if there is a SCA event at the camp facilities. With AED prices dropping, more products to choose from, and the possible consequences of living in our litigious society, the time for a camp to purchase an AED is now. This is especially true of those camps in remote areas where medical response is delayed.

Why should I be a champion for AEDs?   Can’t we just call 911?

The national average for EMS response in the US is 8-10 minutes.  It is recommended (for best chances of survival) AEDs be used early on and ideally within 2-4 minutes.  There is a very good chance emergency medical services (EMS) cannot respond fast enough to save someone in cardiac arrest, particularly in congested urban areas, high-rise buildings, in remote rural areas, or large facilities.

What constitutes gross negligence isn’t spelled out in the law. Per product liability attorneys specializing in AED case law, organizations that have heavy traffic are more at risk if they fail to comply with “standards to provide care” and don’t have an AED at all.  Any manager or camp director at any large or high traffic facility should consider ramifications of not having at least one on premises in the event of Sudden Cardiac Arrest (SCA).  It is most likely their own job they are putting on the line and they should argue hard for them.  As a value-add for those directors whom can’t get top down management on board and funding is an obstacle; they should get hard copy evidence on file from their management if they can not get approval for purchase.  The old “CYA” policy!

** [Special note:  in January 2010 American Camping Association put the following revised accreditation standard into place for all camps except non-medical religious camps (camps where participants by religion do not allow modern medical intervention or treatment such as the Christian Science Church). Standard HW-17 now states: Does the camp have access to an AED (automated external defibrillator) available to the majority

Think Safe Camp Responder Bag (FV845) with Rugged AED

of the camp population, within the timeframe recommended by authoritative sources, and managed by trained personnel? The AED may be located on the camp property or available through another provider. ]

Think Safe can help your organization with AED funding and placement assistance:  AED grants.  Contact our AED GRANT DEPARMENT at grants@think-safe.com for more information and best pricing or match funding for your AED purchase needs.

Contact our industry experts at 888-473-1777 for our special CAMP AED PACKAGE or funding/grant assistance!

Customer LifeSaving Event Post-Event Review

HeartSine ECG (click on this link and link on next page to see an actual scanned ECG record of a lifesaving event) One of our customers recently used their HeartSine samaritan HS01 AED to save the life of a fitness club member!

What does all of the attached ECG picture and lines mean?

It took about 1 second to put on the AED pads after turning on the device.  It took the HeartSine about 8 seconds to analyze and recommend shock.  It took 5 seconds for the employees to stand clear and press the shock button.  Shock 1 was administered about 16 seconds into the rescue/response.

CPR then commenced.  You can see the effectiveness of the CPR and then the patient’s heartbeat restored.  At just past 2 minutes from initial use of the AED, EMS arrived and removed the AED pads, placing on their own pads.

The EMS confirmed that the AED being used so quickly was part of the reason the patient survived. The in-house response time was just under 2-3 minutes from time of collapse to time AED arrived on scene to use. WITH EVERY MINUTE THAT ELAPSES, CHANCES OF SURVIVAL DECREASE BY 10%!

This AED was used in a fitness club, in a metro area, response time for EMS was just under 6 minutes from time of 9-1-1 initial call.

This data was pulled from the AED using event review software that is included FREE with the equipment sold by Think Safe.  A medical director for the fitness club was sent the information for their interpretation and for use by the patient’s medical doctors.

Truly, AEDs are powerful lifesaving devices! The only way to reduce the 300,000 plus death toll on Sudden Cardiac Arrest (the nation’s largest killer) is to increase public knowledge on AEDs and improve AED placements for quick and effective defibrillation response for victims of Sudden Cardiac Arrest (SCA).  With average national EMS response times being 8-10 minutes, workplaces and places of high risk for SCA need to purchase AEDs in order to protect their employees or members.

To find out more about how your organization can easily install and implement an AED or AED program; please call us at 888-473-1777.  Our company can arrange for someone to visit you or your facility or we can speak with you over the phone.  All of our AED packages come with the following at no extra charge:  Prescription (Rx), AED Administrator Toolkit (inspection tags, checklists, drills, placement surveys and install direction, AED acquirer compliance checklists to state laws, post-event review technical assistance and more….

Contact one of our AED experts at:  888-473-1777 or info@firstvoice.us for more information and help.

20 Year Reunion with 1st person saved by AED in Wisconsin!

Has it been that long?…..

[AEDs have been on the market about 20 years! Their prices have gone from $5,000 to $1,200-$1,500.  Their weight and size has been cut in half at least.  Yet, there is one commonality - they are still lifesaving equipment!]

Twenty years ago Wednesday, Waukesha Wisconsin firefighters Todd Laurent and Jeff Schulz saved Chuck Krebs’ life, using what was a brand new defibrillator at the time.  Chuck and his wife Jackie spent Wednesday evening thanking the men who saved him.

Chuck is the first person in Wisconsin saved by a defibrillator!  He had a heart attack and collapsed while at work inside his garage in Waukesha.  He was pronounced dead, but the firefighters arrived promptly and used the defibrillator to bring Chuck back to life.  Chuck returned to a normal life thanks to his heroes.  To read more:   

http://www.todaystmj4.com/news/local/89081037.html

AED Site Risk Assessment: Part2

AED Site Risk Assessment

Many times we get asked at Think Safe the question, “How much risk do I have for someone  having a Sudden Cardiac Arrest (SCA) here?”

In the previous blog post we spoke about determining the level of risk at your facility and if your facility was at higher risk for having a SCA (Sudden Cardiac Arrest) event. We also provided a list of higher risk facilities.

If you want to now move on to assessment tools, here are some questions to answer:

1) Is it unlikely that the existing EMS system would be able to reliably achieve a “call- to-shock” interval of five minutes or less at this site?

2) Has an SCA incident occurred at this site in the past five years and have the demographics of the population served by this site remained relatively constant?

3) Do 10,000 or more persons regularly gather at this location?

4) Does this site have a large concentration of persons over 50 years old?

5) Is there a high probability of SCA at this site based upon this formula:

A. Take the number of individuals at your location and multiply this number by the % of people age 50 or over.
B. Multiply this number by the average number of hours spent at the location each day.
C. Multiply this number by 350 if the location is residential or 250 if the location is non-residential.
D. If your answer is 600,000 or higher, your location has a high probability of SCA.

If you answered YES to any of the above questions you are at higher risk of having an SCA event and you need to talk to our technical experts or a local rep by contacting 888-473-1777 or info@think-safe.com.

Think Safe can provide a full AED Site Assessment Survey for your use and one of our local representatives would be happy to perform on onsite AED placement assessment.  Think Safe’s First Voice product line includes a full line of AEDs and AED accessories.  From low cost and rugged solutions our product catalog has what you need to put in place an effective and protective AED program.

Think Safe, Inc. * 1105 Hawkeye Drive * Hiawatha, IA  52233 * 888-473-1777 * www.firstvoice.us

Automated External Defibrillator Programs

AED Site Risk Assessment

Many times we get asked at Think Safe the question, “How much risk do I have for someone  having a Sudden Cardiac Arrest (SCA) here?”

Due to the number of deaths every year and SCA events that occur, we like it when people appear to be educated that it is only a matter of time – at some point we are all likely to experience or witness a SCA event.  Again, we are talking about the nation’s biggest killer; affecting over 300,000 people in the US annually and killing more people than all forms of cancer combined!

The following information might provide you some helpful insight to determining your levels of risk.  What are the most likely places to have SCA events occur? Some studies have shown a higher incidence in certain locations, listed below.

· Airports
· Community/senior citizen centers
· Dialysis centers
· Ferries/train terminals
· Golf courses
· Health centers/gyms
· Cardiology, internal and family medicine practices, and urgent care centers
· Jails
· Large industrial sites
· Large shopping malls
· Nursing homes
· Private businesses
· Sports/events complexes

Watch for our next blog post on AED Site Risk Assessment for key questions to ask.

Automated External Defibrillator Programs

To see more information about how to assess your risk, contact us at 888-473-1777 or info@think-safe.com.  We can provide you a complimentary (NO CHARGE) AED site risk assessment survey.  If you would like, we can send a local rep to your facility for a NO CHARGE placement assessment as well.

The Think Safe First Voice product line includes a comprehensive AED package that protects our distributors and customers and includes:  AED Administrator Toolkit, AED inspection tag, AED Inspection Checklist, AED Acquirer State Civil Liability Immunity Laws Compliance Checklist, and more….  www.firstvoice.us

AEDs: Use by Hospitals, Nursing Homes and Healthcare Providers

Just what is the standard or duty to provide care of healthcare, long-term care or elderly care providers for Automated External Defibrillators (AEDs)?

From my consistent research and study of the AED industry, the standard appears to be that many nursing homes, elderly housing complexes or assisted living facilities still do not have an AED policy or program.   In 2007 a summary study within the industry showed:

http://www.jamda.com/article/S1525-8610%2807%2900207-1/abstract

Contrarily, here is an Ohio-based midwest article on AEDs & some facilities who have decided to implement AED programs:  http://www.redorbit.com/news/health/358076/many_nursing_homes_lack_device_to_restart_heart_portable_defibrillators/

Now, not taken into consideration is the question regarding “duty to provide care” – and what is really the up-to-date 2010 standard to provide care as it relates to AEDs or CPR in these facilities?

*  Are there any industry mandates taking place? What is the healthcare industry doing about AEDs?

*  What are the trends for DNR orders or Attempted CPR- are the number of DNR orders going up or down as a % of population being admitted to healthcare facilities?  Should nursing homes or long-term care facilities have solid AED programs in place due to a decreasing % of DNR orders and more patient preferences to attempt CPR?

In January 2010 there was a great article I read that showed how UCLA is implementing AED programs across their system, due to the improvement in SCA survival they offer. UCLA Article

Nursing Studies Show AEDs improve SCA response times (this is an additional Nurse.com article on SCA & AEDs in the industry)

I have also read many articles/studies in recent years on in-hospital SCA survival versus out-of-hospital survival and perhaps UCLA is trying to improve SCA survival and change the statistics, which show IN-HOSPITAL survival is lower than OUT-OF-HOSPITAL per many studies.  The above link shows the obstacles facing nurses and staff and why AEDs may be a welcome addition to healthcare facilities.

Regarding long-term and elderly facility industry practices such as DNR advanced directives

Paula Wickham, AED Industry Expert

are followed.  But, methods for identifying CPR status need improvement to enable accurate identification and prompt resuscitation of residents who want CPR:

http://www.gnjournal.com/article/S0197-4572%2898%2990117-3/abstract

It is known that ACPR is infrequently performed in long-term care setting and is rarely successful (successful being defined as admission to the hospital alive).  Survival (defined as discharge from the hospital) is also rare but survival does occur though. All nursing homes are not required to offer ACPR and many nursing homes in the United States, as well as in other parts of the world, do not offer ACPR.

In my assessment from my research, agencies such as the American Bar Association’s Commission on Law & Aging show that about two-thirds (2/3) of the adult population does not have an advanced directive or DNR.  I could not find any recent studies to answer my DNR questions on DNR preferences.

Recent mandates or pending mandates and “encouraged use” Bills have passed in recent years in the following states that are for assisted living facilities or long-term and medical facilities:  Texas, New Jersey, New York, Nevada, Florida and others.

Perhaps it will some day become an expectation for all long-term facilities to have an AED and perform CPR but for now, it appears that each facility has to make their own decision but for sure they should consider their state’s legislation or pending legislation as it affects licensing for their facility.

One exerpt of a study states, “Surveys have shown that many elderly in different parts of the world want to be resuscitated, but may lack knowledge about the specifics of cardiopulmonary resuscitation (CPR). Data from countries other than the US is limited, but differences in physician and patient opinions by nationality regarding CPR do exist.”  In the essence of observing the opinions of those elderly that do want to be resuscitated – perhaps there will be some marketing advantage to employ by organizations that implement AED programs.

This article was written by Paula Wickham, President of Think Safe and AED industry expert.  Think Safe has an entire staff of technical experts for AED bills, laws and mandates.  If you would like more information on AED mandates or pending mandates for your long-term or elderly care facility, you may reach us at 888-473-1777 or by emailing info@think-safe.com and requesting a copy or link to your state’s requirements.