AED devices are designed to be used by anyone and intended to be publicly accessible. "They are safe and easy to use by trained and untrained individuals," according to the Heart and Stroke Foundation of BC and Yukon (HSF) website. The portable devices are the size of a small suitcase and have two pads that attach to a patient's chest, read the heart rhythm and deliver electrical shocks.
They have simple instructions and the voice commands walk a user through the process. When used with CPR in the first 10 minutes of a sudden cardiac arrest the chance of surviving such an episode increases from five per cent to up to 75 per cent. For every minute that passes without a response, the probability of survival declines about seven to 10 per cent, according to studies cited by the HSF.
Each year, more than 2,000 British Columbians die from a sudden cardiac arrest. About two-thirds of victims have no history of heart problems. The HSF notes that after three to five minutes brain damage begins if the heart isn't rebooted.
While ambulance response times in cities may be lower, the average emergency response time province-wide is nine minutes. After 12 minutes, the HSF says death is almost certain.
In understanding how critical time is, it goes without saying the foundation is on a crusade to make AED's more prevalent and accessible throughout communities.
"We're trying to provide more awareness about what an AED is," said Erika Callowhill of the HSF.
Fixing fragmented system could save lives Without any sort of definitive set of laws and guidelines in B.C., not to mention an undereducated public, Callowhill says AED devices could be useless in some instances, particularly if the devices are under lock and key, hidden from public. For instance, Richmond Centre Mall, Aberdeen
Centre and Lansdowne Mall all have AEDs on site, however, they are all kept in their respective security rooms (security guards tend to double as first-aid attendants). When asked, many of the employees at the info kiosks didn't know if an AED was on site. Some didn't know what an AED was. It's highly plausible that in the time it takes to locate a mall employee, explain the situation, get a security guard to arrive with the device and then have it applied, it may be too late to save a person in cardiac arrest.
In fact, Callowhill notes, "We have had instances when an AED has been locked under a desk and someone has not made it because of that." According to the HSF any location that has 1,000 adults over the age of 35 present per day during normal business hours can expect at least one incident of sudden cardiac arrest every five years. However, fear of liability, vandalism and/or unintentional ignorance are reasons why the devices are not more accessable, said Callowhill. "There has actually been cases of vandalism and theft so many businesses keep them under lock and key," Callowhill said, noting an AED device costs about $2,000.
Richmond Centre manager Sheila Luft said its AED placement prevents tampering. Callowhill said HSF wants it clarified by the B.C. government that business people are not to be held liable if they have and use an AED.
Callowhill noted that AEDs could be treated in much the same way as fire extinguishers - publicly accessible but with clear penalties for misuse.
In Richmond, the five civic facilities the News visited all had AEDs visible, near the front entrances, and the first staff member approached at each location was able to quickly locate it.
More laws needed Just last week, the foundation appealed to the provincial government to enact legislation similar to what came into force in Manitoba in 2013. Manitoba's Defibrillator Public Access Act now requires AEDs be installed in high-traffic public places, such as schools, arenas, community centres, airports and athletic facilities. The act also requires AEDs to be registered with 9-1-1 dispatchers so they can assist a responder in finding the exact location of the device. Other details are found in the Act, such as a "three minute rule," which is used to determine how many AEDs are required at each location. The Act requires mandated AED owners allow for member of the public to access a defibrillator and return to the victim in less than three minutes. It assumes an average person can walk 100 meters per minute.
The act also provides clear protection from civil liability for those who use the devices in an emergency. Callowhill said the HSF, at a minimum, is asking the B.C. government to clearly define AED use under the Good Samaritan Act. Ontario has similar laws.
Registry a work in progress According to Callowhill, the foundation's public access campaign has been met with successes as well as room for improvement. While B.C. lacks the comprehensive laws that Manitoba and most states in the U.S. have, it does have the BC Public Access to Defibrillation (PAD) Program, and in February, 2013, the province announced it would help the foundation fund and place 450 AEDs across the province within three years. The PAD Program also has an online AED registry for AED owners but it's only voluntary, save for the abovementioned provincially sponsored devices. Callowhill noted a registry reminds AED owners when pads and batteries need to be changed. Working with the province, the foundation consulted with municipalities as to where the 450 devices would be placed.
Ten devices have been placed in Richmond, mostly in parks, such as Garry Point, Minoru, King George and Garden City.
The registry, however, is still in the process of being fully developed. There is supposed to be an online tool at www.bcpadprogram.com that shows registered devices for the public, however, few show up, including none in Richmond. A BC Ambulance Services spokesperson said it could just be a computer glitch. Callowhill confirmed the ten devices are registered with 9-1-1 in the city, but ones at civic facilities are not yet registered.
