Automated External Defibrillators

With recent advances in technology, automated external defibrillators
(AEDs) are now widely available, safe, effective, portable, and
easy to use. They provide the critical and necessary treatment for
sudden cardiac arrest (SCA) caused by ventricular fibrillation, the
uncoordinated beating of the heart leading to collapse and death.
Using AEDs as soon as possible after sudden cardiac arrest, within
3-4 minutes, can lead to a 60% survival rate.3 CPR is of value
because it supports the circulation and ventilation of the victim
until an electric shock delivered by an AED can restore the fibrillating
heart to normal.
All worksites are potential candidates for AED programs
because of the possibility of SCA and the need for timely defibrillation.
Each workplace should assess its own requirements for an
AED program as part of its first-aid response.
A number of issues should be considered in setting up a
worksite AED program: physician oversight; compliance with local,
state and federal regulations; coordination with local EMS; a
quality assurance program; and a periodic review, among others.
The OSHA website at www.osha.gov or the websites of the
American College of Occupational and Environmental Medicine at
www.acoem.org, the American Heart Association at www.americanheart.
org, the American Red Cross at www.redcross.org,
Federal Occupational Health at www.foh.dhhs.gov, and the
National Center for Early Defibrillation at www.early-defib.org can
provide additional information about AED program development.
10.

First- Aid Supplies

It is advisable for the employer to give a specific person the responsibility
for choosing the types and amounts of first-aid supplies and
for maintaining these supplies. The supplies must be adequate,
should reflect the kinds of injuries that occur, and must be stored in
an area where they are readily available for emergency access. An
automated external defibrillator (AED) should be considered when
selecting first-aid supplies and equipment.
A specific example of the minimal contents of a workplace firstaid
kit is described in American National Standards Institute ANSI
Z308.1 - 2003, Minimum Requirements for Workplace First Aid Kits.
The kits described are suitable for small businesses. For large
operations, employers should determine how many first-aid kits
are needed, and if it is appropriate to augment the kits with
additional first-aid equipment and supplies.
Employers who have unique or changing first-aid needs should
consider upgrading their first-aid kits. The employer can use the
OSHA 300 log, OSHA 301 reports or other records to identify the
first-aid supply needs of their worksite.Consultation with the local fire and rescue service or emergency medical professionals may be
beneficial. By assessing the specific needs of their workplaces,
employers can ensure the availability of adequate first-aid supplies.
Employers should periodically reassess the demand for these
supplies and adjust their inventories.

The Risks

There were 5,703 work-related fatalities in private industry in 2004.
In that same year there were 4.3 million total workplace injuries
and illnesses, of which 1.3 million resulted in days away from
work.
Occupational illnesses, injuries and fatalities in 2004 cost the
United States’ economy $142.2 billion, according to National
Safety Council estimates. The average cost per occupational
fatality in 2004 exceeded one million dollars. To cover the costs to
employers from workplace injuries, it has been calculated that
each and every employee in this country would have had to
generate $1,010 in revenue in 2004.2
Sudden cardiac arrest (SCA) may occur at work. According to
recent statistics from the American Heart Association, there are
250,000 out-of-hospital SCAs annually. The actual number of SCAs
that happen at work are unknown. If an employee collapses
without warning and is not attended to promptly and effectively,
the employee may die. Sudden cardiac arrest is caused by
abnormal, uncoordinated beating of the heart or loss of the
heartbeat altogether, usually as a result of a heart attack.
Workplace events such as electrocution or exposure to low oxygen
environments can lead to SCA. Overexertion at work can also
trigger SCA in those with underlying heart disease.
The outcome of occupational illnesses and injuries depends on
the severity of the injury, available first-aid care and medical
treatment. Prompt, properly administered first aid may mean the
difference between rapid or prolonged recovery, temporary or
permanent disability, and even life or death.

Obtaining and evaluating information about the injuries, illnesses
and fatalities at a work site are essential first steps in planning a
first-aid program. Employers can use the OSHA 300 log, OSHA
301 forms, their Workers’ Compensation insurance carrier reports
or other records to help identify the first-aid needs for their
businesses. For risk assessment purposes, national data for
injuries, illnesses and fatalities may be obtained from the Bureau
of Labor Statistics (BLS) website at www.bls.gov/iif.