SUBSTANTIATION FOR AED DEPLOYMENT CODING
Sudden cardiac arrest (SCA), a leading cause of death, takes longer to attend by EMS in high-rise buildings (call volume, urban traffic, security). Please review http://elevaed.com
The ‘Chain of Survival’ is broken, because EMS cannot reliably defibrillate patients within 3-5 minutes, after which progressive organ damage or death occurs. Survival rates are typically single digit, and in this rapidly growing demographic, failed EMS efforts to date have become an intractable and very costly public health problem.
High-rises do, however, offer compact advantages for sharing the cost of an AED, for education in its use, and their elevators enable prompt access by bystanders/volunteers. The most critical factor is having an AED in the building beforehand – one that is publicly visible and accessible 24/7, to bridge the time until the arrival of EMS – which is the sole purpose of an AED. Currently just 2.1% of SCA’s have an AED applied by bystanders (Weisfeldt JACC 2010).
As a safety agency, the building and fire coding authorities are the appropriate regulators for harmonizing AED deployment. Governments, as legislative agencies, have too many layers and independent AHJ’s for uniform and structured adoption, and their statutes largely address ‘public’ buildings, when most high-rises are privately owned. Local EMS are rescue agencies that act on existing regulations.
This is a heart safety issue – a valid parameter for the evolving Green Building initiative, and the coding authorities have a straightforward opportunity to rationalize our (currently chaotic) AED distribution throughout the built environment.
AEDs will shortly be moving onto the Internet (M2M cellular connectivity), leading to improved monitoring/assistance by in-building personnel, volunteers and NG9-1-1. These locations must have a fixed IP address, be documented in databases, maintained and trusted. High-rise elevator lobbies will anchor the AED in the public’s mind, greatly leveraging its cost, while expanding its use and effectiveness. This topology also promises to protect adjacent buildings within a two minute radius.
SCA survival in high-rises can reasonably be expected to improve by an order of difference when supported by cellular communications, volunteer teams, and a location standard. AEDs cannot perform from security guard lunch rooms and desk drawers as they are now expected to do, when they exist at all. The property management industry will also benefit from unequivocal coding for AEDs.
This proposal specifies basic AEDs for high-rise buildings as defined by the NFPA (75 ft +), and their cost or retrofitting are not major expenses in the context of such buildings. These singular devices will then protect residents and workers around the clock, regardless of their income or health insurance status.
The public expects and deserves our attention to this issue, and the world anticipates our leadership in coding for health safety.