Defibrillator Laws for Canada?

By Yaseen Hemeda / safety-reporter.com
For Traci Wells, it started out like any other day in the office. She was standing in line waiting to get her morning cup of coffee when, suddenly, something went terribly wrong.

Wells started turning blue, and collapsed.

“Fortunately, it was first thing in the morning so there were a lot of people around me and somebody started to do CPR,” said Wells, senior manager of leadership and skill development at Rogers Communications in Toronto.

Quick-thinking employees grabbed an automated external defibrillator (AED) and were able to revive her within four minutes of her collapse. What Wells experienced was a heart attack, which resulted in sudden cardiac arrest, a condition in which the heart stops.

“My heart had completely stopped so they shocked me twice with the AED which brought my heart back to life,” she said.

An AED is a small, portable device that assesses the heart of a person in cardiac arrest for a “shockable” rhythm. If such a rhythm is detected, a button is pressed to deliver a shock or series of shocks to the victim’s heart, allowing it to return to a normal rhythm.

Prior to this dramatic event, Wells experienced no warning signs or symptoms and did not have a medical history of heart problems.

“That’s why it was so scary, because I did not feel any warning signs and I am still undiagnosed. They don’t know why it happened,” said Wells, of the July 9, 2009, event. “I just remember walking to work in the morning and that’s it.”

Wells’ attack was the first time an AED was used at Rogers. Wells feels she wouldn’t be alive had her company not invested in AED.

“Even if it is only ever used once, the power of being able to save a life is pretty phenomenal,” said Wells. “This makes me a lot more committed to Rogers. I want to work for a place that cares about people.”

Kerry Wallace, senior manager of health and safety at Rogers, said Wells’ case has elevated the awareness about the need for AEDs in the workplace.

“We recognized we don’t have them at all our sites and what is the cost of human life?” said Wallace. “You are protecting your human resources and that’s the number one priority to the company. Without our people the company doesn’t exist. It’s an investment in your people.”

Rogers is working on an implementation program to have defibrillators installed at every regularly staffed site.
Richmond, B.C.-based London Drugs is another company investing rigorously in AEDs. It has defibrillators in every one of its 73 stores across Canada and has trained about 1,000 employees on the proper use of AEDs.

“Every London Drugs location will ensure an employee trained in AED use is present when there are customers and staff in the store,” said president Wynne Powell, who claims the chain is the first Canadian retailer to put an AED in every location.

But despite examples like Rogers and London Drugs, the reality is AEDs remain relatively uncommon in the workplace, said Laurie Morrison, a medical doctor and a spokesperson for the Heart and Stroke Foundation.
“Until legislation is mandated that every employer has to have one, then the use of AEDs will be small,” she said.

Because Canada does not mandate the use of AEDs, there is no national cardiac arrest database that would document incident rates for the number of AEDs in the workplace or frequency of use.

But cardiac arrest is a significant killer. There are about 40,000 cardiac arrests in Canada every year — that’s one about every 12 minutes, according to the Heart and Stroke Foundation. And less than five per cent of victims who suffer an attack outside a hospital survive — and the vast majority (70 per cent) of cardiac arrests occur outside a hospital.

Ontario’s Workplace Safety and Insurance Board (WSIB) reports it has registered an average of 200 claims for “acute myocardial infarctions” — in layperson’s terms a heart attack — that occurred in the workplace over the last three years. But not all heart attacks that occur at work are necessarily job related, and the WSIB considers each case on its own merits.

Having an AED onsite can vastly improve a victim’s chance of survival, said Morrison. With an AED, the chance of survival from cardiac arrest can increase by 75 per cent or more over CPR on its own. Defibrillation is more successful if performed within five minutes of cardiac arrest and the chances of survival decreases up to 10 per cent for every minute that passes after the arrest.

A workplace with 2,000 people and an average age of 40 years can expect at least one incident of cardiac arrest in the workplace each year, according to the Heart and Stroke Foundation.

Many employers are not aware of these statistics and education is an important step to fighting workplace complacency, said Morrison.

“I think companies are not aware they should have AEDs and don’t know it can save a life. They fear it will be too expensive,” she said.

For her part, Morrison is advocating for AEDs to become mandatory in all public places. In Ontario, a private members bill passed second reading in May and, if passed, will make it the first province in Canada to mandate AEDs.

AEDs should be as common as fire extinguishers, said Morrison.

“It’s sad that we value buildings and structures more than we value human life,” she said. “The fire extinguisher is going to save the building but an AED can save a life.”

Yaseen Hemeda is an HR compliance product writer for Consult Carswell.


INSTALLING A DEFIBRILLATOR: TIPS FOR EMPLOYERS

How much does it cost, and how many units should be installed?
Automated external defibrillators (AEDs) have come down in price significantly over the past several years, said Terry Brown, Toronto-based president of SOS Emergency Response Technologies, a health and safety retailer that sells AEDS and other safety products.

Units are now priced well under $2,000, he said, a far cry from the $5,000 they cost just a few years ago.
“Awareness and sales are growing, because the need for them is growing and costs have come down,” said Brown.

How many units should be installed?: Because AEDs are not mandatory, there are no rules and regulations around how many units a company should have on-site. A good rule of thumb is if you walk briskly 60 to 90 seconds in any direction, that would be the coverage of that particular AED machine because that would give you a round trip of a maximum of two to three minutes, Brown said.

Installation: Most units come with a carrying bag and wall mount, and can be installed without professional assistance. Employers that want more security can purchase an alarmed cabinet that sells for about $300 to $400. These cabinets are easy to install. Because AEDs are battery powered, and the batteries are not rechargeable, they don’t require a power supply.

Maintenance: Maintenance costs for an AED are relatively small, said Brown. Units do not require regular maintenance, except for daily spot checks to ensure the status indicator light is on as well as monthly checks by the employer to make sure the unit is in good working order. (Most AED machines conduct automatic self-tests daily.) Batteries typically last between three and five years, depending on the unit. New batteries cost about $200 to $300. The pads — which are attached to the victim — need to be replaced every time the unit is used. Pads cost about $70 to $100 per pair. (Some units require the battery to be replaced after every usage.)
Training employees: There is a cost associated with training employees on how to use AEDs. To minimize liability risks, the Heart and Stroke Foundation recommends companies ensure operators have medical oversight, ensure certain members of staff are properly trained and that protocols for continued training, operation and equipment maintenance are in place. The Heart and Stroke Foundation recommends that all employees, if possible, have the skills necessary to perform CPR and the use of an AED.

And training doesn’t have to be expensive. The Heart and Stroke Foundation, for example, has a CPR Anytime Kit available for $35 per kit that teaches the basics of CPR and AED use, and can be used to train multiple staff at the same time. Companies can also hire vendors and consultants to conduct training.

“It doesn’t take more than a Grade 6 education to use an AED and you can learn it in 20 minutes,” said Laurie Morrison, a medical doctor and a spokesperson for the Heart and Stroke Foundation, who believes it is essential to teach every employee.

Each province has its own legislation on the number of staff who must have formal training in first aid and/or CPR who must be on site. For example, the Canada Labour Code — which applies to federally regulated workplaces — states that: “At every workplace at which six or more employees are working at any time, the employer shall ensure that there is a first aid attendant.”


LIABILITY CONCERNS

Can an employer be sued if an AED is used improperly on a victim?

Employers may have concerns about liability and being sued if an automated external defibrillator (AED) is used improperly on a victim. But, to date, it doesn’t appear that anyone in Canada has ever been sued for using an AED.

This may be attributed to “good samaritan” laws that prevent someone from being sued when they are trying to help. Every province and territory — with the exception of New Brunswick and Nunavut — has good samaritan laws on the books. Ontario even has legislation specifically for the use of AEDs. It passed the Heart Defibrillator Civil Liability Act, 2006 (also known as the Chase McEachern Act) which protects individuals from liability for damages that may occur from their use of an AED to save someone’s life at the immediate scene of an emergency, unless damages are caused by gross negligence.

AEDs are also designed to reduce the risk of operator misuse. For example, a shock cannot be administered if the defibrillator does not detect a heart rhythm that needs defibrillating.