American College of Emergency Physicians

The American College of Emergency Physicians (ACEP) believes that the efficacy of early defibrillation with the reliable technology of current automatic external defibrillators (AEDs) is proven and widely accepted within the out-of-hospital provider community. However, before early defibrillation programs can be promoted in a widespread manner, they must be integrated into or coordinated with EMS systems that are designed to maximize the potential for survival in the ventricular fibrillation victim.

AEDs should be carried by all basic life support ambulances. AEDs should also be available to Medical First Responders such as police and fire personnel and to other designated first responders in highly congested population areas.

ACEP endorses the widespread availability of AEDs and the implementation of early defibrillation programs coordinated with an EMS delivery system to ensure the following:

• Immediate activation of the EMS system for the ventricular fibrillation victim
• Immediate delivery of CPR
• Early defibrillation by the first designated responder to arrive on the scene
• Timely provision of advanced life support
• Rapid transport to an emergency medical facility
• Medical direction of all components including the AED program

All of these factors are critical to ensure that the EMS personnel can optimally treat victims of cardiac arrest. Appropriate monitoring of quality of care and outcomes must occur. Legislation may be necessary in some locations to allow for Medical First Responders to use AEDs.

Policy Number 400202
Approved by the ACEP Board of Directors, June 1999

www.acep.org/library/index.cfm/id/1996

American College of Occupational and Environmental Medicine (ACOEM)

The American College of Occupational and Environmental Medicine (ACOEM) supports the establishment of programs by employers to use automated external defibrillators (AEDs) to manage sudden cardiac arrest in workplace settings. ACOEM supports ongoing efforts to enhance emergency response to medical emergencies in the occupational environment.

The College has thus developed a guideline to increase the awareness of the value of AEDs and has presented recommendations to encourage and provide guidance on their use in the workplace. This guideline reviews the following topics: (1) epidemiology, morbidity, and mortality of cardiovascular diseases in the workplace; (2) the "chain of survival" paradigm; (3) history and descriptions of AEDs; (4) standard-of-care interventions and guidelines; (5) public-access defibrillation and federal initiatives; and (6) reommendations for establishing and managing a workplace AED program.

Development of programs to utilize AEDs is a reasonable and appropriate aspect of such programs to manage sudden cardiac arrest, an important cause of morbidity and mortality among working age adults. Implementation of such an AED program, which should be a component of a more general worksite emergency response plan, requires clearly defined medical direction and medical control.

Prepared under the auspices of the Council on Scientific Affairs, peer-reviewed by the members of the Council and approved by the ACOEM Board of Directors on February 11, 2001.

http://www.acoem.org/position/results.asp?CATA_ID=41