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From: Subject: Welcome to Stateline.org Date: Mon, 31 Mar 2003 10:50:20 -0500 MIME-Version: 1.0 Content-Type: multipart/related; boundary="----=_NextPart_000_0077_01C2F773.52EDA180"; type="text/html" X-MimeOLE: Produced By Microsoft MimeOLE V6.00.2600.0000 This is a multi-part message in MIME format. ------=_NextPart_000_0077_01C2F773.52EDA180 Content-Type: text/html; charset="iso-8859-1" Content-Transfer-Encoding: quoted-printable Content-Location: http://www.stateline.org/print_story.do?storyId=296887 Welcome to Stateline.org

Home > Issues > = Healthcare = >=20

Virginia Out To Widen Use Of = Life-Saving=20 Devices

By Shirley Adams, Special to=20 Stateline.org

March 31, 2003

RICHMOND --=20

About 1,000 Americans = die every=20 day from sudden cardiac arrest. Many of them could survive if they = immediately received a jolt of electricity, from a machine called = a=20 defibrillator, to reset their heart.=20

Special automated defibrillators, designed for use by = laypersons with=20 minimal training, have been available since the early 1980s. Over = the last=20 several years, the units have improved to the point where good = Samaritans,=20 with no training at all, have used them successfully to save = lives.=20

Virginia is at the forefront of states that are accelerating = efforts to=20 take advantage of these technological advances. The national = movement=20 envisions that widespread availability of automated external=20 defibrillators, or AEDs, can do for sudden cardiac arrests what = fire=20 extinguishers do for fires.=20

Delegate John M. O'Bannon, R-Henrico, sponsored legislation = this year=20 to remove legal barriers to widespread access to AEDs. His bill = will give=20 legal protection to untrained people who use the machines in good = faith.=20

The legislation earned the unanimous support of the General = Assembly=20 and Gov. Mark Warner has signed it. Warner asked lawmakers to make = it=20 effective immediately and the General Assembly will consider his = request=20 when it reconvenes in Richmond on Wednesday [April 2] for a = one-day "veto=20 session."=20

Without an emergency clause, the legislation would take effect = July 1.=20

"Widespread access to AEDs will be a step in the right = direction," said=20 O'Bannon, a physician. "A thousand deaths a day from ventricular=20 fibrillation are way too many. I think we'll see that number go = down."=20

Unlike heart "attacks," which occur when something blocks = adequate=20 blood flow to the heart muscle, sudden cardiac arrests are almost = always=20 an electrical problem.=20

Normal pumping is regulated by electrical signals that = stimulate each=20 part of the heart to contract at the right time. When those = signals=20 suddenly become chaotic (a condition called ventricular = fibrillation), the=20 heart quivers unproductively, and no blood is pumped. With little = or no=20 warning, the person loses consciousness and stops breathing; death = follows=20 in minutes.=20

In the October 2002 issue of The New England Journal of = Medicine, a=20 team of doctors and experts underscored the scope of the = challenge:=20 "Though highly reversible with the rapid application of a = defibrillator,=20 ventricular fibrillation is otherwise fatal within minutes, even = when=20 cardiopulmonary resuscitation (CPR) is provided immediately."=20

AEDs are different in many ways from traditional full-function=20 defibrillators -- the machines featured in medical dramas on = television=20 and used in real life by highly trained emergency technicians. The = full-function defibrillators are complicated and can kill if = administered=20 improperly.=20

Currently, state law tightly restricts access to both = full-function=20 defibrillators and AEDs. O'Bannon's bill will lift the = restrictions on=20 AEDs, which are specifically designed for public-access use.=20

"Widespread access to AEDs will be a step in = the right=20 direction."
Virginia Del John M. = O'Bannon=20 (R)

Anyone who can find the big green "ON" button, and follow a few = simple=20 instructions, can operate a public-access AED. A recording in the = machines=20 begins providing clear verbal instructions as soon as the power is = turned=20 on. They actually sound quite bossy, but the authoritative voice = probably=20 helps rescuers stay focused.=20

Instead of using bulky paddles, AEDs have self-adhesive, = palm-size pads=20 that are connected to the unit by an electrical cord. The person=20 attempting the rescue places the pads on the victim's chest. After = the=20 pads are on, the operator does not need to touch the patient = unless the=20 AED instructs them to do so.=20

Several scientific studies have tested the safety and = effectiveness of=20 AEDs.=20

A 1999 research project, for example, timed and evaluated two = groups --=20 sixth-grade children with no prior training, and emergency medical = professionals -- as they used AEDs in mock emergencies. All of the = children understood and followed the instructions successfully.=20

When the study was published in Circulation, a medical journal = for=20 heart specialists, the researchers made the following conclusion: = "During=20 mock cardiac arrest, the speed of AED use by untrained children is = only=20 modestly slower than that of professionals."=20

Many people compare modern public-access AEDs to fire = extinguishers,=20 which are so easy to use to save lives that they are found in = almost every=20 public place. In some ways, AEDs are even less dangerous than fire = extinguishers.=20

Fire extinguishers are not idiot-proof. If operators point the = nozzle=20 at themselves, instead of at the fire, they will be hurt by the = blast of=20 chemicals. Fire extinguishers can also be used to cause malicious = harm --=20 by bludgeoning someone, for instance.=20

AEDs are not idiot-proof, either. Before the unit delivers a = shock, it=20 sounds a cautionary warning alarm and issues emphatic orders. "Do = NOT=20 touch the patient!"=20

If operators disobey the defibrillator's orders, they can be = hurt.=20

Unlike fire extinguishers, AEDs would be extremely difficult to = use to=20 cause malicious harm. The units refuse to even charge up unless = their=20 sensors indicate that they are properly applied to a person who is = not=20 breathing and whose heart is in fibrillation.=20

In 1997, Florida became the first state to enact a law = encouraging=20 broad public access to AEDs by trained non-medical personnel such = as=20 police officers and firefighters. Currently, all states have taken = similar=20 steps.=20

What makes Virginia unusual is that its law will expand legal=20 protection for purchasers of AEDs and to untrained AED users = acting in=20 good faith. Only a handful of states, such as Pennsylvania and = Rhode=20 Island, provide such protection from liability.=20

This protection will be important as AEDs become more prevalent = in=20 public places. For example, defibrillators were recently installed = at all=20 service plazas along the Pennsylvania Turnpike. And the Illinois=20 Legislature just passed a law requiring golf courses, school = gymnasiums=20 and other government-owned physical fitness facilities to have = access to=20 at least one AED during hours of operation.=20

Under current Virginia laws, public-access AEDs (which do not = need=20 trained operators) are treated much the same as full-function=20 defibrillators (which definitely do need trained operators).=20

O'Bannon's bill will update these laws so that:=20

AED units can be placed in locations where untrained = good=20 Samaritans might use them.=20

Purchasers will not be required to complete registration = paperwork and=20 pay a state registration fee.=20

Purchasers will not be responsible for preventing use of the = AEDs by=20 untrained good Samaritans.=20

Anyone who makes a good-faith effort to use an AED in a=20 life-threatening situation will be protected from liability.

O'Bannon said he would be thrilled with even a small increase = in the=20 number of cardiac patients who receive emergency treatment in time = to=20 prevent irreversible brain damage.=20

He noted that his bill not only promotes the availability of = AEDs but=20 also urges people to get basic life support training.=20

"The AEDs are great -- no doubt about it," O'Bannon said. "But=20 realistically, there will be many times when CPR and other skills = that are=20 taught in basic life support classes will be needed if the patient = is to=20 have the best possible chance for a full recovery."

Issues to = Watch

Healthcare=20

States to = Watch

Florida =

Pennsylvania=20

Virginia=20 =

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