A statewide automated external defibrillator system in Maryland requires program sites to register the devices, increasing the likelihood that they can be accessed quickly when needed.
In 2008, when NBC journalist and Meet the Press moderator Tim Russert died as a result of cardiac arrest inside an NBC office, questions emerged about the location and use of an automated external defibrillator (AED). The office building had an AED inside; however, it is unknown how soon after the collapse it was retrieved.
When defibrillation is provided within 5 to 7 minutes of cardiac arrest, the survival rate is 30 to 45 percent, according to the American Heart Association. A victim's chances of survival are reduced by 7 to 10 percent with every minute that passes without CPR and defibrillation.
Instances like Russert's have prompted private organizations and state agencies to provide support to individuals and businesses that choose to purchase and maintain AEDs.
“The Achilles' heel of these devices is that people buy the devices and they may not follow up on maintenance,” said Elliot Fisch, president and CEO of Atrus, which specializes in information technology and public access defibrillation. “They set it, and they forget it. An AED doesn’t do anyone any good if no one knows where it is in the time needed.”
The state of Maryland is working with Atrus to launch an AED registry on Sept. 1. The registry will generate email reminders for users to check the device to ensure it is functioning properly. Registered users will also receive prompts to replace electrode pads and batteries that are nearing their expiration date. Additionally, the state will use Atrus’ software AED Link, which will provide registered AED information to 911 dispatchers so they can guide a caller to the nearest device in the event of an emergency.
“We want to work with these good citizens so they can use AEDs successfully,” said Dr. Robert R. Bass, Executive Director of the Maryland Institute for Emergency Medical Services Systems (MIEMSS). “We want to partner with you. We want to know where you are. And we want to pass this info on to the local folks so they know where the AED is.”
There are 4,165 active AED program sites in the state. Prior to the new system, each of these sites would receive a maintenance reminder by mail every few years. The database was limited, however, and communication was not automated.
Today, when individuals obtain an AED, they notify MIEMSS and fill out a registration form. In Maryland, someone at each program site is designated responsible for AED maintenance, and receives the email reminders. MIEMSS will also make registration information available to local jurisdictions. In a couple of years, the registrant will receive a reminder to re-register.
The registry is free to users. Should a business or an individual choose to purchase an AED, it is a state mandate to register the device; however, the operator does not have to make the AED available to another facility in the event of an emergency. If the owner makes the device available to others, Maryland’s 911 dispatchers will receive location data in real-time, thus enabling dispatchers to communicate AED location information to callers reporting potential cardiac arrest incidents.
Another benefit to Maryland is that registration information is automatically uploaded to the National AED Registry, created and managed by Atrus.
“Even if we don’t look at the issue of improved health outcomes, simply from the standpoint of agency workload, this is a great labor saver,” Bass said. “This will streamline a process and get more reminders out. It improves the accuracy and efficiency of the registration process. And we’re going to look for cases in which this registry is facilitating access to these AEDs. So, we’ll be able to measure the health outcomes of this investment.”
Controlled areas, such as Las Vegas casinos, report a survival rate of 70 percent from sudden cardiac arrest by making AEDs available and retrieving them in a timely manner. Chicago O’Hare Airport reports a survival rate of more than 60 percent. The national average for survival is about 5 percent. Maryland is taking a proactive step towards increasing its survival rates by adopting a system that encourages people to register and maintain devices.
“We don’t fine them if they do not re-register,” Bass said. “It’s not a driver’s license. But it’s something that we encourage them to do. It’s really to create a system where these AEDs are able to be used if they need to be.”