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Subject: HOA Automatic External Defibrillators (AED)
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ZeighO1
(Arizona)

Posts:7


02/07/2015 7:50 AM  
Hello,

Has anyone implemented and automatic external defibrillator (AED) program within their HOA/POA? Was your association lawyer behind the decision? Did it effect your liability insurance rates?

My HOA is in the state of Arizona and I want to start such program. Obviously, the big pink elephant in the room are "liability concerns". While every state has their own take on such laws, the Arizona Good Samaritan law specifically mentions AED's in it several times and protects those that make such devices available, as well as those that use it trained or UNTRAINED. The Save Hearts in Arizona Registry & Education (SHARE) sponsored by the Arizona Department of Health Services has registered over 5000 AED's for public use. A neighboring town has AED's on the street corner for anyone to access at anytime and a handful of HOA's in my state have AED's installed.

Still, my HOA board remains more overprotective of money here than life safety. They quote our association lawyer who advises against an AED program, yet this lawyer is clearly unfamiliar with the laws involved or the national trends in there being more of a liability for NOT making an AED available. It has been mentioned that liability insurance would also go up, yet a brief poll of our insurance company and two others found that AED's do NOT increase rates. I respect that my HOA board is trying to make the best decisions for the community, but they are not providing due diligence in the research of their decision in this matter.

So, what have your experiences been?


Thanks,
Dr. Z.
NpS
(Pennsylvania)

Posts:4064


02/07/2015 8:12 AM  
I was a goner 3 years ago. Turned grey. Keeled over. Luckily there was an AED in the room. No one knew how to use it. They used it anyway. It kept me going til the EMTs got there. Got whacked 5 times that night to get my heart restarted. 2% chance of survival. In a coma for a week. Hospital had me on ice the entire time.

Now, every time I walk into a building, my eye automatically scans for an AED. I am seeing them more an more in places I never expected - like a grocery store.

The cool thing about the design of the AED is that there is no expectation that a person who tries to use it knows what to do. As soon as you open the case, a voice instructs you step by step what to do.

We do not have a common meeting place in our HOA, but if we did, I would recommend getting an AED. I would also recommend a CPR demonstration at a HOA meeting.

Our HOA insurance company recommends an AED in any HOA with a clubhouse, pool, etc. No effect on premiums.

I believe that every state has a good samaritan law that shields people who try to save a life from liability.

I think that you are right - your HOA lawyer is out of touch with the modern realities.




Sikubali jukumu. Read all posts at your own risk.
MelissaP1
(Alabama)

Posts:9988


02/07/2015 8:42 AM  
I am trained in the use of the AED and other first responder certifications. By far, I like the AED option as the best if available...

However, having said that... I can see the attorney's point. They are NOT cheap. Especially if you need some that has to be kept outdoors in a public spot. There is some maintenance required and someone will have to volunteer to do it.

The big issue here is possible vandalism if kept outside. Some kids may "try it out" on each other. A VERY dangerous act. The place it has to be kept has to be "open" but also protected. It has to be in an area where it would be accessible in an emergency. Can't lock it up in a clubhouse and no one has a key...Not knowing how your HOA is set up, it's hard to advise a proper place to make this available.

I would also encourage training. Which the American Red Cross may provide. However, you did touch on the biggest issue: "Good Samitarian laws". This protects those who have no training or medical knowledge. They are "safe". However, people like me, nurses, doctors, or others in trained medical field are not. Let's say you drop with a heart attack. Joe Smo gets the AED out and uses it. Never seen one before and can't even spell it. You end up getting burns because they did not check for any Nitroglycerin patches or other metal objects. You sue them. They fall under the "Good Samitarian law". However, if you find out there was a doctor/medically trained person nearby, you could then sue them. They would NOT fall under the "Good Samiterian law". They have a "duty" to respond to a medical issue if so trained. Even if they did not touch you.

Hence, why the lawyer is advising against the AED. What if you have doctor in the neighborhood? He/she does not respond because they don't want the liability. It happens and seen that first hand. Not having the device protects them and all the membership in the end despite itself.

I say if you want one, buy it yourself. Make it available or let people know you have one for use in case of emergency. You will feel better and you won't be spreading the liability or cost onto ALL of your membership.

Former HOA President
NpS
(Pennsylvania)

Posts:4064


02/07/2015 9:37 AM  
Posted By MelissaP1 on 02/07/2015 8:42 AM
people like me, nurses, doctors, or others in trained medical field are not. Let's say you drop with a heart attack. Joe Smo gets the AED out and uses it. Never seen one before and can't even spell it. You end up getting burns because they did not check for any Nitroglycerin patches or other metal objects. You sue them. They fall under the "Good Samitarian law". However, if you find out there was a doctor/medically trained person nearby, you could then sue them. They would NOT fall under the "Good Samiterian law". They have a "duty" to respond to a medical issue if so trained. Even if they did not touch you.


See these articles:

This one says doctors are protected under GS laws in NY, CT, PA, and NJ. Standard is good faith, reasonable care, and no expectation of compensation. Excluded from protection are gross, willful, or wanton negligence.

http://www.emccprtraining.com/blog/post/how-do-good-samaritan-laws-work

This one says doctors are protected in TN except in case of gross negligence. Also, possibly no duty to render assistance.

http://www.tntlaw.net/articles?id=61937

Sikubali jukumu. Read all posts at your own risk.
ZeighO1
(Arizona)

Posts:7


02/07/2015 9:57 AM  
Posted By MelissaP1 on 02/07/2015 8:42 AM
However, people like me, nurses, doctors, or others in trained medical field are not. Let's say you drop with a heart attack. Joe Smo gets the AED out and uses it. Never seen one before and can't even spell it. You end up getting burns because they did not check for any Nitroglycerin patches or other metal objects. You sue them. They fall under the "Good Samitarian law". However, if you find out there was a doctor/medically trained person nearby, you could then sue them. They would NOT fall under the "Good Samiterian law". They have a "duty" to respond to a medical issue if so trained. Even if they did not touch you.

Hence, why the lawyer is advising against the AED. What if you have doctor in the neighborhood? He/she does not respond because they don't want the liability. It happens and seen that first hand. Not having the device protects them and all the membership in the end despite itself..





MelissaP1,

Thanks for your response and especially your service in healthcare. I am also a healthcare provider who has trained hundreds of people over the last 27 years in CPR and AED use, not to mention EMT's and paramedics in the field. Unfortunately, I strongly disagree with you in what the Good Samaritan laws protect.

The Alabama laws for you cover healthcare providers quite well and here is a brief quite from it:

"(Long list of public and private healthcare provides) gratuitously and in good faith, renders first aid or emergency care at the scene of an accident, casualty, or disaster to a person injured therein, he or she shall not be liable for any civil damages as a result of his or her acts or omissions in rendering first aid or emergency care, nor shall he or she be liable for any civil damages as a result of any act or failure to act to provide or arrange for further medical treatment or care for the injured person."

You can read the entire law here:

http://www.aedbrands.com/resource-center/implementation/aed-state-laws/alabama/

The state where I live in, Arizona, is more progressive in their Good Samaritan law and provides more protection for the purchaser and host of the AED. Here is that law for comparison:

http://www.aedbrands.com/resource-center/implementation/aed-state-laws/arizona/

Like I previously mentioned, there is a reason that the Arizona SHARE program has registered over 5000 AED's in public buildings, airports, private businesses and more. This is why you can find AED's on street corners in the City of Sedona, Arizona and at roadside in a handful of proactive HOA's in the state for use by anyone trainer or untrained. There is also no duty to act in Arizona unless you are "on the clock" as a healthcare provider and within the scope of practice. Can anyone be sued for anything? Sure. However, the chances of that happening are very slim in this situation and I challenge anyone to show a case where the rescuer or provider of an AED settled out of court or even went to trial in such an allegation.


Thanks,
Dr. Z.



NpS
(Pennsylvania)

Posts:4064


02/07/2015 10:47 AM  
Posted By ZeighO1 on 02/07/2015 9:57 AM
http://www.aedbrands.com/resource-center/implementation/aed-state-laws


VERY COOL SITE.
EVERYONE SHOULD CHECK IT OUT.
THX DR.Z AND WELCOME.

Sikubali jukumu. Read all posts at your own risk.
LarryB13
(Arizona)

Posts:4099


02/07/2015 11:26 AM  
Posted By ZeighO1 on 02/07/2015 9:57 AM

You can read the entire law here:

http://www.aedbrands.com/resource-center/implementation/aed-state-laws/alabama/

The state where I live in, Arizona, is more progressive in their Good Samaritan law and provides more protection for the purchaser and host of the AED. Here is that law for comparison:

http://www.aedbrands.com/resource-center/implementation/aed-state-laws/arizona/




Dr. Z,

I looked at the page for Arizona and was not impressed with what I saw. The page is made up almost entirely of personal opinion.

Who wrote it? We don't know.
What were the author's qualifications? We don't know.
When was it written? We don't know.
What is the source for the information? We don't know.
Which statutes provide the "Good Samaritan Protection" claimed? We don't know.

Yes, there is a table of history of House Bills introduced in the state legislature and allegations of what they pertained to. A Bill is nothing more than a proposal for adding, amending, or repealing one or more statutes; a Bill is not law. My experience is that those who cite Bills are usually a lobbyist or a newspaper reporter; lawyers and judges normally cite statutes.

I am not saying that the information is wrong. I am saying that the website is presenting a series of legal arguments without any citation to authority to support the conclusions presented.

The problem you are having with the HOA attorney may be rooted in this lack of authority. While I am not an attorney, I have dealt with many of them over the years and reference to specific statutes and/or case law goes a lot farther with them than undocumented opinions from the internet.
JohnB26


Posts:0


02/07/2015 12:33 PM  
A rare SERIOUS reply based upon a resolved debate in my HOA (long but necessary):

An AED is NOT a good thing for SFHOA, Inc. because:

All 50 states have Good Samaritans laws designed to protect companies that choose to deploy AEDs. These laws reduce or eliminate the fear that people who help others could suffer legal repercussions. To receive protection under the Good Samaritan laws, a company must prove they meet all operational requirements for the deployment of an AED Program.

It is important to know what your specific state laws are to determine if Medical Direction is required in your state. Most states require that that medical direction be part of the overall AED plan. Medical Direction will provide a number of essential features to you including reviewing your policies and procedures and making sure adequate training is provided, consulting on AED placement, and EMS Notification.

The maintenance of an AED is minimal but it is very important to have a system in place that tracks this maintenance. The majority of malfunctions in AEDs are due to improper maintenance or battery failure.

AEDs, while easy to use, require ongoing management and maintenance. In addition to training volunteers, a well-designed AED Program includes testing and maintaining your device(s) – a critical and overlooked factor in deploying AEDs in organizations. Whether you have 1 AED, or are a large organization with multiple AEDs deployed, you should have a Medical Oversight and Management program in place. Taking this step ensures that your AED(s) are always maintained, in compliance, registered with local EMS, and are ready for use should they be called upon.
AEDs have accessory parts (batteries and electrodes) that have expiration dates that must be tracked and addressed prior to expiration.

The most important aspect of any AED program is an active system of controls and maintenance protocols that will continually monitor overall compliance and readiness.

It is important to determine your budget early and be sure to include any accessories such as: spare pads (optional), spare batteries (optional), AED cabinet or wall bracket, CPR and AED training (required), Medical Direction (required in some states), long term costs (replacement pads and batteries, refresher training).

Replacement pads (electrodes) and batteries must be replaced at the appropriate time. AED pads are comprised of tin and an adhesive gel which allows the pads to stick on the victim’s chest. Over time, the tin will eat away at the gel and the gel will lose its adhesive properties. For this reason, pads have a fixed expiration date stamped on the package. These pads should be replaced prior to expiration to ensure that they will do their job when the AED must be used.

Batteries do not have a fixed expiration date, but they have a normal life expectancy. A battery’s life can be shortened or prolonged by several variables, including temperature, factory self-tests and usage.

It is of utmost importance that your AED be maintained properly to ensure that these expiration dates are managed closely.

 {page break} 

AS PER: http://www.aeduniverse.com/AED_Laws_by_State_s/97.htm#Southcarolina

{QUOTE}South Carolina
Section 44-76-30 of South Carolina’s Code
A person or entity that acquires an AED shall:
1. Require its designated AED users to have current training in CPR and AED use by the American Heart Association, American Red Cross, or National Safety Council;
2. Maintain and test the AED according to the manufacturer’s operational guidelines and keep written records of maintenance and testing;
3. Employ or obtain a healthcare professional to serve as its AED liaison;
4. Have in place an AED program approved by its AED liaison which includes CPR and AED training, AED protocol or guidelines, AED deployment strategies, and an AED equipment maintenance plan;
5. Include in its AED protocol or guidelines that a person who renders emergency care or treatment to a person in cardiac arrest caused by ventricular fibrillation/tachycardia by using an AED must activate the emergency medical services system or 911 as soon as possible;
6. Report any clinical use of the AED to the AED liaison.
Any person or entity acting in good faith and gratuitously shall be immune from civil liability for the application of an AED unless the person was grossly negligent in the application.
Any designated AED users meeting the requirements of Section 44-76-30(1) and acting according to the required training shall be immune from civil liability for the application of an AED unless the application was grossly negligent.
A person or entity acquiring an AED and meeting the requirements of Section 44-76-30 or an AED liaison meeting the requirements of Section 44-76-30 shall be immune from civil liability for the application of an AED by any person or entity described in items (1) or (2) of this section.{END QUOTE}



JohnB26


Posts:0


02/07/2015 1:55 PM  
I believe that every state has a good samaritan law that shields people who try to save a life from liability.


True, but misleading on its' face, because:

Corporations are treated as both businesses AND persons.

A person or entity acquiring an AED and meeting the requirements of Section xx-yy-zz or an AED liaison meeting the requirements of Section bb-cc-dd shall be immune from civil liability for the application of an AED by any person or entity described in items.....

Note the qualifier for immunity in bold above.

It is an EXPENSIVE can-o-worms for a corporate entity to acquire an AED.


SheliaH
(Indiana)

Posts:3824


02/07/2015 3:11 PM  
I've had CPR and AED training on my job and when I was recertified last year, I was told there's been a push towards teaching people hands only CPR (the chest compressions). Here's an information page from the American Heart Association website for more information.

http://www.heart.org/HEARTORG/CPRAndECC/HandsOnlyCPR/Hands-Only-CPR_UCM_440559_SubHomePage.jsp

Perhaps you can contact your local chapter and see if they could come out and do a training or if there's a poster available that can be put up somewhere in the clubhouse.
ZeighO1
(Arizona)

Posts:7


02/07/2015 8:02 PM  
I started this post to get some real world experience from others who may have done the same thing, but also to get a feel for what people thought about the matter. Wow, I had no idea there was so much misconception and fear out there...

Every state has their own take for a Good Samaritan law. All are designed to protect those willing to step forward and help, yet some lack true foresight into how far that protection will go. My state of Arizona actually has one of the more progressive laws found here (yes, the whole law and not just a legislative bill):

http://www.azdhs.gov/azshare/documents/aed_statutes.pdf

It does a great job in shielding those that implement an AED program all the way to those that use it. Like I mentioned, that is why you can find them on street corners in the City of Sedona, Arizona and required by law in most State of Arizona public buildings. Don't you think that the lawyers paid to protect those governments feel confident in the Good Samaritan law? Not one case can be found in the USA where someone who used an AED in good faith was successfully sued or settled out of court, yet the books are full of public and private entities that were sued because an AED was NOT available. If you really want to dig in deep into the legalities and liabilities of this issue, here is a great presentation by a lawyer who was saved by a AED:

http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CCIQFjAA&url=http%3A%2F%2Fwww.citizencpr.com%2FResources%2F2014%2520Materials%2FPresentations%2FGood%2520Samaritan%2520Laws_The%2520Shocking%2520Truth.pptx&ei=UtrWVKnnNsy3ogSn_oGQDA&usg=AFQjCNHVmLh5kPzgsegyB-sEUU4r_b01dg&bvm=bv.85464276,d.cGU

HA, who would have thought any lawyer had a heart?!

Then there are the requirements for maintaining an AED. Yes, if someone doesn't do what is needed to keep the device in operating shape, they can be sued (as they should be). However, these requirements aren't rocket science. My Zoll AEDPlus self-checks itself at regular intervals and only requires human review once a month with a simple press of a button. Any electronic malfunction or dangerous battery decrease will be made evident with an alert. The pads and batteries last 5 years. This all falls under basic human responsibility with such an important project.

As for "kids shocking each other", HA, it is technically impossible. An AED will only defibrillate upon a narrow set of circumstances and cardiac rhythms. A normal heart rhythm or no heart rhythm at all will NOT generate action from the AED. In fact, I regularly demonstrate this by placing the pads on my chest and offer a one-hundred dollar bill to anyone that can zap me. Can the AED be stolen or otherwise vandalized? Sure. So can a fire extinguisher, but that doesn't stop the emergency device from being made publicly available.

Shocking someone who has a Do-Not-Resusitate order? Unfortunately this recently happened when a police officer resuscitated a man in a convenience store somewhere in Iowa. Did the survivor try to sue? Sadly, yes. Fortunately the case never even made it to a trial hearing because every state requires clear proof of a DNR to be clearly evident via documentation, a wrist bracelet, or other. Still, the Good Samaritan Law would have protected the rescuer if there was notification unless “willful negligence” could have been proven.

Finally, as for the poor guy who is too scared of loosing his hard earned fortune to help someone else and believe in the laws designed to protect him from liability, I am saddened that there is such ignorance and fear in the World. Thankfully for him, the majority of people are ready and willing to do what is needed in an emergency and very well may save his life one day.


Thanks,
Dr. Z.
LarryB13
(Arizona)

Posts:4099


02/07/2015 8:52 PM  
Posted By ZeighO1 on 02/07/2015 8:02 PM

Then there are the requirements for maintaining an AED. Yes, if someone doesn't do what is needed to keep the device in operating shape, they can be sued (as they should be). However, these requirements aren't rocket science. My Zoll AEDPlus self-checks itself at regular intervals and only requires human review once a month with a simple press of a button. Any electronic malfunction or dangerous battery decrease will be made evident with an alert. The pads and batteries last 5 years. This all falls under basic human responsibility with such an important project.




That is the strongest argument you could make AGAINST having one of these devices in the hands of an HOA or condo association. It is one more thing that will never get done and even the proponent says "they can be sued (as they should be)" if the device is not maintained. And the one thing that can be guaranteed is that an AED will not be maintained.

NpS
(Pennsylvania)

Posts:4064


02/07/2015 9:02 PM  
Posted By SkunT on 02/07/2015 6:41 PM
Posted By NpS on 02/07/2015 8:12 AM
I was a goner 3 years ago. Turned grey. Keeled over. Luckily there was an AED in the room. No one knew how to use it. They used it anyway. It kept me going til the EMTs got there. Got whacked 5 times that night to get my heart restarted. 2% chance of survival. In a coma for a week. Hospital had me on ice the entire time.

Now, every time I walk into a building, my eye automatically scans for an AED. I am seeing them more an more in places I never expected - like a grocery store.

The cool thing about the design of the AED is that there is no expectation that a person who tries to use it knows what to do. As soon as you open the case, a voice instructs you step by step what to do.

We do not have a common meeting place in our HOA, but if we did, I would recommend getting an AED. I would also recommend a CPR demonstration at a HOA meeting.

Our HOA insurance company recommends an AED in any HOA with a clubhouse, pool, etc. No effect on premiums.

I believe that every state has a good samaritan law that shields people who try to save a life from liability.

I think that you are right - your HOA lawyer is out of touch with the modern realities.


Well wouldn't that create a liability issue??? what if say the battery went bad all of a sudden someone attempts to revive someone and dead battery... You Bet that HOA is going to get sued which means everyone in the HOA will be civilly liable for the dead battery. Or say some kids breaks it out and thinks what the heck lets zap each other with it, or someone tries to use it but doesn't know the individual has a do not resuscitate wrist band and then sues the HOA for reviving him/her.

Oh and then what about Car wreck equipment to be used in case someone wrecks their car and needs extracted from it? Oh Boy the list of what if items a HOA needs will get ridiculously long.


Well, that's only part of my story Skun. A 78-year old man who himself was in feeble condition had watched a hands-only CPR video on TV just 2 weeks earlier. When he saw me go down, he jumped on me and did what he remembered from the video. People started yelling at him that he was doing CPR the wrong way - but he refused to get off me til the EMTs got there. Meanwhile, someone noticed the AED and started that working.

To you - the gears in your head are turning - and I'm sure you're thinking - aha, even more liability. But to me, the man who gave me CPR and the folks who shocked me with the AED are my heroes.

I have posted many times here that one of my biggest battles in my HOA is getting fellow board members to do the right thing without fear of litigation threats. And our record of only one lawsuit in over 15 years supports that thinking.

You on the other hand have posted that you enjoy the fact that there is a HOA, but somehow you section was excluded from the plat. And you are proud of the fact that the people in the HOA pay for common services that you use and you are quite comfortable being a free-rider at their expense.

I work very hard to protect everyone who lives in my HOA, including folks like you. Luckily, your negativity isn't shared by most contributors to their HOA organizations. Otherwise, we'd all be SOL.

Sikubali jukumu. Read all posts at your own risk.
TimB4
(Virginia)

Posts:17439


02/07/2015 11:16 PM  
I was taught an important lesson by a friend to owned a club that taught fencing (sport). His mindset was not based on how to keep from being sued. He expects to be sued at some point in time. Therefore, he takes steps to minimize his liability when he is sued.

I think that many individuals look at issues based on "how to we keep from being sued" vs. "how can we minimize our liability when we are sued." Living in the litigious society we live in, it may be prudent to think the latter, as we all know a good attorney will name everyone who may have any responsibility at all and let the courts work it out or simply hope the individuals settle vs. fight the issue (as it may be more cost effective).



As for AEDs, personally, if my Association had a clubhouse, pool or gym, I would look into the aspects of getting an AED.

Yes, I would gather a legal opinion concerning the Associations exposure to liability if we had one and if we chose not to have one. However, that would be only so I could be informed of the risks vs. benefits.

If we had one, I would encourage the Association to host training classes (by an outside certified instructor) in the use of the device on a regular basis (perhaps quarterly).

The key point is that having an AED may mean the difference between life and death.



Since you may be sued regardless of the outcome and regardless if you had an AED or not, perhaps it's best to ask how can the Association minimize their liability when they are sued if someone is injured and lives or injured and dies on Association property.


JanetB2
(Colorado)

Posts:4211


02/07/2015 11:57 PM  
Zeigh:

I am curious ... In neighboring town which has one as you stated on many street corners, if used does it potentially set an alarm off for local emergency responders? Has that city had any issues with vandalism of the units or kids violating use?

While my HOA does not have a clubhouse or pool area to potentially consider for our area I would be interested in the local government issues encountered. If I suddenly suffered a potential heart attack would I like one available close to me ... Yes. Would I hold anyone liable for using in an attempt to save my life ... No. I do not see much difference between someone not knowing proper CPR vs not knowing how to use a AED. If the machine does not work then they could revert to the age old CPR to best of their knowledge.

NpS
(Pennsylvania)

Posts:4064


02/08/2015 3:04 AM  
From the front page of the Sudden Cardiac Arrest Foundation website at http://www.sca-aware.org/

About Sudden Cardiac Arrest

Sudden cardiac arrest affects more than 1,000 people outside hospitals each day in the U.S. and only 10 percent survive. When bystanders provide CPR and use automated external defibrillators before EMS arrives, about 40 percent of victims survive. If the national survival rate increased to 40 percent, about 100,000 additional people could be saved each year.

-----------------

Deaths from sudden cardiac arrest are about 10x more frequent than deaths from breast cancer and about 11x more frequent than deaths from automobile accidents.

Motor vehicle deaths in the US peaked at around 55k in 1972 and are now down to around 34k per year. Seat belts were first introduced in cars in the mid-50s as an option. At the time, car manufacturers were afraid of the potential liability from admitting that cars could be unsafe. Under Fed law, seat belts became mandatory in 1968. The first state that made wearing a seat belt mandatory was NY in 1984. By 1995, all states had seat seat belt laws.

The fear of liability for having seat belts became a fear of liability for not having seat belts.

As AED technology progresses and people get past their fears, the AED and CPR tide will also turn. I agree with Tim that now is the time to learn what you can - it could save a life.


Sikubali jukumu. Read all posts at your own risk.
MelissaP1
(Alabama)

Posts:9988


02/08/2015 5:08 AM  
I am not against AED's and I am all for them. Think they are better than regular CPR methods. However, there are certain settings they are NOT appropriate for. Those are in public uncontrolled areas with no assigned role of responsibility. You can find them in an Airport or even your own company. However, that means they are accessible to trained personnel and under the responsibility of that company. I had to undergo training in my company when we acquired one and know it's location. It also has a flashing light on it when the battery gets low or needs attention. I even believe the fire department inspects them when they do the fire equipment.

Let me put it this way so you understand that this is an area of "Well intentions but not in the realm of reality". When I took CPR with the American Red Cross, the instructor was HUGE on having one of those "Mouth protectors" used for CPR. (Something everyone should have on their keychain). It's just a piece of plastic that covers the persons nose/mouth area with a breathing hole in the middle. It is recommended that when giving CPR one protects yourself from bodily fluid exchange. The person could throw up on you or even in your mouth. (Sorry to be gross and frank). If you do not have one, they say use a t-shirt or a paper towel to breath through protecting yourself during the breathing part.

This instructor flat out told everyone that if he did NOT have his "face guard" he would NOT apply CPR. He would let you die! Mind you he is a Paramedic and a trainer in first aid. This should speak VOLUMES when you hear a professional who does this for a living tell you this. Plus this is NOT the ONLY trainer who has ever advised this or I have talked to. My Brother was an EMT. So I am very familiar with first aid procedures and processes.

Having an AED does NOT save anyone's life unless it's applied. However, that all depends on training, the want to have one, and quite frankly ASSUMING everyone with access will use it. Which is too big of an ASSUMPTION to overcome to actually buy and maintain one.

Former HOA President
JohnB26


Posts:0


02/08/2015 5:54 AM  
LarryB13,


ZeighO1
(Arizona)

Posts:7


02/08/2015 7:22 AM  
Posted By JanetB2 on 02/07/2015 11:57 PM
Zeigh:

I am curious ... In neighboring town which has one as you stated on many street corners, if used does it potentially set an alarm off for local emergency responders? Has that city had any issues with vandalism of the units or kids violating use?

While my HOA does not have a clubhouse or pool area to potentially consider for our area I would be interested in the local government issues encountered. If I suddenly suffered a potential heart attack would I like one available close to me ... Yes. Would I hold anyone liable for using in an attempt to save my life ... No. I do not see much difference between someone not knowing proper CPR vs not knowing how to use a AED. If the machine does not work then they could revert to the age old CPR to best of their knowledge.





JanetB2,

Most public access boxes have audible and visual alarms that initiate as soon as the door opens. The kiosk that I have designed senses when the door is opened, when the unit is removed, and temperature. A small video camera also starts capturing the events when triggered. ALL of this data is immediately sent to a list of people via text and email.

Will is stop someone with less than honorable intentions? No. Has the City of Sedona, Arizona had an AED stolen? Yes. Still, this is too rare of an occurrence to halt the program in the face of such great benefit to the community.

As for how your local government would be involved, you are lucky to live in Colorado. There are several public access AED's across the state and 911 dispatching will alert callers to the closest one when needed. Here is a map of just a few:

http://startinghearts.org/map/colorado-aed-map/

There is also the City of Fort Collins, Colorado that has recently signed on with the PulsePoint project. That not only means that AED locations are right at your fingertips via a smartphone app, but that when someone goes down, a mass call for CPR and an AED being delivered to the patient is sent out to those average citizens willing to help. This is probably the best model to organize such emergency help so far.

Now, concerning AED use by someone that has never been trained, it really is easy. I start off all of my classes with someone having to use an AED on a manikin that has never touched one. In every demonstration, the person does almost exactly what is needed through the machines audio and visual prompts. The Zoll AEDPlus even coaches compression depth and cadence. Regardless, not all cardiac dysrhythmias are shockable, so CPR is still needed alongside an AED.


Thanks,
Dr. Z.
JohnB26


Posts:0


02/08/2015 7:25 AM  
Arizona AED Statute:

36-2262. Automated external defibrillators; use; requirements
Except as provided in section 36-2264, a person or entity that acquires an automated external defibrillator shall:
1. Enter into an agreement with a physician who shall oversee the aspects of public access to defibrillation.
2. Require each trained user who uses an automated external defibrillator on a person in cardiac arrest to call telephone number 911 as soon as possible.
3. Submit a written report to the bureau of emergency medical services and trauma systems in the department of health services within five working days after its use.
4. Ensure that the automated external defibrillator is maintained in good working order and tested according to the manufacturer's guidelines.



Limited CORPORATE 'shielding' unless meticulously maintained equipment.


Almost identical to South Carolina
KerryL1
(California)

Posts:7853


02/08/2015 1:24 PM  
We bought an AED for our twin high rise HOA of 211 units about 5 years ago. About 50% of our residents are 50+. There are two fire stations within 3 minutes o us, but what if they're both otherwise engaged?

We keep the AED in the guard kiosk at our vehicle entry gate that's staffed 24/7. The office will bring the AED to a condo, but they are not to try to use it. They are NOT trained and turnover is fairly high in that occupation. Our Board's attorney opined that it's better if residents know that they will use the device and not to rely on staff. Our PM is trained once a year, but, of course, as with any staff is not on the premises 24/7.

Resident are told to call the kiosk first to ask that the AED be brought to their condo. The resident next is instructed to call 911. The officer brings the AED to the unit's front door and prepares the elevators , ect,. for the EMTs' arrival & access.

We offer a "training" session once a year by a certified person, which is lightly attended. But as NpS and Dr. Z explain, the AED gives VERY simple voice commands that anyone can follow!

I don't recall the annual maintenance contract fee which is done per the below, but a majority of our Board agreed that if it saves just one life it's well worth the cost and the remote chance of liability.

So keeping an AED is a lot different here than in HOAs where access to it would be impossible or difficult.

The below is from davis-stirling.com, which is a site for CA HOAS complied by an HOA law firm. For those who like to poke around such sites, there are many useful tips that apply to HOAs across the county.


AEDs
"Because 80% of sudden cardiac arrests occur at home, the Food and Drug Administration decided in September 2004 that consumers could buy a device called an automated external defibrillator ("AED") to jump-start hearts.

BENEFITS. Sudden cardiac arrests are deadly because death can occur within minutes. Each minute that passes without defibrillation decreases the victim's survival chances by 10%. Ten minutes after the sudden cardiac arrest, the patient has a 1% chance of survival. If an electrical shock from an AED can be delivered within 5 minutes of a sudden cardiac arrest, there is a 50% survival rate. Even though ambulances can often arrive within 9 minutes of a 911 call, it is usually too late to save the victim. These statistics have given rise to requests by owners that boards purchase AEDs and train employees to use them. Boards, managers and attorneys have been cautious about the devices for fear of potential liability.

POTENTIAL LIABILITY. The purchase of AEDs by associations can create liability if the victim of a sudden cardiac arrest were to suffer brain damage or die because of alleged negligence by the association. Plaintiff's lawyers would likely claim the association induced their client to rely on the association's employees to save his life. They would allege that but for the inducements and the association's negligence their client would have taken other precautions to protect against a heart attack. The negligence alleged would probably include one or more of the following: (i) the association's employees were too slow to respond to the call for help, (ii) the association's employees failed to properly operate the AED and/or (iii) the AED malfunctioned because the association failed to properly maintain it.

LIMITED PROTECTIONS. As provided for in Civil Code §1714.21(b) organizations that use AEDs have immunity only if they comply with Health & Safety Code §1797.196, which requires that:

The AED be maintained and regularly tested.

The AED be checked for readiness after each use and at least once every 30 days if the AED has not been used in the preceding 30 days.

Any person who uses an AED contacts emergency personnel as soon as possible, and reports any use of the AED to a licensed physician and to the local emergency medical services agency.

For every AED unit acquired up to 5 units, no less than 1 employee per AED unit shall complete a training course in CPR and AED use.

There is a written plan that describes the procedures to be followed in the event of an emergency that may involve the use of an AED."

Read more: Defibrillator http://www.davis-stirling.com/tabid/1310/Default.aspx#ixzz3RBmgSk90
from Davis-Stirling.com by Adams Kessler PLC.
NpS
(Pennsylvania)

Posts:4064


02/08/2015 3:38 PM  
Thanks Kerry. How often have your AED's been used? What result?

Sikubali jukumu. Read all posts at your own risk.
JohnB26


Posts:0


02/08/2015 3:40 PM  
The resident next is instructed to call 911.


ABSOLELUTELY POSITIVELY ENEQUIVOCALLY WRONG

CALL 911 FIRST OR SIMULTANEOUSLY IF NOT ALONE
KerryL1
(California)

Posts:7853


02/09/2015 9:20 AM  
You are right, JohnB--I had it backwards! Always call 911 first! My apologies.

Our AED never has been used NpS, but many are very glad it is here. My understanding is that a few owners also keep one in their condos.
JohnB26


Posts:0


02/09/2015 12:29 PM  
ps.

there are MANY cardiac events where 'shocking' is NOT indicated

the AED will not 'shock' many conditions

however,

time may be spent AWAY from CR (yes, CR not CPR) because of the presence of an AED

it is a 'toss up' with great corporate RESPOSIBILITY and liability to have an AED
KerryL1
(California)

Posts:7853


02/09/2015 12:55 PM  
As I wrote above, JohnB, our board weighed the tiny chance of our HOA's possible liability vs. the tiny chance we might save one life. We opted for the latter.

As Dr. Z. teaches us and as our residents learn in our annual seminar (which includes CR training), the AED will not shock the person unless the device detects the "right" kind of cardiac event.

Sorry I can't stick with this exchange, there's a wrap or something and some replies spread out waaaaay too much.
JohnB26


Posts:0


02/15/2015 7:48 AM  
sorry, I have failed to communicate

the mere presence of an AED may detract from the application of CP unless there are additional responders

proper sequence of events:


CALL 911

Administer CP as per latest guidelines (not CPR, but CP)

Unless you have assistance trying to use the AED will detract from the CP - in many/some cases the AED will be of no help anyway as not all events are 'shockable'

If it's an 'unshockable' event you have wasted valuable CP time attempting use of the AED

The IMPORTANT thing is CONTINUOUS CP UNTIL HELP ARRIVES


just my somewhat informed opinion as a trained CERT member and ex industrial fire brigade member (who maintains certifications on an annual basis)

ps. CERT = civilian emergency response team (training through FEMA)
JohnB26


Posts:0


02/15/2015 7:49 AM  
typo; CP should read CR
ZeighO1
(Arizona)

Posts:7


02/15/2015 10:38 AM  
Posted By JohnB26 on 02/15/2015 7:48 AM
sorry, I have failed to communicate

the mere presence of an AED may detract from the application of CP unless there are additional responders

proper sequence of events:


CALL 911

Administer CP as per latest guidelines (not CPR, but CP)

Unless you have assistance trying to use the AED will detract from the CP - in many/some cases the AED will be of no help anyway as not all events are 'shockable'

If it's an 'unshockable' event you have wasted valuable CP time attempting use of the AED

The IMPORTANT thing is CONTINUOUS CP UNTIL HELP ARRIVES


just my somewhat informed opinion as a trained CERT member and ex industrial fire brigade member (who maintains certifications on an annual basis)

ps. CERT = civilian emergency response team (training through FEMA)





The question of whether CPR or and AED should be applied first when there is only one layperson rescuer is a hotly debated topic among doctors and other emergency medicine healthcare providers. I highly suspect that the American Heart Association (AHA) will officially answer this question in their next national conference. In the meantime, let's not forget the scientific facts:

- Compression-only CPR (or CR, as you call it) is not as effective as traditional CPR with compressions and ventilations. It was only approved by the AHA in 2010 as a way to get more bystandards involved in helping patients.

- Even the most effectively rendered CPR only mimics a fraction of what the human heart does on it's own. It is essentially a bandaid until more advanced emergency medical procedures are available. An AED is one of those procedures.

- Ventricular Fibrillation and Ventricular Tachycardia (both conditions where the heart just quivers and does not effectively pump blood) are present in 68% of cardiac arrests and respond the best to defibrillation. With the rare effect of a precardial thump (what one might dramatically see on TV) upon a witnessed cardiac arrest, no amount of CPR will change the course of the cardiac rhythms mentioned.

- Defibrillation remains the most effective treatment in cardiac arrest whether in the hospital or on the street.

- National standards in Advanced Cardiac Life Support (ACLS, what is taught to professional healthcare providers) dictate that a witnessed cardiac arrest be immediately treated by determining the underlying cardiac rhythm and defibrillation if warranted as quickly as possible. CPR should be started also, but never delay the task of defibrillation. The longer defibrillation is withheld, the less of a chance that it may be effective.

My experience and knowledge come from 27 years in the field as a firefighter/paramedic, teaching paramedic students, AHA CPR Instructor, and AHA ACLS Instructor. So, until it is officially addressed by those allot smarter than I, my strong recommendation is to NEVER delay the application of an AED in a patient without a pulse.


Thanks,
Dr. Z.
JohnB26


Posts:0


02/15/2015 12:49 PM  
The question of whether CPR or and AED should be applied first when there is only one layperson rescuer is a hotly debated topic among doctors and other emergency medicine healthcare providers.


Until it actually is answered the assumption of corporate risk by an HOA is unwarranted for the very slim potential benefits.

The main benefit of an AED in a HOPA community run by senior volunteers would be the good feeling of having the device visible. IMO: It will never be properly maintained including pads.

Its presence WILL delay / interrupt the 'band aid' of CPR / CR.

If I were alone and responding I would dial 911, put the phone on speaker, check/clear air way (in case of actual revival) and start 'pumping' rhythmically until I dropped from exhaustion or help arrived.

Pray that I am your first responder (unless an ambulance gets there first) as you WILL have cracked ribs and you WILL have some actual heart compression.

Some compression is way way better than wasted time with an improperly maintained / inoperative AED, which is what a typical HOA will have on hand after a few months or years.

However: Are you saying that, in your opinion, the time spent trying an AED which may be 50/50 operative is worth the 'shot' even if it delays actual CPR/CR ?

ZeighO1
(Arizona)

Posts:7


02/15/2015 1:56 PM  
Posted By JohnB26 on 02/15/2015 12:49 PM


However: Are you saying that, in your opinion, the time spent trying an AED which may be 50/50 operative is worth the 'shot' even if it delays actual CPR/CR ?






Yes I am...

As mentioned, CPR is merely a bandaid until defibrillation is available, which is the main treatment that cardiac arrest is in dire need of. This if further recognized in ACLS standards. The fact that professional healthcare providers are hardly ever alone and/or rarely have to choose between CPR or an AED as the first task further complicates this discussion in the same situations for laypersons. Still, timing my Zoll AEDPlus to initiate the first shock took 24 seconds from the time that it was turned on (pads were applied to the simulator as the unit marched through the preliminary steps). This is hardly any time "lost" in the grand scheme of the event and the benefits often rapidly diminish the need for further CPR 68% of the time with a revived heart taking over.

Now, concerning whether an AED is operative or not, that should never be an issue if they are maintained per the guidelines and another debate altogether. Not applying an AED as the first step because it "might not work" is like firefighters running to a call instead of driving there in a fire engine, just because the vehicle might not start. Logic dictates that one should attempt the most effective solution to a problem first before resorting to alternatives.


Thanks,
Dr. Z.
JohnB26


Posts:0


02/15/2015 4:01 PM  
OK, I accept that the AED should be the primary response (if available) after calling 911.

In an ideal world the AED would be properly maintained and operative when accessed.

However, in the corporate never-never-land of self managed HOAs I believe that the proper maintenance would, at best, be a 50:50 bet.

Therefor, IMO, it is problematic for a HOA to institute an AED program.

BODs change over and over and continuity of contracts and maintenance procedures are NOT assured (or even probable).

So the AED is likely to simply sit, unmaintained, in its' 'wall box' gathering dust.

I still think the AED sign will merely give a false sense of security.

Dr. Z: If I, myself, were to reach you as a solo first responder (after calling 911) would you, personally, want me to go for aggressive CR or the AED ? (personally)



JohnB26


Posts:0


02/15/2015 4:05 PM  
My responses are based on the OP's original ?

In my 55+ "circling the grave" HOA there is NO continuity or "planning".

We can't even manage to keep up with changing light bulbs in the clubhouse.


HURRAH FOR HOMO SAPIENS
NpS
(Pennsylvania)

Posts:4064


02/15/2015 4:40 PM  
Posted By JohnB26 on 02/15/2015 4:01 PM
So the AED is likely to simply sit, unmaintained, in its' 'wall box' gathering dust.

I still think the AED sign will merely give a false sense of security.


Just like that dusty old fire extinguisher that some HOAs have in the clubhouse and others avoid like the plague because it could create liability.

Sikubali jukumu. Read all posts at your own risk.
JohnB26


Posts:0


02/15/2015 5:55 PM  
The dusty old fire extinguisher may still work and is probably REQUIRED.

The dusty old AED will NOT and is optional.

Either case is a legal liability for the CORPORATION.

TimB4
(Virginia)

Posts:17439


02/15/2015 6:07 PM  
Liability or not, I would like to think that if I needed an AED to save my life that one would be available when I needed it.

NpS
(Pennsylvania)

Posts:4064


02/15/2015 6:37 PM  
Posted By JohnB26 on 02/15/2015 5:55 PM
The dusty old fire extinguisher may still work and is probably REQUIRED.

The dusty old AED will NOT and is optional.

Either case is a legal liability for the CORPORATION.


Thanks for making my point John. It's all just a matter of time as society accepts this new technology and recognizes that the safety elements outweigh the liability. Perhaps through better manufacturing technology. Perhaps through better education. Perhaps through more saved lives like my own. The acceptance factor is growing - which is probably the same way that fire extinguishers got accepted and ultimately regulated.

I think that Dr Z has done us all a great service by shedding some light on the topic and opening up the conversation.

Sikubali jukumu. Read all posts at your own risk.
JohnB26


Posts:0


02/16/2015 7:20 AM  
JohnB26


Posts:0


02/16/2015 2:49 PM  
I simply adore the Socratic Method.

My personal touch includes sarcasm.

JohnB26


Posts:0


02/19/2015 7:33 AM  
p.s.

Dr. Z: If I, myself, were to reach you as a solo first responder (after calling 911) would you, personally, want me to go for aggressive CR or the AED ? (personally)



no reply to date

NpS
(Pennsylvania)

Posts:4064


02/19/2015 8:04 AM  
Posted By JohnB26 on 02/16/2015 2:49 PM
My personal touch includes sarcasm.

Hadn't noticed. Maybe you should amp it up.

Sikubali jukumu. Read all posts at your own risk.
JohnB26


Posts:0


02/19/2015 10:28 AM  
?MOI?
ZeighO1
(Arizona)

Posts:7


02/19/2015 10:54 AM  
I believe that I answered your question on 2/15/15...

The standard of the care of professional EMS does not specifically address what one rescuer is to apply first in coming upon a cardiac arrest. However, there is strong indication and science that applying an AED first is the most efficient use of time and resources. This is what I train my first responders with and what I would want done on myself, should I be the patient.


Thanks,
Dr. Z.
JohnB26


Posts:0


02/19/2015 1:36 PM  
I agree

PROVIDING

that there is a reasonable probability of the AED being in a functional state.

In the sense of this post, I believe that the typical volunteer operated 55+ (HOPA) HOA would NOT properly maintain said AED, nor get rid of it after it self tests and alarms (assuming anyone actually paid attention).

IMO:

There is a 50/50 chance that it would sit dead in its' wall box after 2 or more years of well intentioned 'feel good'.

Then, while the INDIVIDUAL would face no liability for its' attempted use, the CORPORATION would be 'on the hook' for big bucks.

There is no 'corporate shield' unless proper procedure was followed TO THE LETTER.

? How many dead battery operated smoke detectors are there ?

Even though they 'beep' for days before going dead !


ERGO: The legal risk for the typical HOA is too great








The horse is now long dead - probably needed an AED.
KerryL1
(California)

Posts:7853


02/19/2015 3:30 PM  
Recall, JohnB, that my HOA and I'm certain hundreds of other including all of my neighboring high rises have an AED on the premise. Like my HOA we all have contracts for regular required .maintenance.

Perhaps it's different elsewhere, but our 55 y.o+ and al residents can easily understand the simple vocal instructions. Perhaps your HOA has a different demographic. Please don't paint all AED Owners with the same brush.
NpS
(Pennsylvania)

Posts:4064


02/19/2015 6:29 PM  
Posted By JohnB26 on 02/19/2015 1:36 PM
The horse is now long dead - probably needed an AED.

I'd be shocked if you didn't say something like that John.

Sikubali jukumu. Read all posts at your own risk.
JohnB26


Posts:0


02/20/2015 6:56 AM  
I'd be shocked......



EXCELLENT

NpS
(Pennsylvania)

Posts:4064


02/20/2015 7:09 AM  
Posted By JohnB26 on 02/20/2015 6:56 AM
I'd be shocked......



EXCELLENT



Knew you would appreciate it.

Sikubali jukumu. Read all posts at your own risk.
JohnB26


Posts:0


02/20/2015 2:01 PM  
on a serious note:

The standard of the care of professional EMS does not specifically address what one rescuer is to apply first in coming upon a cardiac arrest.



Welcome to 'Brave New World'

love is hate
war is peace
AED first, unless ......................


Proper CR involves HUGE effort to be effective. Effort leading to rib cage injury.

(unless performed on an infant/child)
BonnieG1
(Nebraska)

Posts:1186


02/21/2015 7:59 PM  
Posted By KerryL1 on 02/19/2015 3:30 PM
Recall, JohnB, that my HOA and I'm certain hundreds of other including all of my neighboring high rises have an AED on the premise. Like my HOA we all have contracts for regular required .maintenance.

Perhaps it's different elsewhere, but our 55 y.o+ and al residents can easily understand the simple vocal instructions. Perhaps your HOA has a different demographic. Please don't paint all AED Owners with the same brush.




One of the many ballot items our previous President had us vote for last year was purchasing an AED for our senior community. It was the only item that was voted down. (Not counting items that should have been billed as amendment to our documents). Many of our seniors have a DNR order. and did not want any an AED on site.
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