VANDENBERG AFB PUBLIC ACCESS DEFIBRILLATION (PAD). This instruction establishes the Vandenberg Air Force Base Public Access Defibrillation (PAD) Program and.Safety and Health Information Bulletins. U. S. Department of Labor. Occupational Safety and Health Administration Printer Friendly Version. Cardiac Arrest and Automated External Defibrillators (AEDs)Technical Information Bulletin. TIB 0. 1- 1. 2- 1. This TIB is not a new standard or regulation and it creates no new legal obligations. It is advisory in nature, informational in content, and is intended to assist employers in providing a safe and healthful workplace. OSHA's Directorate of Technical Support (DTS) issues Technical Information Bulletins (TIBs) to provide information about occupational hazards and /or to provide information about noteworthy, innovative, or specialized procedures, practices and research that relate to occupational safety and health. DTS selects topics for TIBs from recognized scientific, industrial hygiene, labor, industry, engineering, and/or medical sources.
The Occupational Safety and Health Act requires employers to comply with hazard- specific safety and health standards. In addition, employers must provide their employees with a workplace free from recognized hazards likely to cause death or serious physical harm under Section 5(a)(1), the General Duty Clause of the Act. Employers can be cited for violating the General Duty Clause if there is a recognized hazard and they do not take appropriate steps to prevent or abate the hazard. However, the failure to implement TIB recommendations is not, in itself, a violation of the General Duty Clause. Citations can only be based on standards, regulations, and the General Duty Clause. Further information about this bulletin may be obtained by contacting OSHA's Directorate of Technical Support and Emergency Management (formerly Directorate of Technical Support) at 2. Purpose To inform employers about the use of automated external defibrillators (AEDs), a life- saving technology, in the treatment of cardiac arrest at work. To provide an information resource to aid in decision- making about these devices at individual worksites. Background. Sixty- one million Americans have cardiovascular disease, resulting in approximately 1 million deaths per year. One- third of these deaths (3. Survival rates for out- of- hospital cardiac arrest are only 1 to 5 percent. Public Access Defibrillation. SAMPLE AED PROCEDURE SAMPLE AED PROCEDURE. Administration (GSA) have worked collaboratively to develop the following guidelines, entitled ``Guidelines for Public Access Defibrillation Programs in Federal Facilities.'' Theses guidelines were prepared. Most often cardiac arrest is due to chaotic beating of the heart (ventricular fibrillation), which can be restored to a normal rhythm if treated early with electric shock (defibrillation). Treatment of witnessed ventricular fibrillation with immediate defibrillation can result in greater than 9. With each minute of delay in defibrillation, nearly 1. In June 1. 99. 9, Chicago's O'Hare and Midway Airports installed automated external defibrillators (AEDs) to respond in 1 minute to cardiac arrest. In the first 1. 0 months, 1. Description of Hazard. In 1. 99. 9 and 2. OSHA were due to sudden cardiac arrest. Work factors that may aggravate or contribute to cardiovascular disease are carbon monoxide, carbon disulfide, halogenated hydrocarbons, smoking, extreme heat or cold, stress, and shift work. Electrical hazards may produce cardiac arrest (ventricular fibrillation). Exposure to noise, lead, or arsenic may produce high blood pressure, increasing the risk for heart disease. AED Use. Use of automated external defibrillators began in the 1. Defibrillation is just one part of the treatment which also includes calling for emergency medical service assistance, cardiopulmonary resuscitation, and for the administration of medications and other life support measures. Early defibrillation, however, is the most critical of all the steps because it is definitive therapy for ventricular fibrillation. AEDs cost between $3,0. The past decade has seen advances in miniaturization and improvement in their reliability and safety. The AED is lightweight, runs on rechargeable batteries, analyzes the heart rhythm, and automatically indicates when to shock. These developments have markedly reduced response time and minimized the need for training. In a study of mock cardiac arrest, the mean time to defibrillation was 6. Many communities have trained first responders (police and firefighters) to use AEDs. Recognizing the need for faster response, the American Heart Association (AHA) has proposed public access defibrillation (PAD), a program that places AEDs close to the victim (in public places) and uses trained lay personnel for defibrillation. Specifically, the program should be designed to reduce the time to defibrillation to no more than 3- 5 minutes. Using this program, a study of cardiac arrest in casinos found that defibrillation by a trained security officer within the first 3 minutes produced a 7. Another study assessing survival for airline passengers with cardiac arrest found that 9. In both instances, cardiac arrest victims could be readily observed and treatment initiated almost immediately. Research on AEDs is ongoing. To determine if trained lay persons are as effective as trained emergency medical service personnel, the National Heart, Lung, and Blood Institute of the National Institutes of Health initiated a study in August 2. The study will also look at whether it is realistic and cost- effective to train a large number of people to use these devices. The Department of Health and Human Services and the General Service Administration published Guidelines for Public Access Defibrillation Programs in Federal Facilities following passage of Public Law 1. November 1. 3, 2. Public Health Improvement Act. The Act authorized placement of AEDs in federal buildings and provided immunity from civil liability for anyone using an AED in a federal building. Several states have adopted legislation that allows a layperson to use an AED and provides legal immunity for proper use. The American College of Occupational and Environmental Medicine, the professional association representing occupational physicians, has issued guidelines for establishing and managing a workplace AED program. Conclusions. The sooner defibrillation is started, the more likely the victim will survive. The optimum time for defibrillation is 3 to 5 minutes after the onset of the cardiac arrest. The AED is a safe, effective, easily learned method of treating victims of cardiac arrest. Recommendations. About 4. OSHA annually. Assuming an average time to defibrillation of 5 minutes would produce a 4. Employers should consider use of AEDs at their worksites to reduce the time to defibrillation with the goal of improving survival. Consult the American Heart Association (http: //www. Cpr. ACOEM Guideline Automated External Defibrillation in the Occupational Setting . Heart and Stroke Statistical Update. Dallas, Texas: American Heart Association, 2. American Heart Association. National Institute for Occupational Safety and Health. Occupational Heart Disease. Guidelines for Public Access Defibrillation Programs in Federal Facilities. Groeneveld P. W., Kwong J. L., Yeuyi L. 2. 86: 1. Gundry J. W., Comess K. A., et al. 1. 00: 1. Marenco J. P., Wang P. J., et al. 2. 85: 1. NIH News Release. National Institutes of Health. National Heart, Lung, and Blood Institute. Use of automated external defibrillators by a US airline. Public Health Improvement Act. Rom, ed: Environmental and Occupational Medicine, Philadelphia: Lippincott- Raven Publishers, 1. Takata T. S., Page R. L., Joglar J. A. 1. Valenzuela T. D., Roe D. J., et al. 3. 43: 1. Zipes D. P, Wellens H. J. J. 9. 8: 2. 33. Accessibility Assistance: Contact OSHA's Directorate of Technical Support and Emergency Management at (2. PDF materials. All other documents, that are not PDF materials or formatted for the web, are available as Microsoft Office. If additional assistance is needed with reading, reviewing or accessing these documents or any figures and illustrations, please also contact OSHA's Directorate of Technical Support and Emergency Management at (2. Books - EPUB is the most common format for e- Books. If you use a Sony Reader, a Nook, or an i. Pad you can download the EPUB file format. 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