1. Encouraging or Requiring Community Access and Use
Updated: July 2008 - Each year, more than 250,000 Americans die from sudden cardiac arrest. According to medical experts, the key to survival is timely initiation of a "chain of survival", including CPR (cardiopulmonary resuscitation). Because of recent technological advances a portable lifesaving device, called an "automated external defibrillator" or "AED" has recently become an important medical tool. Trained non-medical personnel can use these simplified electronic machines to treat a person in cardiac arrest. The AED device "guides the user through the process by audible or visual prompts without requiring any discretion or judgment."1 The American Heart Association notes that at least 20,000 lives could be saved annually by prompt use of AEDs. Ultimately, with broad deployment of AEDs among trained responders, as many as 50,000 deaths due to sudden cardiac arrest could be prevented each year.
Advocates of this approach envision placement of AEDs in public buildings, transportation centers and even large offices and apartment buildings. Meanwhile, the commercial market has expanded substantially, with machines that once sold for $3,000 and up now advertised at under $1,000 for small office, personal or home use.
State Legislators have become actively involved with this issue in the past six years. Most commonly, the recent state laws encourage broader availability, rather than creating new regulatory restrictions.
Most of the bills enacted from 1997 to 2001 included one or more provisions to:
- Establish legislative intent that an "automatic external defibrillator may be used by any person for the purpose of saving the life of another person in cardiac arrest."
- Encourage or require training in the use of AED devices by potential users.
- Require AED devices to be maintained and tested to manufacturer's standards.
- Create a registry of the location of all such defibrillators, or notification of a local emergency medical authority.
- Allow a "Good Samaritan" exemption from liability for any individual who renders emergency treatment with a defibrillator.
- Authorize a state agency to establish more detailed requirements for training and registration.
Florida was the first state to enact such a broad public access law in April 1997 (Chapter 34 of 1997). As of 2001, all fifty states, listed below, had enacted defibrillator laws or adopted regulations.
In 2002, Arizona, California, New Hampshire and New York enacted legislation, all amending existing provisions concerning the regulation of automated external defibrillators. Arizona enacted a measure that will require any state building constructed or renovated at a cost of at least $250,000 to be equipped with automated external defibrillators. SB 1070 requires that the Joint Legislative Budget Committee and the Governor's Office of Strategic Planning and Budgeting should include funding for the placement of automated external defibrillators in capital budgets for new state buildings each fiscal year. The provisions in the act become effective after June 30, 2003. New York legislators enacted new requirements for public school facilities with more than 1000 persons to provide and maintain on-site AED equipment. AB 8779 of 2002 requires that all school sponsored activities have at least one staff person who has been trained in the use of the device present.
In 2003, Utah updated its AED law by establishing a statewide registry; while Virginia updated AED laws by deleting the requirement for registration. Alabama, Alaska, Colorado, Connecticut, Indiana, Kansas, Nebraska, Nevada, Tennessee and Texas also changed or expanded their AED laws.
In 2004 AED laws were changed or expanded in Connecticut, Florida, Hawaii, Idaho, Illinois, Louisiana, Maine, Michigan, Missouri, New York, Ohio, Oklahoma and Rhode Island. The Illinois law (H. 4232) requires every physical fitness facility to have at least one AED on premises, by mid-July 2006, with exceptions.
In 2005-06, Maryland added a requirement that every high school and school-sponsored athletic events have an AED available. California required health clubs to have at least one AED. Florida authorized state and local police vehicles to carry an AED. Indiana and Virginia repealed filing and training requirements. New York required places of public assembly to maintain an AED. Oregon updated Good Samaritan protection for trained AED providers, employers, property-owners and sponsoring agencies. Arizona, Colorado, Florida, Illinois, Maryland, Massachusetts, Nebraska, New Jersey, Pennsylvania, and Wisconsin also enacted AED laws.
In 2007, Texas added a requirement for AEDs not approved for over-the-counter sales.
2008, laws were enacted in Georgia, Idaho, Illinois, Indiana, Iowa, New Hampshire, South Carolina, Tennessee, West Virginia, Wisconsin and the District of Columbia (as of July 8, 2008).
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2. AED Location & States Requiring or Supporting AED Placement
Schools
Colorado (donations), Florida, Georgia (2008), Illinois, Maryland, Michigan, Nevada, New York, Ohio, Pennsylvania, South Carolina (2008) and Virginia require some schools to have portable defibrillators; actual extent varies. Tennessee "encourages" placement in schools (2008.)
Health Clubs
California, Illinois, Indiana (2008), Massachusetts (2007), Michigan, New Jersey, New York, Rhode Island and the District of Columbia (2008) laws now require health clubs to have at least one AED.
Definition example: (Michigan) "Health Club" means an establishment that provides, as its primary purpose, services or facilities that are purported to assist patrons in physical exercise, in weight control, or in figure development, including, but not limited to, a fitness center, studio, salon, or club. A health club does not include a hotel or motel that provides physical fitness equipment or activities, an organization solely offering training or facilities for an individual sport, or a weight reduction center.
Day Care Centers
Wisconsin (2008) requires dentists and day care center personnel to have AED proficiency.
In Places of Public Assembly
New York (2006)
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3. Congress Acts on AEDs
In 2002, Congress incorporated the Community Access to Emergency Devices Act (Community AED Act) into H.R. 3448 (sections 159, 312 and 313) of the Public Health Security and Bioterrorism Response Act. The President signed the bill on June 12, 2002 as Public Law 107-188. The provisions authorize $30 million in federal grants in year one of the five-year measure. The grants, to be made available to applying states and localities, would be used for the purchase and placement of automated external defibrillators (AEDs) in public places where cardiac arrests are likely to occur. Grant funds would also be used to train first responders to administer immediate life-saving care, including AED use and cardiopulmonary resuscitation (CPR). The bill also encourages private companies to purchase AEDs and to train employees in CPR and emergency defibrillation.
To see if your state has enacted AED Legislation. Click here
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