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The Cardiac Arrest Survival Act and the Rural Access to Emergency Devices Act, as components of the federal Public Health Improvement Act of 2000, as well as Good Samaritan laws passed in 47 states, expand Good Samaritan legal protections to users of AEDs throughout the nation. The placement of AEDs in selected locations for immediate use by trained laypersons may be the key intervention to significantly increase survival from an out-of-hospital cardiac arrest.
The chain of survival includes a series of actions designed to reduce mortality associated with cardiac arrest and includes the following links: a) early recognition of cardiopulmonary arrest; b) early CPR; c) early defibrillation when indicated; and d) early advanced cardiac life support care. Well-trained health/fitness facility staff members are essential to maintain strong links in the chain of survival for their clients.
Effective placement and use of AEDs at all health/fitness facilities is encouraged, as permitted by law, to achieve the goal of minimizing the time between recognition of cardiac arrest and successful defibrillation. Until further definitive data are available, AED placement is strongly encouraged in those health/ fitness facilities with a large number of members (i.e., membership less than 2,500); those that offer special programs to clinical populations (i.e., programs for the elderly or those with medical conditions); and those health/ fitness facilities in which the time from the recognition of cardiac arrest until the first shock is delivered by emergency medical services is anticipated to be greater than five minutes. In unsupervised exercise rooms, such as those that might be located in hotels, apartment complexes or office buildings, the AED should be part of the overall PAD plan for the host facility.
Health/fitness facilities should coordinate their PAD program with the local EMS. Emergency drills should be practiced at least once every three months or more often when staff changes occur. PAD programs must comply with local or regional regulation and legislation.