Office shocker Featured

6:18am EDT May 30, 2003
It used to be that smelling salts were the most powerful thing in any first aid kit. But those days are over.

With advances in technology and increased awareness of sudden cardiac arrest mortality rates, some companies are going well beyond stocking a bottle of aspirin and an Ace bandage. They're providing automated external defibrillators (AEDs).

"Companies are concerned with emergency medical preparedness," says Patty Owens, marketing and communication manager at Complient Corp., which installs public defibrillators and sets up emergency response systems. "It's not just AEDs, you want to be prepared for anything if someone goes down."

Sixty-one million Americans have cardiovascular disease, resulting in approximately 1 million deaths each year. One-third of these deaths are due to cardiac arrest -- the sudden and unexpected loss of heart function. And survival rates for out-of-hospital incidents of sudden cardiac arrest are only 1 percent to 5 percent.

The AEDs available to the public administer an electric shock through the chest wall to the heart and have built-in computers to assess the patient's heart rhythm and determine whether defibrillation is needed. With audio and visual prompts to guide the user through the process, a few hours of training can ready an employee to use the device.

AEDs are gaining in popularity, especially with transportation companies and in places where the public gathers.

"We see a trend where public casinos, Amtrak and airlines are stocking AEDs," Owens says.

AEDs are definitely costlier than a first aid kit -- approximately $3,000 to $4,500 with maintenance and instruction --- but with approximately 400 workplace deaths attributed to sudden cardiac arrest each year, and with heart disease on the rise, more and more companies are considering installation.

For many employers, it's not only a public health issue but a risk management issue as well.

"It's a liability issue," Owens says. "We live in a litigious society."

Of course it is not as simple as just hanging an AED by the reception desk. In many states, including Ohio, the apparatus requires a prescription, not to mention staff training, maintenance and proper placement in compliance with a total emergency plan.

And large offices may require multiple, strategically placed AEDs.

"The drop to shock ratio, as we call it, is three to five minutes. After that, you have significant brain [function] loss," Owens says.

As usual, the federal government is on the forefront, stocking federal buildings and offices with AEDs. Also, the Public Improvement Act of 2000 provides immunity from civil liability for anyone using a defibrillator in a federal building. And Good Samaritan laws cover those using AEDs in other buildings.

"Ohio, like most states, requires training," Owens says. "We try to train at least 10 people in an office per AED, but some companies want everyone trained."

With an average EMT response time of eight to 11 minutes, and the survival rate of someone suffering from sudden cardiac arrest decreasing 7 percent to 10 percent with every minute that passes, Owens stresses the need for companies to be prepared for the worst.

"There are no laws yet requiring AEDs," she says. "But unless you work next door to a fire station, there's a always a risk." How to reach: Complient Corp., (800) 757-2929 or

Blame game

Who is to blame for the ever-growing surge in health care costs? Just about everyone, according to a survey conducted by the Managed Care Information Center (MCIC).

MCIC received almost 100 responses to the question, "Who is to blame for soaring health care costs?"

Respondents included consulting firms, 39.6 percent; managed care organizations, 20.8 percent; other health care providers, 15.6 percent; physician organizations (independent practice associations, physician practice management companies, physician organizations, management services organizations), 11.5 percent; and hospitals/medical centers, 10.4 percent.

For the most part, respondents in each category placed the blame on a variety of factors rather than on any one cause. Consultants faulted consumers and managed care plans frequently, while MCOs tended to blame doctors, drug companies and hospitals.

According to the survey, the five top culprits in rising health care costs are:

* Consumers -- 12.5 percent

* Physicians -- 10.4 percent

* Drug costs, pharmaceutical companies -- 8.3 percent

* Everyone -- 7.29 percent

* Government -- 5.2 percent

Other culprits named included an aging population, health maintenance organizations, inefficient hospital management, high liability insurance, expensive technology, lawyers, poor reimbursements, the Health Insurance Portability and Accountability Act (HIPAA), drug manufacturers and drug company advertising costs. Source: Managed Care Information Center, (888) 843-6242.