Evening Ladies and Gents,

The thread Doug started and Scafool's comment has sent me wondering down an ADD side road.

Many of you have heard I will be re-entering the wireless infrastructure industry soon (if someone will tell which cardinal point on the compass to follow).

Said line of work often leads me to be well and truly out in the boonies far from EMS help. This line of work might not be as dangerous as Alaskan crab fishing, but I have seen more than my share of grievous injuries, and sadly, several fatalities.

Considering the afore mentioned risks, my FAK is generally well stocked and I always wish I had more training.

I wish for (and will be getting) AED training out of my own pocket. Having looked at the price of a new AED I see a small problem, my budget. Next as I was shopping, I found refurbished AEDs. Now this brings to mind refurbished parachutes, not something I would want normally. (Unless the aircraft was NOT functioning as advertised and that was all that was available.)

Now for the questions:

1) Does anyone have experience with refurb AED's?
2) Any specific manufacturer better than the rest?
3) Is a vehicle mounted/charged (12VDC) option available?
4) Is a refurb AED like the refurb parachute, better than nothing?
5) If purchased new, what is the life cycle on something like this?
6) How often / how expensive is re-calibration?
7) How long is training?
8) What legal mess am I opening up?
9) Anything I missed?

Keep in mind, I will be purchasing this on my own dime if I do.

Since AED's are medical devices, regulated by the FDA, I assume there are fairly stringent requirements on any authorized refurbs, so functionally, it should be as dependable as a new one and I would personally trust it. I would never purchase a used AED that hadn't been sent back to the manufacturer, for liability reasons on the job, if nothing else. Do these refurb units you found explain who did the refurb?

Someone with actual EMS experience could chime in here, but since you'll be out in the boonies, time will still be a factor since people whose hearts have been shocked back into normal rhythm often require more advanced care within a short time to stabilize their condition. An AED can resolve certain conditions that you can't deal with otherwise, but it's not the end-all-be-all for all cardiac emergencies.

I had my first AED training last year and it's not burdensome. It was part of my first aid + CPR class. Kind of interesting actually, since I had never seen what is inside the unit. Hooking up all the cables to your new flat screen TV is far more complicated than using an AED. I think all AED's have some sort of voice or text prompt to guide you through the process so the hardest part is knowing how to open and apply the electrodes quickly and properly and familiarizing you with the general process the AED goes through so you know what the prompts are referring to.

The legal angle is a crap shoot, if you ask me. But you're doing it with the best of intentions and if you get training, then it seems like you would be OK. Even if the person dies, it's unlikely that waiting an hour for EMS with no AED would have turned out any differently. But who knows? Anything you do on company time potentially opens them up to liability and if you aren't provided an AED by the company, maybe that can be twisted into some sort of maverick act by a lawyer. Good luck with this!

I think you'll find that you'll need some sort of medical control in place. If that's the case, the rest is moot.

If you do it anyway, I can only imagine the liability you'd be facing if something were to go wrong.

The Chicago Fire Dept. was recently successfully sued when one of their AED's failed due to a dead battery, $3.2 million. If you were to have an AED out in the field and you attempted to use it on another person only to have it fail due to maintenance issues, well it doesn't take a lot of imagination to see what could happen.

I'd check with the state health dept. wherever you'd be using the device before making any purchases.

Having said all that, the one I have on hand for my job is nice, an Allheart model. It uses a non-rechargeable battery that's good for quite a few months of storage. The pads are datestamped and must be replaced regularly.

I knew this was not going to be as easy as I thought.

I am a bit embarrassed now.
I looked in the Alberta OHSA regs and didn't see any requirement for AED.
Not even on remote site employing more than 200 people.
It might not be in the regulation or I maybe I am just not reading the list right.
Where I do see them the most is in offices and public buildings that have large numbers of people like malls and colleges.
They have become quite common there.

They are not usually considered part of a mobile kit because they like plugging them in to keep the batteries charged.

Getting the certificate is still good. If you ask the safety officer he will be able to tell you if they supply them on your site.

I think, but don't quote me, that there are 'plug in' models. Though all the ones I've seen have 5-year lithium batteries.

No idea about refurbishes.

They're supposed to be checked daily, and theoretically run through an internal QA during the check. So theoretically there's no external calibration needed.

Training???? You don't need it - push the button that says start and follow the voice prompts.

The big thing with them is the pads have a shelf life. And even in that shelf life, you probably need extra. We went through 2 pairs on a 10 minute ambulance ride after the first pair literally burned through and developed a hole after repeated shocks.

Don't think that they're the be-all&end-all. In something like a trauma, they're not going to be much use (ie, you can't shock a heart that's bled out). So even if you use one and it works, there's a good chance that the person will re-arrest, if you truly are that far from some medical care. Simply b/c you haven't reversed the cause of whatever precipitated their arrest initially.

Have fun dishing out $3000. Wonder if your job will partially reimburse.

Learn something new every day. I assumed (yeah, I know) they were charging inside those little wall mount boxes.

Finally figured out for what AED was an acronym. Automated external defibrillator

It's good form to spell out an acronym during its first use. Don't assume everyone knows.

AED doesn't necessarily help people with an otherwise normal healthy heart that have a cardiac attack from an accident (or too many burgers) they only help people who get an irregular heart rhythm.
So they are more likely to be needed in a public place with a large cross-section of random people than a job site with otherwise healthy people who might have a heart attack.

The machines have a built in analysis system that can tell the state of the patient - they don't apply the shock and will tell you to do CPR if the heart has simply stopped. So are generally safe to use on anyone.

Yes to that NobodySpecial. I think part of the reason is cost and I think that cost is easier to justify in buildings serving a lot of people.
Part of the reason might be how hard it is to set up a location for them on a job site too, but your point about expected levels of fitness makes sense.
On the construction site you might see an AED unit where they are more concerned about electrical shock injuries, but they are not very common.
They do work though and I would like to see more of them and more people trained on them.
Well, as they say, if wishes were horses then beggars would ride.

About the batteries.
The lithium batteries can not be recharged.
Lithium batteries still self discharge over time, so lithium batteries have a claimed shelf life of 5 years but usually the recommended replacement is 3 years.
Reasoning is that they likely sat on a shelf for a year and that they have not been stored in ideal conditions once they are in the machine.

Even though the batteries are tested by the machine automatically every day a lot of people get the rechargeable batteries instead of lithium and just add recharging them to the list of things for maintenance.

The charging station is not usually part of the wall box. It is usually separate. (often on a dusty shelf in the mechanical room or the janitors closet )
The AED is normally kept in grab and go condition, which it would not be if you had to put the charged battery into it each time you needed it.

I am not really sure if the lithium works out to be cheaper than recharger or more expensive or if it is cost neutral.
I am not even sure what the life of the rechargeable batteries is and when they need to be replaced.