AEDs: Do They Belong in Your Facility?
By Kristen A. Walsh
A facility operator's decision of whether to obtain one or more automated external defibrillators (AEDs) should be given careful consideration.
The International Health, Racquet & Sportsclub Association (IHRSA) estimates that 40 percent of gyms have AEDs on-site. These small, computerized medical devices can help treat victims of sudden cardiac arrest (SCA). Survival rates for SCA victims can exceed 90 percent if defibrillation occurs in the first one to two minutes but then decline by about 10 percent per minute thereafter.
Approximately 85 percent of SCA incidents occur in the home or in hospitals. Since comprehensive, location-specific data about where SCA occurs outside of these two areas is severely lacking, efforts to save more lives might best be served by increasing the percentage of "first responding" units with AEDs. Nationally, as of 2000, less than 50 percent of ambulances, 30 percent of fire department vehicles and 10 percent of police vehicles were equipped with the devices.
Still, fitness centers are among the first facilities being required by law in certain areas to have AEDs. This is due, in part, to some evidence indicating that intense physical activity may trigger SCA in people with predisposing conditions.
Fitness center operators are—or soon will be—required by law to have AEDs on their premises in the following areas:
- Illinois: As of Jan. 1, 2006, most indoor physical-fitness facilities serving 100 or more people must obtain AEDs.
- Louisiana: As of Jan. 1, 2005, all physical-fitness facilities with more than 50 members must have an AED on premises.
- New York: As of July 20, 2005, all health clubs with 500 or more members must have at least one AED.
- Rhode Island: As of Jan. 1, 2005, every health club registered with the state must have at least one AED.
- Weston, Fla.: As of March 12, 2005, AEDs are required in gymnasiums, fitness centers and indoor recreational centers greater than 1,500 square feet.
- Montgomery County in Maryland: As of July 1, 2005, all commercial fitness centers with four or more employees must have at least one AED.
These measures also include staff AED-training requirements. As a result of IHRSA's lobbying efforts, the Illinois, Louisiana, Rhode Island and Montgomery County measures all include liability protection for fitness center operators and their employees. IHRSA is fighting for similar protection for New York club operators and their employees and has won broad support in these efforts.
Concerns about liability if an AED is used incorrectly—or if it is on-site but not used during a medical emergency—keep many fitness center operators from buying the devices.
IHRSA has concluded that the adequate liability protection is not yet in place that would allow businesses or their employees to feel safe about having or using AEDs in an emergency situation. The federal Sudden Cardiac Survival Act—the intent of which was to offer liability protection to trained AED users—allows state law to take precedence. On the state level, weak and poorly crafted Good Samaritan Acts provide virtually no protection for businesses or their employees with regards to AED use.
To date, no court has found that a fitness center has a duty to have an AED. However, several lawsuits have been filed alleging that such a duty exists.
Last year, a lawsuit was filed against a Fort Lauderdale, Fla., gym, claiming it failed to provide an AED that could have saved the life of a 49-year-old member who died during an April 2003 workout on a stair-climber. The suit seeks unspecified damages under the Florida Wrongful Death Act. While this case is still pending, several others have been decided in favor of fitness facilities:
- In 2004, an Illinois Appellate Court affirmed a trial court's dismissal of a lawsuit against a YMCA by a member who suffered SCA while exercising on a treadmill in 2003. The member had alleged that the event was predictable and reasonably foreseeable and that the facility had a duty to have an AED. The court found no such duty.
- In 2000, a Florida jury returned a verdict in favor of a health club that was sued for negligence for not having an AED or oxygen present in 1998 when a member suffered a medical emergency, which resulted in brain damage. The jury agreed with the defense that no regulation or health club industry standard required AEDs at the time of the incident.
- In 2002, Pennsylvania's Supreme Court affirmed a trial court's judgment in favor of a defendant health club that was sued by a guest who alleged that the lack of an AED caused more severe injuries than would have been experienced during his 1996 medical emergency if prompt defibrillation occurred. The courts found that that no duty required the club to acquire, maintain and use an AED at the time of the incident.
Club operators can purchase AEDs through IHRSA's Advantage program starting at $1,995 per unit. If a decision is made to move forward with an AED purchase, one unit may not be enough to satisfy the American Heart Association's recommendation that when AEDs are on-site, they be placed where a three-minute response time can be achieved.
Another cost involved is staff training. This cost can be significant in light of the industry's relatively high employee-turnover rates. Training costs can be reduced by having one or more club managers trained by the American Heart Association or the American Red Cross to teach the rest of the staff and new hires how to use the AED.
Kristen A. Walsh is IHRSA's content editor. She can be reached at firstname.lastname@example.org. The International Health, Racquet & Sportsclub Association (IHRSA) is a nonprofit association dedicated to the growth, protection, and promotion of the health club industry and represents more than 6,500 clubs worldwide. IHRSA is an international leader in health club industry education and research. For more information, visit www.ihrsa.org.
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