#104 Save a Life: Know your AED

More than 15% of Out of Hospital Cardiac Arrests (OHCAs) occur in a public location; therefore, public access AEDs and community training have a large role to play in early defibrillation. AED's play an important role in saving lives in dental settings as well. How well do you know your AED? 

• How to maintain an AED: https://bit.ly/3Hk5i4M
• AED Fact Sheet: https://bit.ly/3HkpTWR
• How to Use an AED: https://bit.ly/3LfUqGn
• AED Program Checklist:  https://bit.ly/3AzF5eK
• AED and PAD Program: https://bit.ly/3oHbuNS

                                                 https://www.thecompliancedivas.com

Transcript

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SPEAKER_03 0:04

Welcome.

SPEAKER_02 0:05

I'm Leslie Cannon. I'm Mary Gavoni.

SPEAKER_03 0:09

I'm Linda Harvey. I'm Olivia Long, and together we are the Compliance Divas.

SPEAKER_01 0:17

Welcome to the Compliance Divas podcast. This is Linda Harvey and I will be your moderator for this episode. Today the Divas will be discussing automated external defibrillators, also known as AED. No doubt for years now you've seen AEDs in public and private settings and probably have one in your dental practice. But do you know an AED can save a life? As the Compliance Divas, we bring clarity and simplicity to compliance by navigating the regulatory world to keep you on course. We invite you to subscribe to the Compliance Divas podcast through your favorite podcast channel or on our website, thecompliancedivas.com. Any of the resources that we mentioned during today's podcast can be found in the show notes and on our website. As always, we invite you to submit questions to support at thecompliancedivas.com. And preparing for today's podcast, I learned that more than 15% of out-of-hospital cardiac arrest occur in public locations. And therefore having public access to AEDs and the community training plays a large role in saving lives. And as such, AEDs can play an important role in saving lives in dental settings as well. So today we're going to be asking you how well do you know your AED? Mary, I'd like to start with you today in our conversation. And could you share with us some reasons why offices should have an AED and why do they need to learn how to use one? Who can it be used on?

SPEAKER_02 1:53

Absolutely. Thanks, Linda. Um, well, the first reason that any office, any dental practice should have an AED is as you said, they save lives. And it could be a patient, it could be a team member, it could be the employer, it could be anyone who needs the use of an AED. And we saw a very, very um, I guess, um, nationally recognized example of the use of an AED with Damar Hamlin of the Buffalo Bills, that he probably would not still be alive had it not been for that quick response of that medical team to get to him with the AED. And according to the American Heart Association, nine in 10 cardiac arrest victims who receive a shock from an AED in the first minute will survive. So that's a high success rate for the use of AEDs. It is very important for every dental practice to check with their state dental board, to check with their liability insurance company, and any other regulatory group. It might be a state health department or could even be a state OSHA plan that may require having an AED on site. And I think that Leslie is going to chat a little bit about whether or not those AEDs may even need to be registered with your local EMS service. So make sure you know, for example, if your practice is certified or credentialed to use conscious sedation in the practice, you absolutely have to have one as part of that. But every dental office should have one. And I've seen some dental practices that will share from one office to another. But remember, response time is very quickly. If that practice happened to be closed on a day where that AED is stored in their office, then you may not have access to it. So every office in their office needs to have one. Um, who can you use it on? You can use a standard AED on anyone uh except children under eight years old. And if they are under eight, then you need to have separate pads that are attenuated, meaning that their um charge is um lessened a bit for the um uh application of the the um shock. And if you had infants, which is less than a year old, it's probably not going to happen in a dental practice, but then um it is a manual defibrillator that is used. It's not an automated one that is used for young children. So pediatric practices would need to make sure that they had a standard kit and the attenuated pads to be able to use in in case there's an issue.

SPEAKER_01 4:58

Mary, that is such a great tip, and I'll share a quick story. Um, there's a local group that I was doing some inspections for, and it was a husband and wife, two different specialties. They were in the same building that they had built, but they had their own separate office, so their own reception area, their own front door for each one of their different specialties, but they shared a common door. So when I went into work with a pediatric practice, first thing I asked, because I know they do sedation, was where's your AED? And they said, Oh, it's next door in the other office. And they walked me through, the doors unlocked. And of course, since it's husband and wife in each location, you know, they just leave the door up unlocked. So I had to remind them that they were two separate legal entities. And as such, they each needed their own AED. So they took my advice, thank goodness, and and especially with the world of the pediatrics, needing to have this uh different pads, as you mentioned, was critical. So thank you for those tips. Olivia, thinking about a point that Mary brought up with the with the training or and the the need if you have conscious sedation, that really comes back to what is the training that should be done and just the whole piece about emergency drills. What could you share with our listeners on those topics for safety? Sure, Linda.

SPEAKER_03 6:13

I think our listeners are very familiar with having to take refresher courses on CPR, which usually every two years, but we want to emphasize how important it is to have training on the AED at least annually, and preferably to have everyone trained in the office. And one of the things that I was thinking about in preparation for this episode is that some of the practices rely now, post-COVID, exclusively on video learning for their compliance, which you know, however you choose to do learning and it works with your practice and is successful. But one of the things that concerns me is that if they're relying on onboarding new hires and those anniversary periods are differing. So I want to encourage everyone to make sure that you are satisfying your annual training component. And some of our clients prefer to do AED and CPR at the same time they're doing their annual OSHA and HIPAA. So, what is it that your practice prefers and works well? Now, the American Heart Association does offer both CPR and AED training in both a classroom setting as well as online. So, once again, what works best for your practice? And we want to prepare for those emergencies so that we know how to handle the equipment properly. And when we think of an emergency, we think quite often, well, what if it's one of our patients? But yet, on the other hand, especially with the aging of our employees, and maybe not even an older employee, it could be a young employee. What would happen if it's a fellow team member? Do we know how to use the equipment properly that could save someone's life? So we encourage our listeners to download the implementation checklist that will be available as a resource with this episode. So I would say, in summary, Linda, making sure we allocate the time. And I would also suggest that they put it on their training roster that the attendees sign to show that they did participate in the training. And also it's mandatory. You know, we encourage our clients whenever there's mandatory training to post a memo in the break room or where people congregate that on such and such date there will be mandatory training and everyone is required to participate, and there will be no PTO authorized on that particular day because we all know time is money, and yet these doctors are paying to train these people. We want to make sure everybody's there to get the benefit of it.

SPEAKER_01 9:06

Thank you, Olivia. I just want to put a big explanation point behind what you just said because it's so important that everybody be there for the training. It's required. And I see that happen to us sometimes. They say, oh, well, so-and-so's um they're off today, like there's no big deal. It's like, well, it really is a big deal. And another point that you raised, I think, is important for our listeners to really think about is the anniversary dates of all the team members. They're not all the same. So are we postponing annual training for the majority of the team that puts you out of compliance because you're going to be hiring some new team members in the next few weeks when really you can just you need to stay on track with those training dates and then wrap new team members later into the existing training dates as a team, which means that maybe their training will take place, you know, twice in one year versus just once in that year. Very important. One thing I'd like to stress with that too, Olivia, is with so many individuals coming into our profession now with no dental experience and not even understanding how to maybe handle a medical emergency. Maybe they've never taken um CPR before or don't know what an AED is or how to use it. So it's critical because you never know whose life you may be saving. It may be your employer, doctors, it might be you, or it could be anybody on the team. So, so the next thing I'm thinking of, Leslie, is can you help us out with then the maintenance of an AED? We talk about who has to have it, where you know, what is it, who's training on it, and then where should they, where should it be placed in the office? And how do you keep track of the bads and the the pads and the batteries, you know, that Mary mentioned?

SPEAKER_00 10:37

Well, Linda, there's a lot to cover here, but let me just start out by saying uh if your state requires an AED, you may need to take a look at what other requirements there are for training. Some states don't require an AED. In fact, in California, it's not required in a dental practice. Some team members may not even know that you possess an AED unless it is brought to their attention. So on the onboarding part, that would certainly be important. The other thing is that much like an oxygen tank, we don't use an AED often enough to really have muscle memory of where it's stored and how to use it. So there's some recommendations to keep in mind that when you have a well uh kept AED, it is your best friend in the event of a sudden cardiac emergency arrest and an emergency that could save a person's life, as we already heard. So there should be a maintenance checklist, and there should be somebody who is identified as the person who is the designee for keeping up on that checklist, just like many dental offices will have someone who checks up on the patient emergency kit to make sure that there's no expired pharmaceuticals. So that's uh one important thing is to uh identify somebody to do that. And that person's role should be to visually inspect the general condition of the AED, making sure, like an oxygen tank, it's clean and intact and that there's uh all the supplies needed are next to it or necessary uh for providing uh emergency care to a patient. Also, they should be able to initiate the actual machine activation. So testing the start button is important, checking for the audio alarm or whatever other visual notice is displayed on the unit to make sure that that is operating properly, checking the batteries and replacing past date batteries. Now, some AED units do have a plug where you plug in and they're automatically stored that way where they're always charging. But we should follow the manufacturer's directions, whatever they are, on how often to be looking at how a unit is charging. We should also be inspecting the AED pads because pads may have passed their expiration date as well. So it's a good idea to check for things like cracking, stretched wiring. They may need to be replaced, and we may not even know that until we have an emergency, open up the kit and look inside. Now, a backup set of pads is generally recommended, but uh, you know, it's definitely uh a necessary thing if you need them and don't have them. It's always better to have them and not need them than to need them and not have them. Uh, there's a recommendation, well, of course, with the manufacturer's directions of how frequently to be checking uh your defibrillators, but at a minimum of three months. And, you know, to me, I would not have thought three months, but that's uh what is recommended. And then maybe even perhaps weekly, depending on your situation, uh the size of your facility. And then, of course, always following the AED manufacturer's directions. And then making sure that everyone obviously knows how to utilize the equipment. So when you do do your check to make sure that everything is in good working order and that nothing's expired, that the batteries are in good shape, might be another time to just remind everyone at a morning huddle of this is our AED, this is where it's kept, uh, I've checked it. Uh, you may even consider keeping some kind of physical checkup record of maintenance. I'm looking at a picture in a resource that I found where it looks very much like a fire extinguisher tag and it shows the date by, and there's enough to maybe put uh 20 different um signatures and dates. And uh that might be something to be very handy to help you stay on top of making sure that it has been checked on a regular basis. And of course, where it's stored is very important, not only that everyone knows where it's stored, but in public places, you see that it's clearly visible, airports, it's clearly visible, casinos, places where uh you you may have just someone jump in, a good Samaritan that that wants to help or that knows CPR and is able to get that machine opened and get it started immediately, because you know there is that uh good Samaritan that uh regulation law that that protects others. You don't have to be a dental health care provider to save a life. So that's the information I think that is most important for our listeners to know about an AED.

SPEAKER_01 15:17

Thank you, Leslie. I I think the maintenance checklist is one of the great tips that you just mentioned. And when you mentioned quarter through every three months, what popped into my mind was quarterly when we're conducting the water testing on a quarterly basis. You know, put it in sync with something that you're already doing in the office so it doesn't seem like it's something extra. It just falls right into line with you know the quality checks and quality measures that you're already tracking in a practice. Over the years, I've come across many offices that do their CPR training in the office. And I really like when an office does that because then they can practice in their setting and be comfortable. And I encourage the teams to pull out their AED, even though the trainer may bring a training AED, but pull out your AED at least at that point. So you know that during that year, everybody's touched it and looked at it, and then do so the alternating year when it's time for other annual training. So you actually are getting used to it, and team members know where it's located. So it's so important, as you said, Leslie and Mary, every and Livia, the life you save maybe a team member, maybe doctors, it may be you. It just you just never know when you're going to need to have had this information. It's so important. And I like the fact that we've stressed having the CPR training with the AED training because those two really go hand in hand. And uh, just so that our listeners know, you will find all that information in today's show notes of what the American Hospital Association recommends. And it's just great. Uh, the American, pardon me, the American Heart Association recommends. So just some wonderful information that be sure you download those resources for your practice, incorporate this because with things changing so quickly in healthcare in general and changeovers in dental practice of team members and just getting busy with the taking care of patients. We don't want to let um lose a life or let safety falter in our practice. Divas, do you have any other questions or comments or stories you'd like to share this morning?

SPEAKER_00 17:06

Leslie? I wanted to remind everyone also to check in your state to see if you are required to notify your local emergency services, your local fire department or fire protection agency or your local EMS in any way that you have an AED, because some states that's required. I was surprised when I went through the resources for this podcast that my own state requires notification. That way, if there's an event, the emergency services personnel knows that you have an AED on site and they can uh the 911 operator can walk you through some of the steps or remind you of some of the steps. And if you don't have an AED, of course, then uh they wouldn't uh be alerted to that. But uh please make sure that you check with your own state for the requirements for having one, for making sure that you need whether you need to have a physician uh guide your um your steps with an AED. In some states, there needs to be physicians' approval, and then also whether you need to notify your local emergency services.

SPEAKER_01 18:08

Great chip, Leslie. Thank you so much. Mary, what would you like to add to this?

SPEAKER_02 18:13

It sort of um dovetails with what Leslie had just said. Um, I worked with a practice that is in a state that has a state OSHA plan. And remember that OSHA requires that everyone have CPR training in case somebody is injured on the job. We tend to think of CPR training as more patient focused in case a patient has a medical emergency, but it can be for team members. And there was a dental assistant who came to work one day not feeling well, and she mentioned something to her doctor. Well, you know, I don't feel great today, and she didn't really say much more about that. Nobody really paid too much attention to it until she collapsed at the chair side. She collapsed at chairside because she was having a heart attack. And, you know, 911 was called, the EMS came, but they did not know that they were required in their state to have an AED. And so the family um was very upset. She did survive, but she had some very serious damage to her heart, and the family was very concerned. And so they actually reported it to the state dental board, who then turned it over to OSHA because it's an OSHA or an employee issue, and it resulted in a fine to the practice for not having appropriate um emergency equipment available. Now, again, it is required in that state, and that's why it became that kind of an issue, but they weren't aware of it. So can't stress enough what we've already said. Make sure you know if it is required in your state, and make sure, again, you know how to use it if you need to.

SPEAKER_01 20:03

Boy, what a what a heartbreaking story, Mary. I'm glad that that staff member turned out to be okay. But as you said, she she had some serious heart damage. So saving a life is very important. And this podcast has some great tips and reminders. You may already have had an AAED in your practice for years now, but let's not take it for granted. Let's not take it for granted. Maybe even up on the wall, you may be able to see it as you pass along the hallway and the and the clinical areas, but let's not take it for granted. Let's be sure that we have it's up to date, everybody knows how to use it, the training has been well documented, and that all team members are ready and positioned for any kind of medical emergency that could occur in the dental practice. That wraps up this episode of the compliance divas. We bring clarity and simplicity to compliance by navigating the regulatory world to keep you on course. Please subscribe to our podcast through your favorite podcast channel or on our website, thecompliancedevas.com. The resources that we talked about today will most definitely be in the show notes. So be sure you download them for your practice. And we invite you to submit your questions to support at the compliancedivas.com. And we look forward to seeing you the next episode.