Workplace defibrillators – should you invest in an AED?

Increasingly companies are providing defibrillators, commonly known as AEDs, in the workplace. With first aid courses now including AED awareness training, The Compliance People Consultant Dave Almond looks at the merits of workplace defibrillators.

What is an AED?

When a person is unconscious, unresponsive and not breathing, or not breathing normally they are in cardiac arrest. The heart is no longer pumping blood to the brain and it is important to act immediately. An AED (automated external defibrillator) is an easy to use device which tells the user exactly how to use it and what to do. When someone is in cardiac arrest it is used to shock the heart back into a normal rhythm. Importantly, it will only instruct the user to deliver a shock if one is needed so the user cannot harm the person. AEDs are designed so the user does not need training.

The chain of survival

Before we look at AEDs in the workplace, it is important to see how they fit into what is known as the chain of survival. When someone suffers a sudden cardiac arrest outside a hospital environment, such as at work, there are four key interrelated steps which if delivered effectively and in sequence maximise the chances of survival:

1. 1 – Early recognition and calling for help (calling for an ambulance and cardiopulmonary resuscitation (CPR)).
2. 2 – Early CPR from a bystander (in the workplace this is likely to be a first aider).
3. 3 – Early defibrillation to restart the heart.
4. 4 – Early advanced life support and standardised post-resuscitation care.

For every minute delay in use of a defibrillator the chances of survival for the person fall by 10%. If you wait for the ambulance to arrive, essential opportunities to maintain life may have been missed.

The Nuffield Trust says the average response time for a Category 1 (‘life-threatening’, which includes cardiac arrest) ambulance response in England was 8 minutes and 7 seconds in March 2020. This is a big factor in why more employers are introducing AEDs.

AEDs at work – what are the legal requirements?

While, there are no legal requirements to provide AEDs at work, and no specific regulations which cover the provision or use of AEDs at work, The Health and Safety (First-Aid) Regulations 1981 require employers to provide equipment and facilities which are adequate and appropriate in the circumstances for enabling first-aid to be rendered to their employees if they are injured or become ill at work. This includes the provision of trained first aiders.

The best way an employer can demonstrate that first aid provision is adequate and appropriate is through a first aid needs assessment. This will identify the first aid risks and what is needed to manage them (e.g. enough trained first aiders, first aid kits and equipment in the right locations, etc.).

The assessment should include factors such as:

• the size of the site;
• the number of people on site;
• the health and safety risks (e.g. hazardous substances, machinery, etc.) on site; and
• operating hours.

It should also consider the health of people on site (e.g. are there staff with heart conditions within the workforce and if so, how many are there?), as well as the geographical site location or any site access issues which may present increased journey times for an ambulance arriving there. Resuscitation Council UK suggests it would be a flaw to use the close proximity of an ambulance station as justification not to have an AED, as ambulances are deployed where needed and this may be a significant distance from the ambulance station and consequently, the employer. If there are staff at potential risk of cardiac arrest then the risk of death from a cardiac arrest is very high; this should therefore require further action from the assessment.

According to the Health and Safety Executive (HSE), where the needs assessment identifies the need for an AED in the workplace, The Provision and Use of Work Equipment Regulations 1998 (commonly known as PUWER) will apply. This requires the employer to provide information and written instructions on how to use the AED.

Useful guidance on how to assess whether your company needs an AED is provided by Resuscitation Council UK.

Training requirements

As we have established, AEDs are designed so the user does not require training to use them. However, the HSE advises that fuller training is likely to increase the confidence of the user, making the link with the two main workplace first aid courses: First Aid at Work (FAW) and Emergency First Aid at Work (EFAW), which both now include defibrillator awareness in the syllabus for the courses. The HSE also advises that where the first aid needs assessment identifies the need for an AED, employees are fully trained to use it.

Putting it into practice

When an employer does introduce an AED, it is important to integrate the equipment into the first aid arrangements for the site. This should include:

• suitable signage and communications so staff know the location(s) and how to access the equipment in an emergency;
• suitable information and instructions;
• ongoing monitoring to check the AED is in the correct location when needed; and
• regular testing, including checking the battery and the pads (which have to be replaced periodically, with pads replaced after use).

It is recommended that devices are professionally inspected annually.