The Shock That
Saves: The Need for an
AED Coordinator in the Ames
Community
The Shock that Saves:
The Need for an AED Coordinator
in the Ames Community
Submitted to:
Ames City Council
PO Box 811, 515 Clark Ave.
Ames, IA 50010
Prepared by:
Sam Arnold
Student, Iowa State University
Paramedic
Nathan Gibbs
Student, Iowa State University
Diane Minse
Student, Iowa State University
Annie Stephan
Student, Iowa State University
November 18, 2004
246 N. Hyland, Apt. 1
Ames, IA, 50010
November 18, 2004
Ames City Council
PO Box 811, 515 Clark Ave.
Ames, IA 50010
Dear Ames City Council:
Cardiovascular disease is the number one killer in the United States, and the majority of
cardiovascular deaths are due to sudden cardiac arrest – a condition that can be remedied
through use of an automatic external defibrillator (AED). We initially intended this
report on AEDs to be an exercise in writing a proposal. But as research progressed, it
became obvious that the population of Ames is at risk for sudden cardiac arrest and there
is a great need for an AED program and an AED coordinator in Ames.
It is likely that over 5,100 residents in Ames suffer from some form of cardiovascular
disease. Most public buildings in Ames lack AEDs, and some neighborhoods are outside
the paramedic’s three to five minute coverage zone, which puts victims of sudden cardiac
arrest in those areas at a greater risk of dying. Further, many of the AEDs installed are
poorly placed and lack appropriate signage to be useful in an emergency situation.
Based on these findings, the group recommends that the Ames City Council create an
AED coordinator position in Ames. The coordinator would renovate the current system,
implement new AEDs where appropriate, and coordinate efforts with other emergency
personnel. If the city council has any questions, please contact Sam Arnold at the address
above or at 641-344-9107.
Sincerely,
Sam Arnold
Nathan Gibbs
Diane Minse
Annie Stephan
Table of Contents
ABSTRACT.................................................................................................................. iv
INTRODUCTION ......................................................................................................... 1
Overview ...................................................................................................................... 1
Sudden Cardiac Arrests................................................................................................ 1
Automatic External Defibrillators................................................................................ 1
MAJOR RISKS ............................................................................................................ 3
Population at Risk ........................................................................................................ 3
Extended Time to Shock .............................................................................................. 3
Lack of Organization ................................................................................................... 4
Ames ................................................................................................................ 4
Iowa State University....................................................................................... 5
RECOMMENDATION.................................................................................................. 6
AED Coordinator Position ........................................................................................... 6
Potential Candidates for the Position ........................................................................... 7
COST-BENEFIT ANALYSIS ...................................................................................... 7
Costs............................................................................................................................. 7
Benefits ........................................................................................................................ 9
CONCLUSION ............................................................................................................. 10
APPENDIXES .............................................................................................................. 11
A – Ames Heart Risk Statistics.................................................................................... 11
B – AEDs on the ISU Campus..................................................................................... 13
C – Obtaining Data for the 3-5 Minute Coverage Area ............................................... 17
D – Sample Maintenance Checklist ............................................................................. 18
BIBLIOGRAPHY.......................................................................................................... 19
iii
ABSTRACT
The City of Ames is committed to the safety and well-being of all its residents.
Unfortunately, there are places in Ames where there is not adequate emergency support
for sudden cardiac arrest. Many of the citizens are at risk for sudden cardiac arrest and
could benefit if Ames had an effective early defibrillation program. To meet the needs of
the residents of Ames, we are proposing that the city council create an AED Coordinator
to improve and expand the current defibrillation program in Ames.
iv
INTRODUCTION
Overview
The City of Ames, Iowa prides itself on its motto “caring people, quality programs, and
exceptional service,” showing great commitment to the community and the well-being of
everyone within it. Mary Greeley and the Fire Department are currently responsible for
responding to emergencies in the Ames community, with Iowa State Police assisting in response
to emergencies in the university area. Unfortunately, these programs alone do not provide
adequate emergency coverage in the event of a sudden cardiac arrest. Currently, many residents
of Ames are at risk for sudden cardiac arrest, and the immediate attention needed to increase the
chances of surviving a cardiac arrest is not provided because of a lack of organization of the
current early defibrillation program. To fulfill the city’s commitment to its citizens and their
well-being, Ames needs an effective automated external defibrillator (AED) program with an
AED coordinator. An effective program will make AEDs readily available throughout the
community with appropriate signage and maintenance to keep them in working order. In order
to implement an effective program, the group suggests that the city council create an AED
coordinator position in Ames.
Sudden Cardiac Arrests
A sudden cardiac arrest (SCA) is a situation where the heart suddenly stops beating, causing the
victim to become unresponsive and quit breathing. SCA is one of many types of cardiovascular
diseases (CVD’s), and it is the only type of CVD that causes the heart to suddenly stop beating.
The majority of SCAs occur as a result of an uncoordinated heart rhythm called ventricular
fibrillation (VF). During VF, the normal pumping action of the heart stops, and instead, the heart
contracts sporadically, creating a quivering motion. The victim will die within minutes from a
lack of a supply of oxygen to the heart and other vital organs if action is not taken immediately.
Each year, approximately 250,000 people in the United States die from SCA, making it one of
the leading causes of death (16). The victims have a better chance of survival if someone
recognizes the problem, calls 911, and begins cardiopulmonary resuscitation (CPR). However,
CPR will not restore a normal heart beat.
Automatic External Defibrillators
CPR helps prolong the life of the victim by temporarily providing oxygen to the vital organs, but
it only restores normal heart function to 3 percent of victims (10). The only effective treatment
to reestablish a normal heart rhythm when the heart has gone into ventricular fibrillation is
defibrillation. A device called an automated external defibrillator (AED) can analyze the
victim’s heart rhythm and allows the user to deliver an electric shock. The goal of defibrillation
is to momentarily suspend all activity in the heart to stop the sporadic VF, allowing the
pacemaker cells in the heart to start a normal heart beat again.
No matter what brand of AED is used, the same steps are followed to deliver treatment to the
victim. Once the user turns on the machine, voice and text prompts direct the user in the proper
steps to provide care. The user follows the prompts to first check the victim’s responsiveness
1
and then call 911. Next, the user is prompted to place the electrode patches on the victim’s chest
and stand clear so the machine can analyze the heart rhythm. The AED is able to recognize a VF
within 10 seconds and, if found, it will store an electric charge and direct the user to press the
shock button. The user then must make sure no one is touching the victim before pressing the
button that will deliver a shock to help restore normal heart rhythm.
AEDs are simple lifesaving devices that most people can be trained to use. In fact, it is easier to
train someone to use an AED than it is to train the person to perform CPR. Even untrained
bystanders can almost always provide effective care to an SCA victim because the voice prompts
are so easy to follow. To prove how easy it is to operate an AED, a group of sixth graders were
given basic AED training and then tested their knowledge on a dummy simulating SCA.
Although the students were not allowed to ask questions, they were able to correctly shock the
victim’s heart. In addition, they were able to do this an average of only 27 seconds slower than
the EMTs in the room (13).
Besides being easy to use, AEDs are extremely safe. It is impossible to deliver an inappropriate
shock because the machine will not allow the responder to initiate a shock unless it has detected
VF. Also, if properly attached the to victim, the AED will make a correct “shock” decision more
than 95 percent of the time and a correct “no shock” decision more than 98 percent of the time.
This level of accuracy is greater than that of emergency professionals (17).
Although immediate CPR by bystanders greatly increases the victim’s chance of survival,
defibrillation must also be delivered quickly to allow the heart to resume normal function.
Following an SCA, the chance of saving the victim drops 10 percent with each minute that
passes, as illustrated in Figure 1 (8). Studies have shown that only three to five percent of SCA
victims survive long enough to reach the emergency room (13). However, if defibrillation is
provided within the first three to five minutes of collapse, the victim has a 75-80 percent chance
of survival. Of the 250,000 victims who die from SCA each year, many could be saved by an
effective AED program; several of these survivors could be in Ames.
Estimated Chance of Surviving an SCA as Time
Elapses
Estimated Chance of Survival
(percent)
100
90
80
70
60
50
40
30
20
10
0
1
2
3
4
5
6
7
8
9
10
Tim e Elapsed (m inutes)
Figure 1: This graph shows that, without defibrillation, the
chance of surviving an SCA decreases 10% with each minute that
passes.
2
MAJOR RISKS
Population at Risk
The risk of dying from sudden cardiac arrest is very real. Over the past one hundred years,
cardiovascular disease (CVD) occurrence has risen steadily to become the number one cause of
death in America. In fact, CVD is directly linked to 29 percent of all deaths nationally and
accounted for 35 percent of all deaths in Iowa in 2002. Of the deaths related to CVD, it is
thought that 60 percent are caused by SCA (16). Appendix A indicates the leading causes of
death for both Iowa and the nation.
National statistics show that 23 percent of the population is currently affected by some form of
CVD, which corresponds to over 5,100 residents in Ames, not including the student population
(3, 12). Statistics also show that the average age of onset for CVD symptoms is declining; thus,
it is reasonable to assume that even more residents will be at risk in the near future.
Extended Time to Shock
A victim of cardiac arrest has the greatest chance of survival when immediate CPR is performed
and an AED is used to provide defibrillation within three to five minutes of the victim
collapsing. Ames has four first-responder locations equipped with AEDS - Mary Greeley and
three fire stations. Figure 2 shows the areas these locations can reach within three to five
minutes.
There are many areas of Ames that cannot be reached in three to five minutes. The majority of
the areas that aren’t covered are neighborhoods and public recreation areas, such as Emma
McCarthey Lee Park, Izaak Walton Park, Parkview Park and Innis Grove Park. Since 50-80
percent of all SCAs occur at home, AEDs should be placed in these neighborhoods and public
areas to provide coverage to residents of Ames that are otherwise outside the 3-5 minute
coverage zones (7, 14). Appendix B describes the process used to obtain the coverage map.
Figure 2: This map illustrates the 3-5 minute coverage areas of the hospital and fire
stations in Ames, as well as suggested AED locations.
3
Currently, only two public areas, the city jail and the Ames School District, are equipped with
AEDs (14). AEDs should be placed in all public areas of high traffic, including the public
library, community center, ice arena and municipal pool. Figure 2 shows these locations within
the city. The residents of Ames heavily use all of these locations, but none of them have an AED
on site. It is especially important that the latter three have an AED on-site because they all are
facilities for physical activity, which creates a higher risk for the occurrence of an SCA.
Although the fire stations and hospital are equipped with AEDs, it may be minutes before an
emergency situation at one of these locations is recognized as an SCA and the paramedics are
contacted. Traffic and difficulty finding the patient may also delay the response time. Even if a
first responder arrives and provides defibrillation five minutes after SCA occurs, a patient only
has a 50 percent chance of survival. An SCA victim could be reached much quicker if an AED
was available on-site. This quick response could increase the victim’s chance of survival to 90
percent if the first shock were delivered within one minute. In 1999, Chicago’s O’Hare
International Airport implemented an AED program that demonstrates the advantage of having
AEDs in place to allow for a quick response. A fire station near O’Hare provides emergency
service to the airport, but on-site AEDs allowed for quicker response times and subsequently a
better SCA victim survival rate (6).
Thirty-three AEDs were positioned in high-traffic areas along the terminals of the airport with
only 60 to 90 seconds of walking time between each AED. Signs to indicate the location of each
unit were placed in highly visible areas, very similar to terminal restroom signs. Along with
appropriate signage, television commercials in the terminal waiting areas aired every half hour to
alert passengers of the presence of the AEDs. Within only a year and a half of the program
implementation, 22 people had been administered shock from one of the terminal AEDs. Of
these 22 people, 75 percent re-gained consciousness and 56 percent survived to be released from
the hospital. Although a 56 percent survival rate may not appear very successful, it is actually a
great improvement from the expected 3-5 percent survival rate without the use of AEDs (6).
Ames faces a similar situation to that of O’Hare. Emergency responders can reach many
important public buildings in the city, just like emergency personnel were available to service the
airport. However, immediate on-site response will dramatically increase survival rates in Ames
public areas, just as it did in O’Hare.
Lack of Organization
The lack of planning and organization surrounding the AEDs in Ames and on the Iowa State
University campus presents a risk to residents and students. While Ames lacks AEDs in its hightraffic public areas, the ISU campus does have AEDs in many of its high-traffic areas, but their
placement and related signage must be improved if they are to be utilized in an emergency
situation.
Ames
The city lacks an organized effort to provide AEDs at essential locations. Since 50-80 percent of
SCAs occur in the home, there must be a coordinated effort to situate AEDs in public places near
4
residential neighborhoods. Large public events, such as the Special Olympics and the Hershey
track meet, should also have an AED available since they involve a large number of people.
Iowa State University
ISU has access to AEDs in many public locations, but must
improve their visibility and signage for them to be effective
in emergency situations. Five ISU Police Department cars
are currently equipped with AEDs, which provides good
coverage to several parts of the campus that fall outside the
response zone of the Ames fire stations and Mary Greeley.
Also, AEDs are located in all of the campus recreation
buildings – Beyer, State Gym, Leid and Forker. However,
AEDs cannot be used to save lives if they are not readily
available in an emergency. To be readily available, the
AEDs need to have easily accessable and be very visible with
appropriate signage. Although some of the AEDs on campus
meet this requirement, several do not and are in need of
renovation.
Lied Recreation Athletic Center and State Gym are two
places on campus where AEDs are readily available. The
AEDs at Lied are well-placed in open, high-traffic areas
next to the staffed entry desk and basketball courts on the
first floor and near the exercise equipment and track on the
second floor. Also, Figure 3 shows the signs that mark the
AEDs to make them more visible.
Figure 3: The AEDs in Lied Recreation
Athletic Center on the ISU campus are
made visible with signs located above each
AED.
State Gym also has excellent signage to indicate the presence and location of AEDs within the
building. Figure 4 shows the sign that appears on every entry door to the building to indicate
there is an AED located inside. Besides simply knowing there is an AED present, the floor plans
located in several areas throughout the building specify the location of each AED, as shown in
Figure 5.
Figure 4: A sign is displayed on each door
into State Gym on the ISU campus to
indicate there is an AED located inside the
building.
Figure 5: State Gym on the ISU campus has
several floor plans located in various areas of
the building that show the precise location of
the AED.
5
While Lied and State Gym have AEDs readily available, Forker is one building on the ISU
campus that has a poorly placed, poorly marked AED. Figure 6 shows that inadequate location
and signage may make it difficult for someone to find the AED if there is an emergency that
requires one. There are no maps in Forker that indicate where its AED is, and signs are not even
on the doors to show there is an AED inside the building. In an emergency, most people would
not consider looking for an AED in a narrow hallway in
the basement, far from the gyms and pool. Most people
AED
wouldn’t even notice the unmarked white box on the
white wall. Finding an inadequately marked AED in an
obscure location would be even more difficult in a
stressful situation, such as when an SCA occurs.
Forker is an example of why simply buying AEDs for
public buildings is not enough. In order for AEDs to be
effective, they must be placed so they are visible and well
marked. As demonstrated in Lied and Forker, the AEDs
should be placed in visible locations, all entry doors
should be marked with signs to indicate the presence of
an AED in the building, and the maps in the building
should show the precise location of the AED. This will
ensure the AED is readily available in an emergency.
Appendix C contains floor plans for every building on the
ISU campus that is equipped with an AED. Comments
are included for each floor plan regarding the placement Figure 6: The AED in Forker on the ISU
campus is located in a narrow hallway in the
and signage surrounding each AED.
basement, far from the gyms and pool, and is
not made visible with signs, causing it to be
almost worthless in an emergency.
ISU also has many high-traffic public events, such as
football games at Jack Trice Stadium, basketball games
and concerts at Hilton Coliseum, and concerts at
Stephens Auditorium. Paramedics staff all of these events and can provide defibrillation in case
of an SCA, but many cities feel that AEDs are needed in addition to paramedics at large public
events; for example, the Des Moines Civic Center has two AEDs in addition to paramedics at
every large event to help facilitate early defibrillation, should the need arise (14).
RECOMMENDATION
AED Coordinator Position
Clearly, there is a need for an expansion of the current AED system in Ames because of the large
number of people in the community who are at risk for an SCA, the lack of appropriate coverage
of the city, and the lack of organization for the AEDs currently in place. A city AED coordinator
would improve and expand the current AED system to make it a more effective life-saving
device. The coordinator would have various duties and responsibilities to help accomplish this
task, including renovating the current system, implementing new AED systems, and maintaining
the efficacy of the entire program.
6
Renovating the current system would involve assessing the condition of the system and making
improvements based on that assessment. Through our evaluation of the AEDs on the ISU
campus, we found several to be located in inaccessible positions and lacking the appropriate
signage to indicate their presence. The coordinator would be assigned the task of ensuring that
these AEDs are refurbished based on these observations so they can be as successful as possible
in the event of an SCA in the area.
New AED systems need to be implemented in areas around the city that demonstrate need
because of high traffic, including those within the three to five minute coverage area of Mary
Greeley Medical Center and the fire stations, to ensure an even quicker response than emergency
responders can provide. Putting AED systems into operation in these areas necessitates a
coordinator to select the sites where an AED would be most beneficial, apply for funding
through the various grant systems available, put the AED in place, and provide training to
willing people in the area.
The entire AED program needs to be watched over by the coordinator to make sure the system is
maintained to an appropriate level that would allow it to have maximum efficiency.
Maintenance would involve the continuation of proper training of personnel working near the
devices and of others willing to take on the responsibility, the documentation of each time an
SCA occurs, coordinating with emergency responders, and performing or appointing people to
perform routine checks of the AEDs to make sure they are in proper working order. Appendix D
contains a sample monthly maintenance checklist that could be used to assess the condition of
the AEDs.
Potential Candidates for the Position
A variety of people currently working for the city of Ames or in a health-related position are
potential candidates for the position as the city AED coordinator. Such people include members
of the Fire Department or in law enforcement, public health workers, or EMS personnel. Several
people may initially be required to set up an effective program through renovating current
systems and implementing new systems. After this early stage of the program has been put in
place, the position may be given to a single person to oversee the maintenance of the program to
ensure that it is as efficient as possible.
COST-BENEFIT ANALYSIS
Costs
Once found only in hospitals, defibrillators are now inexpensive and can be placed in other
locations nearer to the victims, greatly increasing the person’s chance of surviving a SCA. There
will be a variety of costs associated with implementing a city-wide AED program. These costs
include purchasing and distributing the AEDs, providing maintenance, offering training, and
paying salaries, but the projected cost will help ensure a greater level of safety for Ames
residents.
7
The placement of AEDs around the community will have an initial cost of approximately $3000
per unit, although the price can range from $1500 to $4000 depending on the device. Since an
AED usually has a life of about five years, this cost can be divided by five to give an average
cost of about $600 per year (9).
In addition to the cost for the devices, maintenance
costs need to be considered, primarily consisting
of replacement of peripheral equipment. Two
batteries should be available for each device so
there is always a spare. The cost of the batteries
depends on the device, as it may require either
lead acid batteries or lithium batteries. Lead acid
batteries need to be replaced about every two
years, which, with a price of about $150 each,
would give a yearly cost of about $75 per device.
The yearly price of lithium batteries varies greatly,
since a single battery costs from $100 to $300 and
needs to be replaced every one to five years,
depending on usage and the capacity of the
Figure 7: The costs for implementing an
battery. Spare electrode patches should be kept
AED program are variable. However, yearly
with each device as well, as they are thrown out
costs for various aspects of the program can
be estimated.
after use. At least two sets of patches, costing
about $20 a set, should be on-hand for each
device. Also, the patches tend to dry up over time, so unused patches should be replaced every
two years. Other maintenance costs would be ensuring that ancillary supplies – hand towel,
scissors, and razor – are available with each AED, which would cost only a minimal amount.
Based on these estimates, the yearly cost of maintenance for each device would be
approximately $100 (9).
AED training, is offered through the American Heart Association, the American Red Cross, the
American Council and other organizations, as well as through AED manufacturers. The cost of
training varies, depending on whether it is performed by paid personnel or by volunteers and the
number of people who need to be trained. CPR Instructors in the community may be willing to
volunteer their time to help implement such a community-oriented program. A single three to
four hour class from one of these sources is sufficient to properly train a person to have ample
knowledge of the workings and use of an AED since the process is highly intuitive and relatively
simple (2). The people who should be trained include police officers, fire fighters, ambulance
personnel, lifeguards, and others with jobs requiring the handling of emergencies. On average,
the initial training will cost $100 per person and yearly refresher courses will cost $35 (9).
Since initial and refresher training requires relatively little time and a relatively small cost,
training is a worthwhile investment because of the value of early defibrillation.
The coordinator of the AED program, if the person is already employed by the city, would likely
require an increased salary to cover the extra hours of work needed to implement and maintain
the program. This cost may initially be distributed to several people during the more demanding
8
first stages of the program. The exact wages these people receive will depend on the city’s Pay
Plan (7).
Various sources of funding are available to help cover these costs. The simplest, most direct
approach is to include the costs of implementing the AED program in the next budget cycle for
the city. If the costs for the program cannot be funded directly, alternative funding sources are
available through local companies and industries, private foundations, public charities, and
government grants. The following organizations are just a few that provide online applications
for grant money to communities that are establishing AED programs:
 American CPR Training (http://www.cpr-training-classes.com/)
 American Environmental Health and Safety (http://www.healthsafety.com/)
 AED.com (http://aed.com/)
 AED Instructor Foundation (http://aedinstructorfoundation.org)*
Benefits
Research shows that ventricular fibrillation is one of the leading causes of death in the United
States and that early defibrillation not only improves the chances of survival, but is crucial since
the possibility of saving the victim decreases by about 10 percent every minute that passes.
AEDs are user friendly, safe, accurate, and effective in providing this critical early defibrillation.
Several situations have demonstrated this great life-saving capability of an effective AED
program.
In Honolulu, Hawaii, the Chief of Police, Lee Donohue, was responsible for initiating the local
AED program. Only a few months after the program was put in place, Donohue himself became
the first SCA victim to be saved by an AED made available through the program (11).
There has also been success in Ames, where a 73-year-old man suffered an SCA while driving
his vehicle and was saved by two Iowa State University Police officers. The two officers, who
happened to be in the area on a routine traffic violation, were able to save the man’s life by using
an AED. Funding provided by the GSB in 2002 allowed for the placement of AEDs in each ISU
patrol car. If the officers had not had an AED readily available in their patrol car, the man may
not have been saved in time (1).
There are countless other stories affirming the value of having an effective AED program in
place. Only with a program in Ames that would place AEDs throughout the community can the
citizens feel their lives are sufficiently looked after. The implementation of an AED program
suited to the Ames community could show an improvement in SCA survival. Along with this,
Ames’s government and medical professionals could take pride in knowing that all of the
citizens of Ames are well cared for, in compliance with the Ames city motto.
*
The voucher required to apply for this grant is available from Sam Arnold, a Paramedic in the group.
9
CONCLUSION
SCA can happen anywhere, at anytime, and to anyone. It can come about quickly and with no
warning, and just as quickly, action needs to be taken or the victim will most likely die. AEDs
are important in combating SCA. The city of Ames should be concerned with providing AEDs to
the victims as quickly as possible, especially since there is a large portion of the population at
high risk for having an SCA. Unfortunately, Ames is unable to provide the immediate attention
required to treat victims of SCA due to insufficient organization.
To provide the rapid treatment necessary to increase the chance of surviving an SCA, an efficient
AED program needs to be implemented throughout the city. The best approach to providing this
service to the community is appointing an AED coordinator to implement and maintain the
program. Although there will be a variety of costs associated with this program, many sources of
funding are available, and any cost incurred is worth the benefit of having AEDs to help save
lives. Ames has high standards for maintaining the well-being of its residents and should not be
content to let SCA victims die. Appointing an AED coordinator to implementing an efficient
program can definitely provide the shock that saves lives.
10
APPENDIXES
Appendix A – Ames Heart Risk Statistics
This appendix discusses the sources of information and related calculations for the
number of Ames residents at risk for heart disease.
Figure 1 is a chart taken from the Center for Disease Control’s National Vital Statistics
Report, Deaths: Final Data for 2001.
Figure 1: Leading national causes of death. Source: CDC
As you can see, diseases of the heart, or CVD accounted for 29% of all deaths
nationwide. Further, as the table below shows, CVD accounted for 29% of all deaths in
Iowa as well. The table was taken from the center for disease control websites
publication “Vital Statistics of Iowa, in Brief, 2003”.
Figure 2: Leading causes of death in Iowa.
Source: IDPH
11
Also, the AHA’s publication “Heart Disease and Stroke Statistics – 2004 update” states
on page 20 that “… the overwhelming number of sudden cardiac deaths from coronary
disease (estimated at about 340,000 per year) is thought to be from ventricular
fibrillation.” Because CVD accounted for 700,142 deaths in the Nation in 2001, SCA
(caused by VF) accounted for approximately 48% of those deaths.
The table taken from page 3 of the AHA’s publication, “Heart Disease and Stroke
Statistics – 2004 update,” shows that 22.6% of the population is affected by CVD as seen
in Figure 3.
Figure 3: Prevalence of heart disease in
the United States. Source: AHA
When you consider the population of Ames without students shown in Figure 4, the total
number of Ames residents that will likely experience CVD is 5177.
Figure 4: Ames demographics. Source: City of Ames and ISU
12
Appendix B – AED’s on the ISU Campus
The buildings on the ISU campus that have AED’s are Beyer, Forker, State Gym and
Lied Recreation Center. This appendix contains floorplans of those buildings with notes
about their placement and related signage
Forker
Forker is home to the exercise and sports science department. It contains three gyms, a
pool, racquetball courts and many general purpose recreational rooms. A floorplan of the
first floor of Forker, indicating the location of the AED is shown in Figure 5.
Figure 5: Floor plan for the first floor of Forker on the ISU campus showing the
location of the AED. Source: ISU
Note that the AED is placed in hallway far from the gyms. Further, the AED is very
poorly marked – there are no signs at the entrances of the building indicating an AED is
present, and there is no signage in the hallway for the AED. Figure 6 shows the hallway
that contains the AED in Forker.
13
The AED is the small white box on the wall to the left.
The total lack of signage for the AED and its poor
placement in the building make it almost useless in an
emergency situation. If the AED were placed in one of
the gyms, the pool areas, or even the commons area, it
would be much more visible in an emergency. Signage
on the doors, building maps indicating the AED’s
location and signage above the AED would make it more
visible and useful as well.
Beyer
Beyer Hall contains a pool and racquetball courts. It has
a commons area and a few staffed administrative offices.
Figure 7 contains a floorplan of the first floor of Beyer
hall. It shows the location of the AED in Beyer and the
pool and racquetball courts.
Figure 6: Photo of the AED in
Forker on the ISU campus.
Figure 7: Floor plan of Beyer Hall on the ISU campus showing the location of
the AED. Source: ISU
The AED is well marked – there are signs on every door, as shown in Figure 8, and there
is a sign on the wall just above the AED, as shown in Figure 9.
14
Figure 8: Sign posted on door of Beyer Hall
indicating that an AED is located inside.
Figure 9: Sign marking presence of
an AED on wall of Beyer Hall.
Still, the AED is not in a very visible area. It’s at the bottom of a stairwell, near an
entrance that is not often used. It would be much more effective if it were placed in the
commons area, near the administrative offices for high visibility (and so that the office
staff could have easy access to it), or in the pool area.
Lied Recreation Center
Figure 10: Floor plan of first floor of Lied
Recreation Center showing the location of the AED.
Source: ISU
Figure 11: Floor plan of the third floor of Lied
Recreation Center showing the location of the AED.
Source: ISU
Lied is the largest recreation center on campus, and it has two AEDs as a result. Figures
10 and 11 show the floorplans of the first and third floors of Lied.
15
Note that on the first floor the AED is near the
staffed entrance desk, in a commons area, and near
the basketball courts and soccer field – it has
excellent visibility and is quickly accessible. A
picture of the AED on the first floor is shown in
Figure 12. Similarly, the AED on the second floor
is highly visible and located between the track and
the weightlifting area – it’s very visible and quickly
accessible. Further, Leids has signs on every door
indicating the presence of AED’s. Lied is an
excellent example of how to make effective use of
AEDs.
State Gym
Figure 12: Photo of the AED placed on the
third floor of Lied Recreation Center.
State Gym contains a basketball court, racquetball
courts a small track and administrative office.
Figure 13 shows a floorplan of the second floor of State Gym.
The AED is well placed - near the basketball court and the administrative offices. It is
one of the few staffed areas in State Gym, and it’s easily accessible from the workout
areas. Further, State Gym has signs on all of the entry doors indicating the presence of
the AED, and every building map in State Gym shows the location of the AED, as shown
in Figure 14.
Figure 13: Floor plan of the second floor of State
Gym indicating the location of the AED.
Source: ISU
Figure 14: Photo of the map that is in State Gym,
showing the location of the AED.
16
Appendix C – Obtaining Data for the 3-5 Minute Coverage Map
The map of coverage areas for each fire station shows to average location that could be
reached in five minutes. This data was collected by driving for five minutes on major
east-west and north-south roads. To allow for the Opti-Com system which allows
emergency vehicles to control the traffic lights, time was paused when approaching
intersections with yellow or red lights. The boundaries on the map shows the distance
that could be traveled in five minutes by using the average distance reached at 0900,
1500, and 2100 on weekdays. This coverage map shows only the distance that can be
covered in 5 minutes by units from each of the stations, but does not account for the time
that passes from when a dispatcher receives the 911 call to when the units are en route to
the scene. If this interval were added, the actual response zones would be slightly
smaller.
17
Appendix D - Sample Maintenance Checklist
18
BIBLIOGRAPHY
1. “AED.com: Saving Lives Through Education.” AED.com. <http://www.aed.com>
October 27, 2004.
2. “AED Training.” National Center for Early Defibrillation. <http://www.earlydefib.org/03_06_08.html> November 1, 2004.
3. “Ames Population.” City of Ames. <http://ames.areaconnect.com/statistics.htm>
November 2, 2004.
4. Bledsoe et al. “Cardiac Arrest.” Paramedic Care: Principles and Practice. 2001
Prentice-Hall. pp 212-216.
5. “Building Floor Plans.” Iowa State University. <http://www.fpm.iastate.edu/maps/
buildings/> October 24, 2004.
6. Caffrey, Sherry L. “Public Use of Automated External Defibrillators” The New
England Journal of Medicine. 2002, v 347, pp 1242-1247.
7. “City of Ames Website.” City of Ames. <http://www.city.ames.ia.us/> November 3,
2004.
8. “ECC Guidelines: The Automated External Defibrillator.” Circulation. 2000, v 102,
i 60. American Heart Association.
9. “Evaluate Cost-Effectiveness.” National Center for Early Defibrillation.
<http://www.early-defib.org/03_06_09.html> November 1, 2004.
10. “Grant Guidebook: The Strategy of Opposites.” <http://www.theideabank.com/pdfs/
grantguidebookpdf.pdf> November 1, 2004.
11. Honolulu Police Department. <http://www.honolulupd.org/museum/history6.htm>
October 31, 2004.
12. “ISU Enrollment.” Iowa State University. <http://www.iastate.edu/~inst_res_info/
pdffiles/pcr/0902a.pdf> November 2, 2004.
13. Orr, Tamra B. “Sudden Cardiac Arrest Can Hit Anyone, Anytime: Find Out What is
Saving Lives.” Current Health 2: A Weekly Reader Publication. January 2003,
v 29, i 5, pp 28-29. Weekly Reader Corp.
14. Polito, Marilyn. Director of Emergency Services, Mary Greeley Medical Center.
Email 11 November 2004.
19
15. “Professional Support and Educational Materials for Initial Emergency Care
Instructors.” AED Instructor Foundation.
<http://www.aedinstructorfoundation.org> October 24, 2004.
16. “Sudden Cardiac Arrest Facts and Statistics.” American Heart Association.
<http://www.americanheart.org/> October 25, 2004.
17. Zipes, Douglas. “Questions and Answers About AEDs.” Medical Update. June
2003, v 28, i 1, pp 3. Benjamin Franklin Literacy and Medical Society, Inc.
20