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I ran with your idea, Crofty! I'll jury-rig a panel computer to feed the AEDs juice, reduce battery size, slam them onto the Net and toss in a Walmart cellphone so they can talk to an SCA coach. ;-) **Link Removed**

Here is a link to a study on that question. http://www.resuscitationjournal.com/article/S0300-9572(10)00244-3/abstract Personally I would defer to the AED's known falloff after 4 minutes, and shoot first. -Dwight

Good suggestions, very much appreciated. I agree with you all that the service agreement is a must, it's about $20 a month and it's all done by Physio-Control people (in my case). The AED purchase itself brings insurance with it (indemnification). It's going to be interesting how the fire...

AEDs are serviced by shipping them in, with loaner replacements often. Anybody can perform that function. Who inspects is flexible, the building ownership's designated employee can do that. What we need is a Fire Code mandate for an AED in the elevator lobby, and it would be nice if the Fire...

Thank you, I do agree of course. I wonder if ambulance people could inspect AEDs in high rises? I'm having some trouble getting fire people to see this as a future responsibility. Heart safety is a critical matter, and in high-rises you don't survive an SCA without and AED of some sort being...

I'm an AED consultant researching whether or not EMS crews actually reach victims of sudden cardiac arrest inside four minutes, after which survival rates fall off fast. I feel that this short a time is unreachable, in practical terms, since you can't negotiate with city traffic, building...

JPINF said Agreed. The answer seems to lie with the AED and its evolving communications functions.

Thank you for these superb comments, Akulahawk. First - having the security people well versed on guiding in the EMS people is essential. That should be obvious, cheap, and hopefully already basic to their 'training'; but if not it has to be addressed. Second - putting the AED into...

I guess there's a key issue of scale - if the facility is big enough then one of the crew on each shift can be a paramedic, and it's justified, especially in dangerous industrial venues. I'm still trying to rescue the idea here of getting a monitor/defib into very large residential and business...

That's what I'm trying nail down. What does it take, training and ticket wise, equipment-wise, infrastructure, etc. to get to the point where cardiac emergencies are dealt with as a whole, not just AEDs being there for SCA's.

Thanks for making that distinction, Nolan. Ideally I would want to see the guy with the ticket be allowed to run a LifePak 15, because vital signs monitoring and ePCR etc. connects with d2B procedures and upgrades the basic AED function to cover STEMI's. Given that requirement, what...

In large building complexes, how practical would it be to require that at least one security staffer each shift have an EMT ticket (and pay)? I see that as complementary to having an AED PAD in the lobby, until EMS crews can fight their way there. Covers STEMI's as well as SCA's. Look at the...

Socialism is new and fragile in the US, where the word lobbyist is hard to find in the Constitution, but everywhere in Washington. It's a lame duck, all agree, and the real danger is that the duck has cancer.

There are a number of those initiatives about. Here's one on a larger scale: www.atrusinc.com - Dwight

http://blogs.wsj.com/chinarealtime/2010/11/17/china%E2%80%99s-netizens-react-to-shanghai-tower-blaze/ Apparently caused by using flammable insulation, started by untrained welders. For some reason the media are pretty quiet about this. - Dwight

That suggestion is pure genius, which is why I started a company to pursue it. See www.elevaed.com ElevAED has applied to the ASME, the elevator regulators who will rule on it next year. But in the meantime I'm proposing one in every lobby (of towers) as the next best thing for proximity...

The approach I'm taking is that every high-rise should have an AED in its lobby. When the building's worth $20M what's $2K for a device that addresses the time barrier EMS responders can't be expected to always meet. If it's a fixture in the lobby every time you take the elevator, then maybe...