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State Laws on Cardiac Arrest and Defibrillators

State Laws on Cardiac Arrest and Defibrillators

State AED Legislation - Good Samaritan Table

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State Laws on Cardiac Arrest & Defibrillators -(As of January 2013)

Visit the following website for a comprehensive list of the State Requirements for Defibrillators to: 

http://www.ncsl.org/research/health/laws-on-cardiac-arrest-and-defibrillators-aeds.aspx

 Encouraging or requiring community access and use

Updated January 2013 (Includes an archive list of laws 1997-2010)

Each year, more than 250,000 Americans die from sudden cardiac arrest.  According to medical experts, the key to survival is timely initiation of a "chain of survival", including CPR (cardiopulmonary resuscitation).  Because of recent technological advances a portable lifesaving device, called an "automated external defibrillator" or "AED" has recently become an important medical tool.  Trained non-medical personnel can use these simplified electronic machines to treat a person in cardiac arrest. The AED device "guides the user through the process by audible or visual prompts without requiring any discretion or judgment."1 The American Heart Association notes that at least 20,000 lives could be saved annually by prompt use of AEDs. Ultimately, with broad deployment of AEDs among trained responders, as many as 50,000 deaths due to sudden cardiac arrest could be prevented each year. 

2013 Federal Update: FDA Seeks to Toughen Defibrillator Regulations, the New York Times, March 22, 2013 BY Sabrina Tavernese. "The devices, which can be found in malls, airports, casinos, churches in addition to medical settings, re-establish cardiac rhythms in patients whose hearts have abruptly stopped or lost their regular beats. Such cardiac arrests kill as many as 400,000 people a year in the United States, according to the American Heart Association, more deaths than caused by Alzheimer’s disease, diabetes and accidents combined. There have been 45,000 reports of the devices failing or malfunctioning since 2005, agency officials said. The vast majority of them were due to manufacturing problems, officials said, but some were because of improper maintenance, such as battery failure. Manufacturers have recalled the devices 88 times in that period."

Advocates of this approach envision placement of AEDs in public buildings, transportation centers and even large offices and apartment buildings.   Meanwhile, the commercial market has expanded substantially, with machines that once sold for $3,000 and up now advertised at under $1,000 for small office, personal or home use.

State Legislators have become actively involved with this issue in the past six years.  Most commonly, the recent state laws encourage broader availability, rather than creating new regulatory restrictions. Most of the bills enacted from 1997 to 2001 included one or more provisions to:

automated external defibrillator automated external defibrillator

Establish legislative intent that an "automatic external defibrillator may be used by any person for the purpose of saving the life of another person in cardiac arrest."

  • Encourage or require training in the use of AED devices by potential users.
  • Require AED devices to be maintained and tested to manufacturer's standards.
  • Create a registry of the location of all such defibrillators, or notification of a local emergency medical authority.
  • Allow a "Good Samaritan" exemption from liability for any individual who renders emergency treatment with a defibrillator.
  • Authorize a state agency to establish more detailed requirements for training and registration.

Florida was the first state to enact such a broad public access law in April 1997 (Chapter 34 of 1997). As of 2001, all fifty states, listed below, had enacted defibrillator laws or adopted regulations. 

In 2003, Utah updated its AED law by establishing a statewide registry; while Virginia updated AED laws by deleting the requirement for registration.  Alabama, Alaska, Colorado, Connecticut, Indiana, Kansas, Nebraska, Nevada, Tennessee and Texas also changed or expanded their AED laws.

In 2004, AED laws were changed or expanded in Connecticut, Florida, Hawaii, Idaho, Illinois, Louisiana, Maine, Michigan, Missouri, New York, Ohio, Oklahoma and Rhode Island.  The Illinois law (H. 4232)requires every physical fitness facility to have at least one AED on premises, by mid-July 2006, with exceptions. 

In 2005-06, Maryland added a requirement that every high school and school-sponsored athletic events have an AED available.  California required health clubs to have at least one AED.  Florida authorized state and local police vehicles to carry an AED.  Indiana and Virginia repealed filing and training requirements. New York required places of public assembly to maintain an AED.  Oregon updated Good Samaritan protection for trained AED providers, employers, property-owners and sponsoring agencies.  Arizona, Colorado, Florida, Illinios, Maryland, Massachusetts, Nebraska, New Jersey, Pennsylvania, and Wisconsin also enacted AED laws.

In 2007, Texas added a requirement for AEDs not approved for over-the-counter sales.

In 2008 laws were enacted in Georgia, Idaho, Illinois, Indiana, Iowa, Massachusetts, New Hampshire, New York, South Carolina, Tennessee, West Virginia, Wisconsin and the District of Columbia (as of July 8, 2008).

In 2009, Illinois added dentist offices; Kansas and North Carolina expanded access by allowing "any person to use an AED.

In 2010, recently Arizona, Idaho, Maryland, Missouri and Oregon enacted laws to assure that program facilitators, individuals, businesses and entities that place AEDs in their establishments are afforded appropriate immunity. Maryland and Missouri’s new laws also guarantee protections to lay rescuers who in “good faith” use an AED when working to save someone from sudden cardiac arrest.  Iowa and Wisconsin require all high schools students to be offered life-saving CPR training. These trainings must offer psychomotor skill development, which help ensure critical hands-on course work will be offered. Arkansas secured $300,000 to fund a Medical Emergency Response Planning in Schools program to assure that the AEDs are placed appropriately and school staff is trained properly. (adopted from AHA materials).

A 2011-12 AED Legislative Snapshot

As of January 2012 there were a total of fifty six state bills pending or recently passed which specifically relate to Defibrillators (AEDs) and Cardiac Arrest. They relate to a variety of subjects: training in the workplace, schools, and medical facilities, availability of Defibrillators (AEDs) in gyms, places of work, schools, government buildings, community centers, golf courses, public areas, and medical facilities, a declaration of Cardiac Awareness Month, emergency actions plans of school districts to include Defibrillators (AEDs) in their emergency plan equipment, immunity from civil liability for the use of Defibrillators (AEDs) in good faith during an emergency, and tax credits for the cost of purchasing Defibrillators (AEDs).

2012-2013 Update States with pending or newly passed  legislation include Illinois, New Jersey, Pennsylvania and Virginia.

 

TABLE 1 - AED Required Use and Placement

 AED Location  States Requiring or Supporting AED Placement
 Schools   California "urges" K-12 schools to implement AED programs (2005), Colorado (donations), Florida, Georgia (2008), Illinois, Iowa (2010), Maryland, Michigan, Nevada, New Jersey (2012), New York, Ohio, Pennsylvania, South Carolina (2008), Virginia and Wisconsin (2010) require some schools to have portable defibrillators; actual extent varies.  Tennessee "encourages" placement in schools (2008.)  
 Health Clubs  California, IllinoisIndiana (2007, 2008), Massachusetts (2007), Michigan, New Jersey, New York, Pennsylvania (2012), Rhode Island and the District of Columbia (2008) laws now require health clubs to have at least one AED.  Definition example (Michigan): "Health club" means an establishment that provides, as its primary purpose, services or facilities that are purported to assist patrons in physical exercise, in weight control, or in figure development, including, but not limited to, a fitness center, studio, salon, or club. A health club does not include a hotel or motel that provides physical fitness equipment or activities, an organization solely offering training or facilities for an individual sport, or a weight reduction center.
 Day Care Centers  Wisconsin (2008 - requires day care center personnel to have AED proficiency)
 Dental offices  Illinois (2009), Wisconsin (2008- requires dentists to have AED proficiency.)
 Places of Public Assembly  New York (2006)
 Swimming Pools  New York (2008)

 

Congress Acts on AEDs: In 2002, Congress incorporated the Community Access to Emergency Devices Act (Community AED Act) into H.R. 3448  of 2002(sections 159, 312 and 313) of the Public Health Security and Bioterrorism Response Act.  The President signed the bill on June 12, 2002 as Public Law 107-188.   The provisions authorize $30 million in federal grants in year one of the five-year measure. The grants, to be made available to applying states and localities, would be used for the purchase and placement of automated external defibrillators (AEDs) in public places where cardiac arrests are likely to occur. Grant funds would also be used to train first responders to administer immediate life-saving care, including AED use and cardiopulmonary resuscitation (CPR). The bill also encourages private companies to purchase AEDs and to train employees in CPR and emergency defibrillation.

 

 

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