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For those of you who haven't had a CPR refresher in a few years, they now heavily promote the use of AED's [Automated external defibrillator]. The prognosis for recovery after CPR alone is in the single digits and moves well, well into the double digits if supplemented with an AED.

Gyms, schools, and works areas should all have a $1000.00 AED onsite. I was surprised that he had to wait for the ambulance to arrive before being defibrillated, since he was in a gym.



Remember things like this when people complain about "modern Health and Safety red tape". "Oh we need to have a this and a that and failed out inspection! Get off our back, let me create jobs."

This shit saves lives.


This is the equivalent of "think of the children!"

Not everything that supposedly saves lives is worthy of being enshrined into law.


But it is worthy of being incentivized.

Defibrillators are a public good & a good candidate for a government incentive (or mandate).


So do you practice what you preach and carry one of these with you where ever you go, or in your vehicle? If not then why do you feel the government should impose that on a business? Why not make a law that says every business has to have a trained EMT on site during business hours. I'm sure that would save even more lives...


We have that. In germany the Berufsgenossenschaft mandates that every company with more than 2 and up to 20 employees has at least 1 person trained in first aid on site. Companies larger than that need 5% - 10% of the personal trained, depending on what work is done.

http://de.wikipedia.org/wiki/Unfallverh%C3%BCtungsvorschrift...


What is the consequence if 3 co-founders start a company, and only find out about this requirement a year later?

See item 7 of http://www.paulgraham.com/america.html to know why I asked it.


Good question.

* First: It's employees. Founders don't need to be employees. In fact, I'd say most are not.

* Second: You have to go through a basic first-aid course when you get your drivers license. So most people actually are basically trained. I think you have to refresh that course every two years to comply with the regulation, but that's a refresher only. It's really a basic first-aid class that's required if you're a small company.

* Third: This is the kind of regulation where you get a slap on the hand the first time you violate it. So I'd assume the answer is "Basically nothing"

Btw: Paul Grahams view on the regulations in germany is a bit outdated. SAP started in a garage. And you don't need 20k to start a startup. You need 25.000 Euro to form a GmbH which is one kind of a LLC. There's a lot of reasons why big startups mainly happen in the USA, but the garage issue is none of them.


Right, and that is probably a negligible cost as you can get first aid training for free in a lot of places. The point is the op is advocating that businesses be required to buy expensive equipment that they themselves probably wouldn't be willing to spend the money on.


I need to pay that persons training, the wage for the lost day of work once a year. The training cost itself is negligible, but a day not billed to a customer costs me ~ 800 USD. I can nearly pay an AED for that.

However, given that a colleague nearly died from a stroke (he completely recovered) and another colleague permanently failed to show up for work after a bike crash, I think that having more people solidly trained in emergency procedures can't be a bad thing. And a one-time investment for medical equipment mandated for companies from a certain size on might be a good thing to consider.


Actually if you read the OPs statement twice, you'll realize that he just voices his surprise that no AED was on site and does not advocate anything.


In a normal office you wouldn't need more than one AED per 50+ employees. That's an insignificant cost.


This is so true ... I lost a cousin at a young age due to hypertrophic cardiomyopathy induced cardiac arrest and he could have been saved with an AED (simply restoring a normal rhythm). If you're interested in helping to promote the availability of AEDs in the U.S., check out http://gregaed.org/. If you do nothing else, learn CPR, artificial respiration and how to use an AED. You don't know who you'll end up helping (and hopefully you'll never use it) but you might also save someone's family a lot of suffering.

Thanks!


Definitely, there's really no excuse if you're a company. If nothing else it's a moral booster for the employees. I really wish AEDs would get even cheaper so they became ubiquitous outside of work.

In Stockholm there's this system which enables emergence services to send out alerts to people with the proper training and/or equipment in the area of a heart failure.

http://news.ycombinator.com/item?id=4740974


What are the legalities involved here? If you attempt to help are you opening yourself up to potential blame and legal action? What about DNR wishes the person may or may not have, or religious beliefs?


Nobody wants to live in a world where people find a dying person laying on the floor and let him die because they're afraid of legal issues. The law protects you from such nonsense.

Even if it didn't, in my opinion, no person worth a damn would allow that consideration to color their response.


A few months ago there was an incident in China where a young girl was run over by a truck while crossing a street. Nobody stepped in to help, precisely because they were afraid of the legal consequences. The entire thing was recorded on video, and it got a lot of exposure. It was horrific, the kind of thing one wishes you had never seen or heard about.

On the other hand, and thankfully this was a much minor event, my wife once got a traffic ticket for moving her car a few meters past a red light in order to make room for an ambulance. Something like that is enough to make you think twice.


Can't speak about China, but most states in the US have laws to protect people with the proper training from legal exposure (for example if you're giving proper CPR and break a patient's ribs). http://en.wikipedia.org/wiki/Good_Samaritan_law#United_State...


I just watched it, after googling for it. As a dad, I'm sick and want to go home and hug my kids. I can't understand how these people lost their humanity, but I've certainly lost mine towards them.


Counterpoint and proviso: know what the hell you are doing. It's easily possible to do more harm than good if you don't know better.

For example, whenever a motorcyclist gets into a crash, people get the bright idea that they need to get the helmet off. No, the helmet is bracing their neck, which may very well be badly injured, so sometimes if you just pull it off, now the guy's a quadriplegic, and since you were just "trying to help", the law shields you from legal responsibility even though you just crippled someone for life.


The helmet must be removed for unconscious injured. If the person is fully able to respond you should leave the helmet on unless asked otherwise, but you must remove the helmet when the injured looses consciousness. Not taking the helmet of may have the injured die of blood or puke inhaled or just his tongue blocking respiration. So you're damned if you do and more damned if you don't.

Be careful when you remove the helmet, always remove glasses first, open the helmet and pull carefully straight "upwards". Keep the spine straight. Just before you completely remove the helmet use one hand to support the head, so it doesn't bump down. If there's a second person to help, one supports the neck and the other one pulls.

Just refresh your first aid class and do the best you can. It's in pretty much all cases better than no first aid.


Without the means or training to manage the victim's airway, there's no advantage to removing the helmet. Leave it for trained rescuers.


Better yet, become a trained first responder yourself. And urge your family members and colleagues (and anyone you spend significant amounts of time with) to do so as well.


By the time a trained rescuer arrives, the biker is dead or has massive brain damage from oxygen loss. So whatever you do can only be better than doing nothing.


I agree with that, but in the specific case of AEDs it's hard to get something badly wrong to the extent that you actively harm: the main failure case is not doing something properly that could've been done. So you should definitely yield to someone who has better training, if available. But if there isn't such a person available, the AEDs thesmelves are completely automated and intended to be used by non-experts (experts use EDs that aren't fully automated): they sample the heart signal for several kinds of situations that can be corrected by defibrillation, and then apply the right one if detected. They won't fire at all if they're not placed correctly and/or if it isn't one of the situations where defibrillation would help, so you can't accidentally give someone the wrong kind of shock that makes the situation worse.


Yeah, AED's are a massive help.


I heard from a guy (not Chinese national but married to one) who lives in China saying that in China, don't help anyone having accident on the street. He said there are many cases where when you help, you end up paying the bills because the person (or his/her family) would tell hospital that you cause the accident. Simply because they don't have money.

EDIT: He added that if you do want to help, make sure you have witnesses that you're trying to help.


This is the current federal law on the subject: http://www.law.cornell.edu/uscode/search/display.html?terms=...

Basically, you are immune from liability unless you either: 1) are a licensed professional acting within the scope of your employment, in which case normal professional liability rules would apply; or 2) do something that a court finds grossly negligent.


Unfortunately, it may cost you quite a bit of time and money to convince said court that what you did was not grossly negligent should someone press the issue.


No one in their right mind would press the issue, lest it causes a chilling effect on bystanders attempting to help someone in need.


Lawsuits and "right mind" seldom are within shouting distance of one another.

http://suite101.com/article/good-samaritan-risks-lawsuit---s...

And just for a twist:

http://abovethelaw.com/2011/08/lawsuit-of-the-day-good-samar...


Good Samaritan laws cover a layperson attempting to do good (so long as you're not doing something a reasonable person would realize to be actively harmful).

In most states, "ignoring" a DNR order is covered similarly. Point of interest:

Even as an EMS provider, with a patient who has a valid and active POLST (Physician's Orders on Life Sustaining Treatment - a more detailed DNR, that offers advice on comfort measures, intubation, and the like) - if the family wants heroic measures (CPR, etc), then we are required to do so (though my personal moral and ethical compass has issues with this).


I suppose if you think it's better that the person dies than you get sued...




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