Defibrillators are an essential piece of equipment that all electricians should carry with them or have on a work site. Sean Carroll finds out what is being done to make them more accessible.

Electricians are no strangers to electric shocks. That’s not to say that every sparkie has been shocked, but by working with electricity all day, every day, there’s a lot of awareness around electrical safety and taking all the appropriate measures to stay safe and shock-free.

There are ways to limit the risks of electrocution, but there will always be accidents that lead to the worst-case scenario, a sudden cardiac arrest (SCA).

Across Australia, 30,000 SCAs occur out of hospital each year, with many occurring in the workplace. Only 10% of people survive SCAs if they don’t receive rapid defibrillation in time, according to data from St John Ambulance Victoria.

And these events aren’t specific to a certain demographic. People of all ages, all fitness levels and with any pre-existing conditions can experience a SCA.

Certain workplaces, particularly those involving live electricity, present an increased risk of SCAs induced by an electric shock. Employees in construction, electrical transmission and distribution networks face a significant threat, with SCAs accounting for 15% of all the fatalities in the construction sector per The McKell Institute’s report, AEDs on Australian worksites: A low-cost proposal to save lives.

And it’s not just high voltage that triggers these events, even low voltage alternating current can induce ventricular fibrillation (a type of lethal arrhythmia or irregular heartbeat seen in SCA). The only way to survive such an event is via chest compression CPR and rapid defibrillation. When a defibrillator is applied to a person’s exposed chest, a small electrical current shocks the heart, resetting the chaotic heart cells and allowing the heart to start its natural pumping rhythm again.

When someone goes into cardiac arrest, time is crucial. Every minute that a person spends without appropriate medical attention can mean the difference between life or death. Having a defibrillator nearby and using it before an ambulance arrives increases the chance of survival.

“Even the best ambulance response time, at around ten minutes, might not be enough time to save someone’s life, we need witnesses to act quickly with CPR and get a defibrillator on them to buy time while waiting for the ambulance to arrive,” Rapid Response Revival (RRR) chief marketing officer Mark Hillebrand says.

RRR is a medical technology company focused on transforming the automated external defibrillator (AED) market. Mark says that the company has invested heavily in research and development to make defibrillator technology automated, accessible and easy to use.

“The founder of our company, Donovan Casey, looked into the pain points with defibrillators and worked hard with our engineering team to make them easier to use and always ready for use. In the past, defibs used to be large, scary-looking machines that in public settings are often out of order with an expired battery or electrode gel pads, but our latest solution is very user-friendly and always ready,” Mark explains.

CellAED is a much smaller defib, about the size of a bar of chocolate, and to use it, the responder needs to snap it in half to turn it on, peel the label off the back to expose the electrode pads, and then stick the two pads on the affected person’s bare chest.

Mark tells a story that was in the news a few months back about a rugby player in Sydney who was worried about using a defibrillator, saying that he was concerned he might hurt his friend who had just experienced a SCA. This isn’t an issue with CellAED: “We have fully automated the process where once the defib is put onto someone, it does a quick heart rhythm analysis and determines whether they need a shock or not, it will automatically deliver a shock if it detects a shockable rhythm without the user needing to push a button; it also has voice instructions and metronome beep to guide the user through the process and perform CPR at the right time. Out of all our use cases so far, the resounding feedback from the users is the same, that the voice for CellAED was calming and reassuring, it told them exactly what to do every step of the way.”

He adds that there is nothing wrong with the older defibrillators, they work if kept maintained and can be accessed quickly. Mark says that the new solution, CellAED is like the LED light bulb to the fluorescent lamp, both output the same number of lumens, but one is just more compact and requires less power.

This ease of use, and increased portability, is something that RRR is hoping will see more defibrillators where they’re needed, keeping them on-site and carried with sparkies just in case something happens.

“It’s an essential bit of kit that every electrician should have. It’s not mandatory under any legislation at the moment but it’s a bloody good idea,” NECA Group WHS manager Owen Leslie says.

“The idea is that you buy it and never use it, it’s just insurance. And if you do, well then that’s great because it was there when you needed it.”

Owen says that electricians should include defibrillator access in their pre-start risk assessment. It’s important that, before conducting electrical work, sparkies understand where the nearest defib is, whether that’s on their van, in a house or even now, carried with them.

Mark believes that defibrillators should become a regular part of safety equipment: “I think defibrillators should be in the same space as smoke detectors and a bike helmet, something that has to be done to protect yourself.

“At the moment, defibrillators are expensive pieces of equipment and as we scale and the technology evolves, that price will come down. It needs to become mandatory for everyone working in a trade. I wouldn’t want it to be a case of: ‘Hey, this is mandatory for electricians but not for plumbers,’ because we know that everyone is at risk.”

Owen points out that money isn’t an issue when it comes to government regulation.

“Look at the silica safety situation right now, that’s costing businesses a lot of money but it’s mandatory. I don’t think the cost is stopping defibrillators from becoming mandatory, there’s just not enough people calling for it right now, there’s no media circus or headlines about the topic,” he says.

“Electric shocks are the number one killer among electricians so at the moment, every electrician should have one or go get one.”

Access to AEDs shouldn’t just be seen as a safety measure; it’s a critical tool against the fatal consequences of electric shock-induced cardiac complications. SCAs are unpredictable and while there isn’t much in the way of prevention, people can be prepared.

“The chances of this happening are pretty slim but if it does happen, you’re going to want to be prepared,” Mark concludes.

“I believe there will be regulation in the future to encourage the use of these devices. For the moment, it’s the innovators and the good employers who are starting to adopt this technology. For the employers that want to provide safe workplaces when it’s not mandatory, it’s great. At the end of the day, the cost of losing an employee, a friend or a family member is just too high.”

BOX OUT 1: What’s the difference between a cardiac arrest and a heart attack?

Sometimes the two terms are used interchangeably to describe a serious heart event but the two are completely different problems. The difference between a cardiac arrest and a heart attack boils down to a difference between a ‘plumbing’ and an ‘electrical’ issue.

During a heart attack, one or more of the arteries that take blood to the heart’s own tissue become blocked or narrowed. This means that less blood (and consequently less oxygen) is delivered to the heart muscle. The heart muscle in the area being fed by the blocked artery becomes damaged and can die.

The blockage in the artery can be because of a build-up of fat and cholesterol (a plaque), or sometimes it is due to a severe spasm of the artery wall that causes the artery to narrow temporarily, restricting blood flow to the heart muscle.

During a cardiac arrest, there is a problem with the signals that tell the heart when and how to contract. This means that it either stops beating or isn’t beating enough to get your blood moving around your body as it should be.

This can be caused by abnormal heart rhythms (arrhythmia), cardiomyopathies, which affect the tissue of the heart, congenital heart diseases that are present from birth, or sometimes a traumatic event that causes a large amount of blood loss (a haemorrhage).

BOX OUT 2: Servicing defibrillators

The most common cause of a defibrillator failing is usually a flat or expired battery. Defibrillator batteries are not rechargeable and once these batteries expire, they must be replaced. Defibrillators will require a battery and pad replacement every two to five years (check your defibrillator for its expiry date).

Electricians are in a unique position because they already have a range of solutions that they maintain and test so a defibrillator should fit under an existing asset register.

“For sparkies who bring a defibrillator to their day-to-day jobs or have one on a work site, you just include the defibrillator with all the other electrical tests and maintenance. From time to time, they need a battery change and some new pads but other than that, the maintenance is relatively easy and cheap.”

Mark says that the AED from Rapid Response Revival is a fully integrated AED meaning the battery and pads are part of the device. It has a two-year expiry and the LED on the front of the device informs you of the battery status, flashing green when fully operational and ready to use and warns you when the battery is low. The company sells their units through a membership program where they will send you a replacement when the time comes.

“We ask people to buy the first one outright and then under our annual membership, we replace them for free,” he says.

“We do this because we don’t want people to hesitate and worry about having to buy a new one. We don’t want anyone to see someone on the ground and think about how long the person has been there or if it’s financially viable to use the device.”

CellAED devices also come with a built-in SIM card so that the company can remotely monitor the devices. The unit sends a monthly update to inform the customer of the battery status and the expiry date. CellAED has been designed to ensure there is no maintenance and people always have a working defib. RRR manages the recycling of the devices by getting the old devices sent back when their replacement arrives.