Friday, 6:30 p.m. It's been a normal day at your club, and you're getting ready to head out the door when you hear a staff member shout: “Call 911! Grab the AED!” An elderly man has collapsed on the floor, a victim of sudden cardiac arrest (SCA). As another staff member calls 911, you grab the automatic external defibrillator (AED) from the wall and run to the man's side. You place the pads on his chest, the machine reads his heart rate and instructs you to give him a life-saving shock. His pulse regulates, and the ambulance arrives to take the man to the hospital. He is released the next day in good health.

Because of scenarios like this, health clubs around the United States are considering the purchase of AEDs — devices that use an electric shock to reset the abnormal rhythm of the heart caused by sudden cardiac arrest. Studies of AEDs have shown that if a person is treated within a couple of minutes of an attack, his or her chance of surviving is greatly increased. But for every minute the SCA goes untreated, the victim has a 10 percent less chance of survival.

IHRSA estimates that 25 percent of all U.S. clubs have AEDs and staff members trained to use them. Though having AEDs in health clubs isn't required, some states are trying to pass mandates that would require AEDs and staff training for their use. Few states currently have legislation in the works for AEDs in clubs.

“Illinois is the farthest along (when it comes to AED legislation in health clubs). Its mandate passed the legislature and it is on the governor's desk,” says Kevin Buckley, deputy director of government relations for IHRSA. “Legislation has been introduced in Rhode Island, New York, New Jersey and Louisiana, and on the county-level in Maryland and New York state.”

So how do you decide whether to invest in an AED in your club? A look at the pros and cons should help make the decision easier, and further inform you about AED technology, costs and benefits.

PROS

  • AEDs save lives

    According to the American Red Cross, sudden cardiac arrest is one of the leading causes of death in the United States. The Red Cross estimates that more than 250,000 people die each year from SCAs. People working out in health clubs are at a higher risk because they are strenuously exercising their hearts. A joint statement published by the American Heart Association (AHA) and the American College of Sports Medicine recommended that sports clubs have AEDs.

    “Folks that are in the health club setting are at a higher risk, and health clubs should be prepared,” says Robin McCune, director of national accounts for the Emergency Cardiovascular Care Programs at the American Heart Association.

    By using AEDs, many lives can be saved in the health club environment.

    “I recommend AED programs for health clubs because the evolving science seems to suggest that health clubs are at a higher risk than other environments,” says Richard A. Lazar, CEO of the Early Defibrillation Law & Policy Center in Portland, OR. “Those working out appear to have a greater likelihood of cardiac arrest than people sitting in front of televisions.”

  • AEDs can decrease liability

    No regulations require health clubs to have AEDs, but if there isn't an AED in your club and an incident occurs and help can't be reached in time, you may be held liable, says Lazar. Having an AED can prevent this liability as long as staff members know where the AED is, know how to use it, and it is part of an effective emergency preparedness system.

  • AEDs are easy to use

    Their easy-to-use interface is a major benefit. Because the device is automated, all a rescuer has to do is follow the instructions given by the machine. Most AEDs have a speaker that gives step-by-step instructions. A study done by the Journal of the American Medical Association found that even sixth graders could be trained to use an AED, and after training, they could use the equipment just six seconds slower than trained professionals. Michael Beauvais, club manager for Oak Park Athletic Club in Oak Park, IL, has implemented AEDs in his club and finds their interface uncomplicated. “They (AEDs) are simple to use. They walk you through everything,” Beauvais says. “The computer is amazing.”

CONS

  • Costs can be prohibitive

    One major drawback of an AED is the cost — on average about $2,000. Club owners must keep expense in mind when buying an AED because they not only have to pay for the machine, they have to pay to train their staff to use it.

    “States recommend that AED users be trained by the American Heart Association or the Red Cross,” says Lazar. “Health clubs must decide who in their program can access and use their AED.”

    The cost of training varies from $20 to $60 per person, which includes two to four hours of training on how to use the AED, as well as adult and child CPR training, lessons in how to help someone who is choking, the use of barrier devices and the telltale signs of heart attacks, stroke, cardiac arrest and foreign-body airway obstruction.

  • Non-use can create liability

    Although having an AED can prevent some liability issues, it can also present some problems for health clubs. If an emergency program isn't implemented around the AED, trouble can arise. If a club has an AED, and it isn't used when it should be, the club can be sued. Geof Eng, general manager and owner of The Grand Health Club in Tulsa, OK, says he hasn't invested in an AED for his club for several reasons, but one of them has to do with liability.

Though cost and liability are two major disadvantages of putting an AED in your club, some club owners have other reasons. “We've looked into them, but we're not going to do them at this point,” says Eng. “Our clientele base isn't really that age, and we have EMS not even a mile away.”

Before implementing AEDs in your club, it's important to look at all of your options and decide what is best for your clients and staff, as well as consider your financial situation. Even if an AED program is carefully designed, Lazar says, not everyone can be saved every time. But, just having an AED allows a club to be better prepared for an emergency.

“There is really no reason not to have one,” says Peter Kaiser, general manager for Lakeshore Athletic Club Downtown in Chicago. “It's there because it's so easy to learn how to use. If the statistics are true that it takes just minutes and seconds to save someone, and you can get the machine to the person, administer the care and help them out before the paramedics arrive, why not have one?”