[Artemisia] Re: Event Emergency

[Catherine Helm-Clark]

On Apr 18, 2007, at 1:04 PM, artemisia-request at lists.gallowglass.org  
wrote:
> I was also surprised that there was no resusciation equipment.
> Every venue that has athletic activity should have a defibrillator
> - the modern ones are safe and effective in the treatment of
> ventricular arrhythmias.  I was made to understand that one is
> not provided due to perceived liability, but my thinking is that
> having a defibrillator for a major event falls within the ambit of
> things that ought to be done.

I'm not going to argue against AEDs since anyone with half
a brain and a CPR cert already knows that survival stats with
an AED are demonstrably better than plain CPR performed with
no ancillary equipment.  But that's not the problem as perceived
by the Board of the Directors of the SCA. The liability concern
as I understand it is thus: while first aiders may be trained in the
use of AEDs, they are not trained and are not familiar (and not
expected to be familiar) with the maintenance of AEDs.  Since
AEDs incorporate software and sometimes firmware that must
be actively upgraded, the maintenance of these devices is
non-trivial, especially since different states have differing
protocols for using AEDs, protocols that are reflected in the
programming.  So, not only is the maintenance non-trivial but
assuring that a traveling AED is set-up correctly for use in the
state it is being taken to (especially if that AED is traveling to
events in several different states)  is very non-trivial and far
beyond the expectations and training of your average first-
aider, which is the standard that we write our chirurgeonate
policies to. On top of that, last time I checked (which was a year
and a half ago), there was also non-trivial paperwork that has
to be processed before any software/firmware upgrades can
be made to an AED.  And all of the maintenance related
paperwork needs to be of a certain high standard where that
standard is dictated by case law, as anyone in the medical or
engineering professions can tell you.  And even if all the
maintenance was done correctly, in court if it wasn't
documented, it didn't happen...

All of this can boil down to liability for damages if an AED owned
by an SCA group was improperly maintained or even if the paper
trail for that AED was not kept properly.  Bad paperwork can be
just as deadly as real malfeasance in the hands of the right
lawyer for the plaintiff.  Then there is the issue of cost.  AEDs
are hardly cheap and are beyond the budget of most first aiders.
Basically, one could argue that the prudent person test  would
result in opining that AEDs are not normal and expected items
for a non-professional first aid kit.  The same can not be said
if we were applying the prudent person test to a healthcare
professional or a large facility with a large daily throughput
of people.  As far as applying the prudent person test to AED
ownership by not-for-profit groups like the SCA, things are a
lot more ambivalent due to the nature of most SCA events
(small) and the nature of the organization (exploring history
through re-creation).  It would be a more common expectation
for a facility to own an AED, like a park or a campground, than
for a living-history club like the SCA to own AEDs - but the area
is grey and I know of no case law to date that might shed a bit
more light on this subject.

So the BoD decided that risks of malfeasance and/or
misfeasance from improperly maintained/serviced/documented
AEDs were greater than the risk of nonfeasance from not providing
one at every event, especially since there is not a clear cut duty
of care under common law for the SCA to provide AEDs at every
event, not when we don't require there to be first aiders at every
event (excluding those where we already have a duty of care for
advanced first responder services like Pennsic).

Mind you, I don't make the policies nor do I agree with all of
the policies that apply to first aiders at events (e.g. section III.8
of the SCA Chirugeons' Handbook).  The current AED policy is that
SCA groups can not own AEDs, whether purchased or donated.
There's nothing on the books, however, that prevents an individual
or group of individuals from buying and owning an AED that they
just  happened to take with them to events...

ttfn
Therasia