Compatibility, Standardization, and Cost

I’m about to do something not often done on this website.  I’m about to argue that KISD should spend more money than originally planned on something.  It’s not turf or stadiums, though.

One of the interesting things I learned last night when I took my CPR/AED renewal was that KISD is in the process of purchasing 55 AEDs for use on all of their campuses.  They are evaluating various models and comparing costs before making the purchase, which is of course the right thing to do.  In the absence of other factors, I’d suggest using cost to feature analysis and picking the one with the most features for the lowest cost. 

However, there are other factors to consider.  Specifically, the City of Keller has standardized on the LIFEPAK 500 AED from Medtronic.  While the LIFEPAK 500 isn’t the lowest cost model, it had the advantage of being directly compatible with the LIFEPAK 12 Defibrillator/Monitor that Keller Fire-Rescue carries on its trucks and medic units.  This means that the electrical pads that were applied to the patient for the AED can be plugged directly into the LIFEPAK 12 and the LIFEPAK 12 can use those pads for both defibrillation and pacing.  The 500 is also compatible with the Medtronic LIFEPAK defibrillator/monitors carried by the majority of EMS agencies in the KISD area (i.e. Medstar for Ft. Worth, Watagua DPS, Southlake Fire, etc). 

So why is this compatibility so important?  Can’t any AED save a life?  Certainly having an AED is better than not having one, so should KISD choose another one it’s not like their brand will cause people to die that wouldn’t have otherwise died (hopefully blank stare  ).  Still, though, there are some good reasons for compatibility:

  • As noted above, the electrode pads used by the LIFEPAK 500 are directly compatible with the LIFEPAK 12 and can be used for defibrillation and pacing as well as reading electrical activity (ECG) on the monitor.  Other brands would likely require removing the pads and replacing them with compatible ones.
  • Once a pad is used for defibrillation it will cause a burn (first degree) on the patient’s skin.  This is an acceptable side-effect, given that the alternative is dying.  However, it also means that if you have to change the pads you have to find a different position, which may require putting the new ones in a suboptimal location, as well as causing new burns.  The ideal locations are on the upper right chest and on the left side, towards the bottom of the ribcage, such that you’re making a diagonal through the heart.
  • When a pad is used the first time it breaks down some of the electrical resistance and will be more effective afterwards.  Replacing the pads means having to start over.
  • Changing pads takes additional time over just plugging the pads into the LIFEPAK 12.

While all AEDs are designed to be easy to use (per FDA/US Gov requirements), it should also be noted that Keller Fire-Rescue trains quite a few people in town on CPR and AEDs and the training is done with the 500T (the “inert” trainer for the 500; it simulates AED operation pretty realistically, but can’t actually shock anyone).  It certainly can’t hurt to have the same model of AED available that Keller Fire-Rescue trains with (although I do acknowledge that many KISD schools are outside Keller itself). 

This is one situation where I think spending a bit extra to insure compatibility and continuity of care is worth it. 

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