    [Public Papers of the Presidents of the United States: WILLIAM J. CLINTON (2000, Book I)]
    [May 19, 2000]
    [Pages 992-993]
    [From the U.S. Government Publishing Office www.gpo.gov]

    Memorandum on Automated External Defibrillators in Federal Buildings
    May 19, 2000

    Memorandum for the Secretary of Health and Human Services, the
    Administrator for General Services

    Subject: Automated External Defibrillators in Federal Buildings

        This country has taken many steps to try to reduce the number of
    persons who die each year from heart disease. Advances in the field of
    medicine and private-sector public education campaigns have helped to
    prevent and treat heart disease, but there is much more work we can do.
    Recent studies estimate that more than 250,000 persons die each year
    from sudden cardiac arrest--about 700 a day.
        The most common lethal arrhythmia responsible for sudden cardiac
    arrest and collapse is ventricular fibrillation, which if treated
    quickly, can be reversed. By some estimates, one-quarter to one-third of
    people in sudden cardiac arrest might be saved with optimal emergency
    care. One of the most effective ways to reduce the number of people who
    die from sudden cardiac arrest is the prompt intervention of
    defibrillation. Estimates show that for every minute that passes without
    defibrillation, a victim's chances of survival decrease by seven to ten
    percent. After as little as 10 minutes, very few resuscitation attempts
    are successful. Automated external defibrillators (AEDs), which deliver
    a shock through the chest wall to the heart and enable the heart to
    regain its own normal rhythm, may be a helpful adjunct to
    cardiopulmonary resuscitation (CPR) and local Emergency Medical Services
    (EMS) in saving lives.
        Recently, private companies, local governments, and airports have
    begun instituting programs to put AEDs into place and have provided
    training programs on how to use the devices for their employees. In June
    of 1999, the City of Chicago put AEDs within a minute's walk in airport
    terminals with accompanying emergency medical support. In the first
    month after they were made available, the devices saved four lives.
    Similar results may be found in Las Vegas, where many buildings now
    provide AEDs.
        The Federal Government employs approximately 1.8 million people.
    Many millions more visit Federal buildings each year. While a number of
    agencies such as the Department of

    [[Page 993]]

    Transportation and the Environmental Protection Agency have begun
    putting AEDs in some of their buildings, I believe that we must make a
    more systematic effort to provide for the safety of Federal employees
    and the persons who visit Federal buildings each year.
        To that end, I direct you to report back to me within 120 days with
    guidelines on a program for AED placement in Federal buildings. These
    guidelines should optimize the use of AEDs, putting them in buildings
    and other Federal areas. These guidelines should include, among other
    issues, training programs in the use of cardiopulmonary resuscitation
    (CPR) and AEDs; appropriate physician oversight; integration with the
    local EMS system; the use and maintenance of AEDs; placement of AEDs in
    each facility according to each facility's needs; response system
    activation and coordination; and legal issues. In creating these
    guidelines, you should cooperate and consult with interested parties,
    including other Federal agencies--particularly, the Office of Personnel
    Management, the Department of Transportation, and the Department of
    Justice--and State and local agencies focusing on research and public
    health, consumers, health organizations, and academia. The plan should
    make special efforts to build on efforts of the private sector,
    including nonprofits such as the American Heart Association and the
    American Red Cross, through the use of public-private partnerships or
    other appropriate mechanisms.
        These steps, taken together, will help to protect the lives of
    Federal employees and the millions of other persons who visit Federal
    buildings each year.

                                                          William J. Clinton

    Note: This memorandum was made available by the Office of the Press
    Secretary on May 19 but was embargoed for release until 10:06 a.m. on
    May 20.