[Weekly Compilation of Presidential Documents Volume 36, Number 21 (Monday, May 29, 2000)]
[Pages 1177-1178]
[Online from the Government Publishing Office, www.gpo.gov]

<R04>
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

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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 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.