INTRODUCTION:



INTRODUCTION:

According to the American Heart Association, heart disease affects nearly 8 percent of all Americans and results in nearly 350,000 deaths each year. While several electrical abnormalities can result in sudden cardiac arrest, the majority begin with ventricular fibrillation. Rapid treatment of ventricular fibrillation, through the application of a controlled electrical shock, is essential to the victim’s survival. The American College of Occupational and Environmental Medicine (ACOEM) recommends placement, when practical, of Automated External Defibrillators (AEDs) in sufficient workplace locations to allow initiation of resuscitation and use of the AED (the so-called “drop to shock” interval) within 5 minutes of recognized cardiac arrest.

POLICY:

It is the policy of the [ENTER ENTITIY NAME] to provide an Automated External Defibrillator (AED) at various locations throughout the [City or Town] to make early defibrillation accessible to staff and other persons who experience sudden cardiac arrest. The purpose of this policy is to establish training, medical oversight, and guidelines for the placement, maintenance and use of Automated External Defibrillators by authorized individuals.

DEFINITIONS

Authorized Individual: means any person, not otherwise licensed or certified to use an AED, who has met the training standards set forth by this policy and Section 1797.196 of the Health and Safety Code, and who has been issued a written validation from the Medical Director for the use of an AED.

Automatic/Automated External Defibrillator (AED), means an external defibrillator capable of analyzing and delivering a shock to a patient when it determines the patient’s heart is in ventricular fibrillation or ventricular tachycardia.

Cardiopulmonary Resuscitation (CPR), means a basic emergency procedure for life support, consisting of artificial respiration and manual external cardiac massage in compliance with the standards of the American Heart Association or American Red Cross and the regulations adopted by the local Emergency Medical Services (EMS) Authority.

Medical Director: means a California licensed physician/surgeon who issues a written prescription for the use of the AED by authorized individual(s) and who assists in the development, implementation, and maintenance of the medical control of the AED program.

The Program Coordinator is person(s) at the [City or Town] responsible for the overall coordination, implementation, and continued administration of the program.

RESPONSIBILITIES

The Program Coordinator shall:

➢ Maintain a copy of manufacturer’s equipment and/or user manual for each type of AED in their inventory,

➢ Ensure AED units are properly maintained and tested in accordance with manufacturer’s guidelines,

➢ Ensure department personnel receive and maintain training in accordance with guidelines established by this policy and maintain training, maintenance and testing records,

➢ Ensure that adequate AED-related supplies and recommended ancillary medical equipment are kept on-hand,

➢ Ensure that the [ENTER ENTITY NAME] AED Program Medical Director is notified of any use of the department’s AED unit,

➢ Promptly notify the City Manager and Medical Director of any maintenance issues or unit failures;

➢ Participate in annual program reviews.

➢ Notify the local EMS agency of the existence, location and type of AED at each [ENTER ENTITY NAME]site.

➢ Conduct ongoing scheduled audits of the AED locations and equipment to ensure readiness and identify damage or vandalism issues at least once every 30 days .

MEDICAL OVERSIGHT

A. Medical Control

Before prescribing and authorizing the use of an AED, the Medical Director shall approve appropriate policies and procedures for the use of an AED that shall include:

➢ A description of the use of the AED, including, but not limited to, written medical protocols, identification of authorized personnel, standing orders, notification of use and a method to review incidents;

➢ Provisions to comply with federal, state, and the Local Emergency Medical Services (EMS) policies and procedures;

➢ A program for training and testing personnel in the use of the AED that complies with regulations adopted by the Local EMS Authority and the standards of the American Heart Association or the American Red Cross;

➢ A program to ensure the continued competency of authorized individuals, including periodic training and quarterly skill proficiency demonstrations, monitored by either the Medical Director or designee;

➢ Procedures for the review of each AED application and the recording of such; and,

➢ Conditions for the rescission or termination of authority for the use of an AED.

B. Testing and Written Validation

In order for an individual to obtain authorization to use an AED, the individual shall complete training and shall pass both written and skill examinations, as approved by the Medical Director. The examinations shall test the ability of the individual to access and manage the conditions as specified in this program.

The Medical Director shall issue a written validation or other documented proof of the individual’s authorization to use an AED.

V. TRAINING

Training shall include continuing education, quarterly demonstration of skills proficiency, regular updates on new methods/skills, and current knowledge of pertinent issues regarding the use of AED per the American Red Cross or American Heart Association guidelines. Training shall be documented (Attachment A) and consist of not less than four (4) hours and shall include the following topics and skills:

A. Proper use, maintenance and inspection of the AED.

B. The importance of:

➢ CPR

➢ Defibrillation

➢ Advanced life support

➢ Internal emergency response system

C. Overview of the local EMS system, including 9-1-1 access and interaction with EMS personnel.

D. Assessment of an unconscious patient to determine if cardiac arrest has occurred and the appropriateness of applying and activating an AED.

E. Defibrillator safety precautions that will enable the authorized individual to administer shock without jeopardizing the safety of the patient, him/herself or other nearby persons.

F. Recognition that an electrical shock has been delivered to the patient and that the defibrillator is no longer charged.

G. Rapid, accurate assessment of the patient’s post-shock status to determine if further activation of the AED is necessary.

H. Authorized individual’s responsibility of continuation of care, such as repeated shocks if necessary and/or administering CPR/First Aid until the arrival of more medically qualified personnel.

I. The location of AED units within the City/Town.

VI. AED MAINTENANCE AND SUPPLIES

A. The AED shall be maintained and regularly tested according to the operation and maintenance guidelines set forth by the manufacturer, the American Heart Association or the American Red Cross, and any applicable rules and regulations set forth by the governmental authority under the Federal Food and Drug Administration or other applicable state and federal authority.

B. The AED is to be checked for readiness after each use and at least once every 30 days. Record of inspections shall be maintained (Attachment B).

C. A supply kit shall be maintained and be readily available for use with the AED. The kit shall contain at least the following:

➢ Back-up battery set specific to the units in use.

➢ Extra set of pads (and pediatric pads if applicable) specific to the units in use.

➢ Safety razor for shaving chest hair when necessary to apply the pads

➢ Cardiovascular pulmonary resuscitation barrier (face shield or mask) for protection from transmission of infectious disease

➢ Two pairs of unused medical examination gloves

➢ EMT Shears

➢ Towels

VII. PLACEMENT OF AED

Where practical, AED’s shall be located to allow initiation of resuscitation and use of the AED within 5 minutes of a recognized cardiac arrest. Placement of AED’s and supplies will be considered, in part, using the following criteria and approved by the Medical Director:

➢ Departments or other functional areas that are staffed with Authorized Individuals.

➢ Locations considered to present a higher than normal risk for occupants to suffer sudden cardiac arrest (i.e. areas where there are recreation programs or seniors).

➢ During large functions outside of building locations, or during a disaster, the AED may be strategically placed in a location by the Program Coordinator or designee.

➢ All AED locations should be documented on Attachment C.

VIII. USING AED WITH OTHER MEDICAL PROFESSIONALS

A. When on the scene of a medical emergency involving a sudden cardiac arrest with other medical professionals, authorized individuals are to use the AED in the manner they were trained, so long as it does not interfere with the actions of other public safety personnel (firefighters and paramedics) and other medical professionals (nurses, physicians and surgeons).

B. Should more highly trained medical professionals arrive on scene after authorized individuals have used or are currently using the AED, the individual should communicate with these professionals and ask for their direction regarding continued use of the AED.

IX. NOTIFICATION AND PLACING AED BACK INTO SERVICE

Once the Program Coordinator is notified that the AED has been used in an actual cardiac arrest incident, the Program Coordinator shall contact all of the the following as soon as possible, but no later than the next business day:

➢ Medical Director

➢ Local EMS Authority

➢ City Manager or Risk Manager

➢ Any other contacts deemed necessary

Appendix D details a list of steps that must be followed after deployment of an AED and prior to the AED being placed back in service.

X. REVIEW OF INCIDENTS

A. Internal Post Event Documentation: It is important to document each use of the AED whether a shock was delivered or not. As such, an accident form shall be completed by the responding authorized individual each time the AED is used. These forms are available from the Program Coordinator.

B. External Post Event Documentation: After notification of the use of the AED, the Medical Director and other appropriate personnel shall review the incident for the purpose of medical control. This will be accomplished by transferring the data stored on the AED to a computer where the time, number of shocks delivered, and heart rhythm pre/post shock may be analyzed.

XI. RECORDKEEPING

The Program Coordinator shall maintain the following records in accordance with this policy and the [City’s or Town’s] record retention policy:

➢ A copy of the physician’s prescription for the AED.

➢ Training documentation from an American Heart Association or American Red Cross-recognized AED training class.

➢ Log of maintenance checks of the AED, including the dates checked and the name of the person that performed the review.

➢ A current roster of all personnel who are authorized individuals.

a. A copy of a valid AED operator’s certificate for any employee authorized to operate the AED.

b. A log of quarterly proficiency demonstrations for each holder of an AED operator’s certificate. The log shall contain the dates of the demonstrations as well as the manner of demonstration.

ATTACHMENT A

AED Operator Training Record

Please complete and maintain the following information for each individual authorized to operate the AED(s) at your site.

|Name |

|Title |Age |

|Date of Initial Training |Initials |

|Training Location |

|Date of Refresher Training |Initials |

|Training Location |

|Date of Refresher Training |Initials |

|Training Location |

|Date of Refresher Training |Initials |

|Training Location |

Operator Signature Date

Program Manager Signature Date

ATTACHMENT B

AED Monthly Safety Inspection Record For

Year

Complete a separate record for each AED

|Date |Inspector Initials |Inspection Type |Carrying Case |Battery Charged? |Contains Required |Additional Equipment: |

| | | |Intact? | |Supplies? | |

| | |Monthly ( |Yes ( No( |Yes ( No( |Yes ( No( | |

| | |After Use ( | | | | |

| | |Monthly ( |Yes ( No( |Yes ( No( |Yes ( No( | |

| | |After Use ( | | | | |

| | |Monthly ( |Yes ( No( |Yes ( No( |Yes ( No( | |

| | |After Use ( | | | | |

| | |Monthly ( |Yes ( No( |Yes ( No( |Yes ( No( | |

| | |After Use ( | | | | |

| | |Monthly ( |Yes ( No( |Yes ( No( |Yes ( No( | |

| | |After Use ( | | | | |

| | |Monthly ( |Yes ( No( |Yes ( No( |Yes ( No( | |

| | |After Use ( | | | | |

| | |Monthly ( |Yes ( No( |Yes ( No( |Yes ( No( | |

| | |After Use ( | | | | |

| | |Monthly ( |Yes ( No( |Yes ( No( |Yes ( No( | |

| | |After Use ( | | | | |

| | |Monthly ( |Yes ( No( |Yes ( No( |Yes ( No( | |

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| | |Monthly ( |Yes ( No( |Yes ( No( |Yes ( No( | |

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| | |Monthly ( |Yes ( No( |Yes ( No( |Yes ( No( | |

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| | |Monthly ( |Yes ( No( |Yes ( No( |Yes ( No( | |

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| | |Monthly ( |Yes ( No( |Yes ( No( |Yes ( No( | |

| | |After Use ( | | | | |

| | |Monthly ( |Yes ( No( |Yes ( No( |Yes ( No( | |

| | |After Use ( | | | | |

| | |Monthly ( |Yes ( No( |Yes ( No( |Yes ( No( | |

| | |After Use ( | | | | |

ATTACHMENT C

AED Locations

|AED |Building |Specific Location |

|1 |City Hall |Room 115 |

|2 |Community Development |Lobby |

|3 |Water Treatment Plant |Main Office |

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ATTACHMENT D

Returning AED to Service After Use

The following steps shall be completed prior to placing the AED back in service following its use

(NOTE: Consult with the AED manufacturer to ensure these are the steps recommended for your agency’s AED):

Replace battery in the AED

Perform complete battery insertion test (BIT)

Request a new battery from the manufacturer or licensed equipment supplier

Mark used battery “training only” and send to Program Coordinator

Note use and BIT date on maintenance log

Replace electrode pads (replacement pads should be obtained from the manufacture or licensed equipment supplier)

Request new AED data card from manufacturer or licensed equipment supplier

Place this checklist with maintenance records.

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