Annex E - Public Access Defibrillation
This policy shall provide guidance in the management or administration of a Public Access Defibrillation (PAD) program and shall include treatment of children under eight years old or under 25 Kg. (55 lbs).
Sudden Cardiac Arrest (SCA) is a condition that occurs when the electrical impulses of the human heart malfunction causing a disturbance in the heart's electrical rhythm called ventricular fibrillation (VF). This erratic and ineffective electrical heart rhythm causes complete cessation of the heart's normal function of pumping blood resulting in sudden death. The most effective treatment for this condition is the administration of an electrical current to the heart by a defibrillator, delivered within a short time of the onset of VF.
An AED is used to treat victims who experience SCA. It is only to be applied to victims who are unconscious, without pulse, and no signs of circulation or normal breathing. The AED will analyze the heart rhythm and advise the operator if a shockable rhythm is detected. If a shockable rhythm is detected, the AED will charge to the appropriate energy level and advise the operator to deliver a shock.
David J. Hubeny, Public Access Defibrillation (PAD) Program Coordinator
NYS University Police Couper Administration Building
PAD Program Coordinator Responsibilities
- Selection of employees for AED training and distribution of AED-trained employee lists as required
- Coordination of training for emergency responders
- Coordinating equipment and accessory maintenance
- Maintain on file a specifications/technical information sheet for each approved AED model assigned or donated to the University
- Revision of this procedure as required
- Monitoring the effectiveness of this system
- Communication with medical director on issues related to medical emergency response program including post-event reviews
- County/State AED Guidelines
- Medical emergency action plan
- Infection control procedure for universal precautions
- AED Internal Response Procedure
- AED Event Summary Form
- AED Inspection Checklist
The medical advisor of the AED program is Michael Leonard, M.D. The medical advisor of the AED program has ongoing responsibility for:
- Providing medical direction for use of AED's
- Writing a prescription for AED's
- Reviewing and approving guidelines for emergency procedures related to use of AED's and CPR
- Evaluation of post-event review forms and digital files downloaded from the AED
Authorized AED users
The AED may be used by:
- Employees trained in the proper use of AED's (i.e. University Police, Environmental Health and Safety, Harpur's Ferry Student Volunteer Ambulance, Health Services Staff, Athletic Training staff, Campus Recreation Staff, Emergency Response Team, etc.)
- Additional staff as identified by the PAD Program Coordinator
- Any trained volunteer responder who has successfully completed an approved CPR/AED training program within the last two years and has a current successful course completion card
- All others as appropriate within New York State laws and regulations
AED-Trained Employee Responsibilities:
- Activating internal emergency response system and providing prompt basic life support including AED and first aid according to training and experience
- Understanding and complying with requirements of this policy
- Following the procedures and guidelines of the AED program
Volunteer Responder Responsibilities:
- Anyone can, at their discretion, provide voluntary assistance to victims of medical emergencies. Volunteer responders can assist in emergencies, but must only participate to the extent allowed by their training and experience. Volunteer responders may have training adequate to administer first aid, CPR and use the AED's deployed throughout the campus. These responders are encouraged to contribute to emergency response only to the extent they are comfortable.
University Police Responsibilities:
The University Police are responsible for:
- Receiving emergency medical calls from internal locations
- Contacting the external community 9-1-1 response team (EMS) if required
- Deploying AED-trained employees to emergency location
- Assigning someone to meet responding EMS aid vehicle and direct EMS personnel to site of medical emergency
- The Cardiac Science G3 PowerHeart Automated External Defibrillator (AED) has been approved for this program. This AED conforms to the state/county standards
- The AED and related first-aid emergency equipment will be brought to all potentially cardiac related medical emergencies or at the discretion of the emergency responders
- The AED should be used on any person who is at least 8 years of age and displays ALL the symptoms of cardiac arrest. The AED will be placed only after the following symptoms are confirmed:
- Victim is unresponsive
- Victim is not breathing, or is breathing ineffectively
- Victim has no signs of circulation such as pulse and coughing, or movement
NOTE: If the AED is equipped with Infant/Child Reduced Energy Defibrillation Electrode Pads, the AED (with the Infant/Child pads) may be used on children under eight years old or under 25 Kg. (55 lbs).
Location of AEDs
Under typical circumstances the AED will be at predetermined locations. These locations should allow the device to be easily accessible by staff. AEDs can be found in nearly every campus building. Oftentimes, multiple units are located in large buildings. Buildings equipped with an AED are clearly marked on every entrance to the building. These signs indicate the location of the nearest AED to that doorway.
Additional resuscitation equipment:
- Each AED shall include the following equipment:
- One set of adult electrodes
- One set of pediatric electrodes (if AED is compatible)
- CPR barrier mask
- Non-latex disposable gloves
- Disposable razor
- Safety glasses
All equipment and accessories necessary for support of medical emergency response shall be maintained in a state of readiness. Specific maintenance requirements include:
- The PAD Program Coordinator shall be informed of changes in availability of emergency medical response equipment. If equipment is withdrawn from service, the PAD Program Coordinator shall be informed and then notified when equipment is returned to service. • The PAD Program Coordinator shall be responsible for informing response teams of changes to availability of emergency medical equipment.
- The PAD Program Coordinator or designee shall be responsible for having regular equipment maintenance performed. All maintenance tasks shall be performed according to equipment maintenance procedures as outlined in the operating instructions.
- Following use of emergency response equipment, all equipment shall be cleaned and/or decontaminated as required. If contamination includes body fluids, the equipment shall be disinfected according to Binghamton University Bloodborne Pathogen cleaning procedures.
Routine Inspections / Maintenance
- The AED Program Coordinator, or designee, will perform regular inspections of the units as necessary to ensure compliance with the program.
- If maintenance problems are detected contact the AED Program Coordinator immediately.
- If the expiration date on the electrode is near, notify the PAD Program Coordinator or designee immediately.
- Trained employees will renew first-aid and AED training as required by the training agency / organization (i.e. American Red Cross, American Heart Association, etc.)
Medical Response Documentation
Internal Post-Event Documentation: It is important to document each use of the defibrillator. The following forms shall be sent to the PAD Program Coordinator or designee within 24 hours of the use of an AED:
- An accident report form (CS-13) shall be completed by a responding employee for each accident requiring first-aid of any type.
- The AED-trained employee or volunteer responder shall complete an Event Summary Form whenever an AED is connected to a patient.
External Post-Event Documentation: A copy of Event Summary Form shall be presented within 48 hours of the emergency to the following:
- Medical director of the AED program
- Local EMS, county, state officials as designated in state AED requirements and local regulations
- At a minimum, event information supplied shall include any recorded data, and all electronic files captured by the AED.
Following each use of an AED, a review shall be conducted to learn from the experience. The PAD Program Coordinator or designee shall conduct and document the post-event review. All key participants in the event shall participate in the review. Included in the review shall be the identification of actions that went well and the collection of opportunities for improvement as well as critical incident stress debriefing. A summary of the post-event review shall be sent to the PAD Program Coordinator and the PAD Medical Director.
System Verification and Review
The medical emergency response system is ultimately successful if necessary medical assistance is provided to victims in a timely and safe manner. Since actual use of this system procedure is expected to be very infrequent, other measures of effectiveness are required.
Annual System Assessment
Once each calendar year, the AED Program Coordinator or designee shall conduct and document a system readiness review. This review shall include review of the following elements:
- Training records
- Equipment operation and maintenance records