Critical Elements for Public Access or
Home-Based Defibrillation Programs
(Based off the American Heart Association
Recommendations)
Background of Public
Access Defibrillation
Public access
defibrillation (PAD) programs are designed to improve survival from
sudden out-of-hospital cardiac arrest. PAD programs
include placement of AED's throughout the community and training of
lay rescuers in CPR and use of an AED.
If PAD programs are to improve survival from sudden
cardiac arrest, they must significantly reduce two intervals:
(1) Between collapse and start of CPR and
(2) Between collapse and delivery of
first shock
Successful PAD programs
require physician oversight, careful planning, lay rescuer training
and supervision, quality assurance monitoring, and a strong link
with the local EMS system.
By calling us, we will help you
with the following steps:
1. Preliminary
Steps: Preparation and Planning for PAD Program
A) Establish immunity from civil liability (or provide
indemnification) for:
-Lay
responders who volunteer to learn AED use and their
instructors
-Physicians who authorize AED use
-Premises or facility owners who support or allow a PAD
program.
B) Identify a source of training, instructors,
and training equipment
C) Establish communication among the following need-to-know
groups:
-Personnel or employees receiving training
-Baldwin EMS Department
-Dispatcher Center through Baldwin EMS Department.
D) Contact Baldwin EMS Department
to conduct a site visit at that
site.
Goals of the site visit:
-Identify most important responding group at your
site
-Determine placement of the AED. The AED should be
placed near a telephone or
be equipped with a device to provide automated EMS
notification.
-Ensure that the AED being considered is compatible.
2. Pre-event Training and Program
Establishment
A) Adopt approved treatment protocols consistent with
recommendations of the American Safety and Health
Institute and the Baldwin EMS Department.
B) Adopt an approved national training course integrating CPR
skills and AED use.
C) Train all anticipated users.
D) Establish methods to accomplish and
document the following tasks:
-Ensure skills maintenance. (include refresher training and mock
drills)
-Ensure device maintenance and readiness-for-use checks.
-Notify clinical director of clinical use of an AED.
-Review AED performance after any field use.
-Review lay rescuer performance after any field use
-Provide post-event psychological support to rescuers, family
members, co-workers,
etc.
-Determine clinical outcomes - What happened to the person who
collapsed?
The Baldwin EMS Department is able to train you and your
staff for CPR, First Aid and AED using the American Safety and
Health Institute (ASHI) program, a nationally accredited training
program. See the "CPR and Training" page to the left for more
information.
3. Post-Clinical Event Quality Improvement
Monitoring: Incident Review
A) Review AED performance. (requires
access to event documentation)
B) Review lay rescuer performance during
field use and provide feedback.
C) Modify protocols or provide additional
refreshers as needed.
D) Offer and provide post-event
psychological support to rescuer, rescuer co-workers, and
victim's family members.
E) Determine clinical outcome of person
who collapsed - requires authority to access private hospital
records from either physician or EMS
medical director.
F) Develop plan to track community-wide
outcomes and performances over time.
These critical elements for successful
PAD programs can be achieved in a variety of ways.
In the United States these programs can
best be provided by programs closely affiliated with community EMS
systems.
