Town of Portsmouth, RI Chapter A408 AED Policy

[HISTORY: Adopted by the Town Council of the Town of Portsmouth 9-13-2006 by Ord. No. 2006-09-13. Amendments noted where applicable.]

§ A408-1 Purpose.

The purpose of this policy is to provide guidance in the efficient and effective administration of an AED program for the Town of Portsmouth.

§ A408-2 Background; intent.

A. Each year, approximately 250,000 people die from sudden cardiac arrest (SCA). 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 and results in sudden death. The most effective treatment for this condition is the administration of an electrical current to the heart delivered by a defibrillator within a short time after 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 and do not have a pulse, signs of circulation and 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 an electric shock.

B. The chance of survival decreases an estimated 10% each minute without defibrillation even when prompt bystander cardiopulmonary resuscitation (CPR) is initiated. The use of an AED is intended to maximize the chance of survival based upon the steps taken during the critical minutes before emergency medical services (EMS) providers arrive and assume responsibility for the care of the patient. The following policy and procedures are designed to direct trained responders in the Town of Portsmouth to deliver early defibrillation to victims of SCA.

C. The policy is intended to greatly increase the chance of survival of an SCA prior to the arrival of the local EMS. This policy does not create an obligation to use the AED's nor create an expectation that either an AED or trained employee will be present at every event.

§ A408-3 Objectives.

A. Establish an AED program task force comprised of local Town, school and emergency medical services personnel to provide effective AED utilization.

B. Educate personnel to recognize the signs and symptoms of SCA.

C. Educate personnel in the appropriate use of AED. Provide training and certification in CPR/AED for interested individuals.

§ A408-4 Adoption of policy.

In recognition of the value of administering defibrillation promptly and appropriately, the Town Council has authorized the purchase of AEDs and hereby adopts this policy to provide program guidance and assist trained volunteers in the event of an SCA situation.

§ A408-5 Assignment of Program Coordinators; contact information.

Deputy Chief Robert Church and firefighter Kevin Jenks are designated as Program Coordinators and are available to answer any questions concerning the AED Policy. They may be contacted as follows:

Robert Church	Fire Department	683-1200	Mobile: [phone]
Kevin Jenks	Fire Department	683-1200	Mobile: [phone]
Fax: [phone]

§ A408-6 Program Coordinator responsibilities.

Specific Program Coordinator responsibilities are as follows: selection of equipment and volunteers for AED training, distribution of AED-trained lists, coordination of training for emergency responders, maintenance of equipment and accessories, retention of a specifications/technical information sheet for each approved AED model, consultation/coordination with local emergency medical services (EMS), revision of this policy as required, monitoring the effectiveness of this program and communication with the Medical Advisor on issues related to the medical emergency response program, including post-event reviews.

§ A408-7 Medical Advisor.

The Medical Advisor for the AED program is David Johnson, M.D., 161 Chase Road, Portsmouth, RI 02871, Telephone: [phone]. He/she will provide medical oversight of the AED program, including the following: writing prescriptions for AEDs, reviewing and approving guidelines for emergency procedures related to the use of AEDs and CPR in accordance with state and local laws, assisting in coordinating the program with the local EMS and assisting in a post-event review with all responders involved.

§ A408-8 Notification of local EMS.

EMS in the Town is responsible for on-scene delivery of emergency medical care. The Program Coordinators will notify rescue personnel of deployment and location of AEDs.

§ A408-9 Authorized AED users.

AEDs may be used by the following certified personnel:

A. Any trained volunteer responder who has successfully completed an approved AED/CPR (cardiopulmonary resuscitation) training program and holds a current health care provider card or a Heartsaver/AED course completion card.

B. Any professional rescuer who is currently certified according to the guidelines of a nationally recognized program such as the American Heart Association, the American Red Cross or the National Safety Council.

§ A408-10 Training.

A. Training classes should meet the guidelines of a nationally recognized program, such as the American Heart Association, the American Red Cross or the National Safety Council.

B. To meet the need for lay rescuer training, the American Heart Association has developed a course called "Heartsaver AED for Lay Rescuers and First Responders." This eight- to ten-hour course teaches volunteers to recognize the warning signs of heart attack, perform CPR and use an AED.

C. All participants successfully completing the course receive an American Heart Association Heartsaver AED course completion card with a recommended renewal date of two years from the date of issue.

D. Retraining in AED/CPR should occur at least every two years, sooner if equipment, policies or procedures change. Trained volunteers are strongly encouraged to renew AED/CPR training at least every two years.

E. A mock "cardiac arrest drill" will take place at each facility with an AED. The annual drill will be scheduled and monitored by the Program Coordinators. See Appendix A for the form to be used.

§ A408-11 Trained volunteer responsibilities.

In the event of an emergency medical situation, the trained volunteer is to activate the external emergency response by directing someone to call 911. Trained volunteers should recognize the signs of SCA, start CPR immediately, locate and use the defibrillator and care for the victim until the EMS team arrives. See Appendix B for details of the protocol.

§ A408-12 Selection of equipment.

The Program Coordinators have selected the Zoll AED Plus as the preferred AED. This model has been approved by the Food and Drug Administration (FDA) and includes product features that add speed, reliability, and confidence to the responder team. A list of FDA-approved AEDs is available at www.americanheart.org/cpr.

§ A408-13 Additional resuscitation equipment.

Each AED will have one set of defibrillation electrodes connected to the device and one spare set of electrodes with the AED bag. Two sets of infant/child electrodes should also be included in the AED bag. One resuscitation kit will be connected to the handle of the AED. This kit contains two pairs of latex-free gloves, one razor, one set of trauma shears, and one face mask barrier device.

§ A408-14 Quantity and location of AEDs.

When deciding where to place an AED and how many are needed, the Program Coordinators shall use a three-minute response time as a guideline to help determine the number of AEDs needed and the appropriate location(s).

A. The following are the initial location assignments:

(1) Portsmouth Town Hall: south entrance, lobby wall to the left of the Council Chambers.

(2) Portsmouth Senior Center: The AED program is to be implemented as soon as CPR/AED training is completed. Location is to be determined.

(3) Portsmouth High School: The AED program is to be implemented as soon as CPR/AED training is completed. Location is to be determined.

(4) Melville Elementary School: The AED program is to be implemented as soon as CPR/AED training is completed and AEDs are purchased. Location is to be determined.

(5) Sandy Point Beach: The AED will be located at the facility during the beach operating season. The AED will be stationed at the head lifeguard chair with appropriate signage during the facility's operating hours. The AED and locator signage will be stored and secured in the bathhouse during nonoperational hours.

B. The AED will be stored at the Portsmouth Fire Department for possible redeployment during the off season. Notification of redeployment will be made by the Program Coordinators.

§ A408-15 Equipment maintenance.

A. All equipment and accessories necessary for supporting the medical emergency response shall be maintained in a state of readiness. The AED Program Coordinators 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 manufacturer's operating instructions.

B. A volunteer, assigned by the AED Program Coordinators or designee, will perform a monthly AED check as described in Appendix C. The AED will perform a self-diagnostic test that includes a check of battery strength and an evaluation of the internal components. The volunteer will initial the checklist at the completion of the monthly check. The checklist will be stored with the AED.

C. Following the use of emergency response equipment, the Program Coordinators will ensure that all equipment is cleaned and/or decontaminated as required. The Program Coordinators will provide one red biohazard bag for expendable equipment/supplies. The Program Coordinators will replace pads, pocket masks and other related resuscitation supplies that were used. The Program Coordinators will complete the AED maintenance checklist as described in Appendix C and return the AED to a state of readiness.

§ A408-16 Post-event review and documentation.

A. Following each AED use, a review shall be conducted to provide lessons learned from the experience. The Program Coordinators 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 were beneficial, opportunities for improvement, a critical incident stress debriefing, response time evaluation and strategies for improvement.

B. The Program Coordinators will develop a summary of the post-event review and send a copy to the Medical Advisor. The AED Program Coordinators shall maintain a copy of the post-event review summary.