River Falls Area Ambulance

Public Access Defibrillation

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.

☻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.

**Note:  River Falls EMS will take a large part in these following 3 steps!

1.  Preliminary Steps: Preparation and Planning for PAD Program

☻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.

☻Identify a licensed physician to serve as medical director

☻Identify a source of training, instructors, and training equipment

        - River Falls EMS is an American Heart Association training center, so will take care of these needs.

☻Establish communication among the following need-to-know groups:

        -PAD Medical Director

        -Personnel or employees receiving training

        -River Falls Area Ambulance Service

        -Emergency Medical Dispatchers (River Falls Ambulance will do this!)

☻Contact River Falls EMS to conduct a site visit at that site.

                Goals of the site visit:

                        -Identify most important responding group at the site (in general, personnel working closest to a 24-                        

                         hour/7-day a week schedule).

                        -Determine number and placement of the AED.  The AED should be placed near a telephone or

                         be equipped with a device to provide automated EMS notification.

                        -In an AED area, the AED will ideally be placed within a 1.5 minute walking distance of area

                         covered. 

                        -Ensure that the AED being considered is compatible with River Falls EMS defibrillators.

2. Pre-event Training and Program Establishment

☻Adopt approved treatment protocols consistent with recommendations of the American Heart Association and River Falls EMS.

☻Adopt an approved national training course integrating CPR skills and AED use.

☻ Train all anticipated users.

☻ 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?       

3. Post-Clinical Event Quality Improvement Monitoring: Incident Review

☻ Review AED performance. (requires access to event documentation)

☻ Review lay rescuer performance during field use and provide feedback.

☻ Modify protocols or provide additional refreshers as needed.

☻ Offer and provide post-event psychological support to rescuer, rescuer co-workers, and victim's family members.

☻Determine clinical outcome of person who collapsed - requires authority to access private hospital records from    

    either physician or EMS medical director.

☻ 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.