II. U. Public Access Defibrillation (PAD) Policy

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Public access refers to accessibility for trained users to use AED’s in public places.  Public access does not mean that any member of the public witnessing a sudden cardiac arrest should be able to use the device.  AED’s are to be used only by individuals with the proper training and certification in accordance with state and local laws.

PURPOSE:

To provide guidance in the management or administration of a workplace AED program. 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, 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 deliver a shock.

SYSTEM OWNER:

West Warwick Public Schools

Program Coordinator:  Director of Personnel & Human Resources

OWNER’S RESPONSIBILITIES:

• Identification of employees for AED training and distribution of AED-trained employee lists
• Coordination of training for emergency responders
• Coordination of equipment purchases and accessory maintenance
• Maintain on file a specifications/technical information sheet for each approved AED model assigned or donated to the school
• Revision of this procedure as required
• Monitoring the effectiveness of this system
• Communication with medical director (School Physician/Thundermist Health) on issues related to medical emergency response program including post-event reviews

APPLICABLE DOCUMENTS:

• List of trained responders
• AED Procedure Manual
• AED Maintenance Checklist

MEDICAL CONTROL:

The medical advisor of the AED program is the physician assigned by Thundermist Health.  The medical advisor of the AED program has ongoing responsibility for:

• Providing medical direction for use of AEDs
• Writing a prescription for AEDs
• Reviewing and approving guidelines for emergency procedures related to the use of AEDs and CPR
• Evaluation of Post-Event with all rescuers involved

AUTHORIZED AED USERS:

The AED may be used by:

• Any EMS
• Any trained volunteer responder who has successfully completed an approved CPR/AED training program within the last one year and has a current successful course completion card

 AED-TRAINED EMPLOYEE RESPONSIBILITIES:

• Activating external emergency response by directing someone to call 911
• Activating internal emergency response system and providing prompt basic life support including AED and CPR according to training and experience
• Understanding and complying with requirements of this policy
• Following the more detailed procedures and guidelines for the AED program

 VOLUNTEER RESPONDER RESPONSIBILITIES:

• Anyone can, at their discretion, provide voluntary assistance to victims of medical emergencies. The extent to which these individuals respond shall be appropriate to their training and experience. These responders are encouraged to contribute to emergency response only to the extent they are comfortable. The emergency medical response of these individuals may include CPR, AED or medical first aid.

RECEPTIONIST/OPERATOR RESPONSIBILITIES:

The main receptionist/ operator is responsible for:

• Receiving emergency medical calls from internal locations
• Contacting the external community 9-1-1 response team (EMS)
• Deploying AED-trained employees to emergency location
• Assigning someone to meet responding EMS aid vehicle and direct EMS personnel to site of medical emergency

 

EQUIPMENT:

Approved equipment:

The LIFEPAK CR Plus Automated External Defibrillators (AEDs) have been approved for this program. The AED conforms to the units used by the Town of West Warwick.

• The AED will be brought to all medical emergencies.
• The AED should be used on any person who displays ALL the symptoms of sudden cardiac arrest (SCA). The AED electrodes/pads will be applied to the victim 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

LOCATION OF AEDs:

• West Warwick High School (outside gymnasium, front entrance foyer, entrance in rear of building)
• John F. Deering Middle School (front foyer near media center entrance, lower level stairwells)
• Greenbush Elementary School (front foyer outside gymnasium, outside entrance to library)
• John F. Horgan Elementary School (front entrance behind clerk, cafeteria on lower level)
• Maisie E. Quinn Elementary School  (front foyer outside gymnasium entrance, corridor outside other gymnasium entrance)
• Wakefield Hills Elementary School (front foyer outside gymnasium/cafeteria, corridor on second floor in rear of building)
• Athletic Director’s Office (for use on playing fields)
• Administration Building (near main entrance)
• West Warwick Ice Rink
• West Warwick Civic Center

ADDITIONAL RESUSCITATION EQUIPMENT:

Each AED will have one set of adult defibrillation electrodes connected to the device, one spare set of adult electrodes and one set of pediatric electrodes (for children/infants) stored with the AED. 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 facemask barrier device.

EQUIPMENT MAINTENANCE:

All equipment and accessories necessary for support of medical emergency response shall be maintained in a state of readiness. Specific maintenance requirements include:

• The AED 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.
• Completion of the AED Maintenance Checklist

ROUTINE MAINTENANCE:

The AED will perform a self-diagnostic test that includes a check of battery strength and an evaluation of the internal components. A volunteer, assigned by the AED Program Coordinator or designee, will perform a monthly AED check following the procedure checklist. The procedure checklist will be initialed at the completion of the monthly check. The procedure checklist will be posted with the AED.

• If the OK icon is NOT present on the readiness display, contact the AED Program Coordinator or designee immediately.
• If the battery icon is visible, the CHARGE-PAK™ charging unit needs to be replaced. You may continue to use the AED if needed.
• If the wrench icon is visible, the AED needs service. You may attempt to use the AED if needed. Continue to provide CPR until another AED is brought to the victim or EMS arrives to take over care.
• If the expiration date on the electrode is near, notify the AED Program Coordinator or designee immediately.

INITIAL TRAINING:

Trained Employees:

• Must complete training adequate to provide CPR and AED. AED training must be a course approved by the state. The Personnel and Human Resources Office shall maintain training records for the trained employees. 

Volunteer Responders:

• These responders will possess various amounts of training in emergency medical response and their training may be supplied by sources outside of the company. 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 AEDs deployed throughout the campus. Any volunteer wishing to potentially use one of the AEDs deployed on the campus should have successfully completed a state approved AED course including CPR within the last year. The Program Coordinator will maintain training records for the volunteer responders.

REFRESHER TRAINING:

• Trained employees will renew AED/ CPR training every year.
• Volunteer responders should obtain documented renewal training annually. Volunteer responders are encouraged to periodically refresh their AED skills.

MEDICAL RESPONSE DOCUMENTATION:

INTERNAL POST-EVENT DOCUMENTATION: It is important to document each use of the medical emergency response system. The following forms shall be sent to the AED Program Coordinator or designee within 24 hours of a medical event:

• An accident report form 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 incident/accident form whenever an AED is used.

EXTERNAL POST-EVENT DOCUMENTATION: A copy of AED use information shall be presented within 48 hours of the emergency to the following:

• Program Coordinator (Director of Personnel and Human Resources)
• Medical director of the AED program
• Local EMS (West Warwick Fire Department)
• At a minimum, event information supplied shall include any recorded data, and all electronic files captured by the AED.

POST-EVENT REVIEW:

Following each deployment of the response team member, or if a volunteer responder uses an AED, a review shall be conducted to learn from the experience. The AED 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 safety committee. The safety committee chairperson shall maintain a copy of the post-event review summary.  This means that every incident must be reviewed to establish whether the patient was treated according to established protocol.  The following steps should be taken as soon after the resuscitation as possible.

• Return AED to state of readiness
• Replace pads, pocket mask and other peripheral supplies that were used
• Review the case with the overseeing physician, EMS and involved rescuers
• Complete AED Maintenance Checklist

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, the effectiveness should be reviewed periodically.

ANNUAL SYSTEM ASSESSMENT:

Once each calendar year, the AED Program Coordinator or Medical Director shall conduct and document a system readiness review. This review shall include review of the following elements:

• Training records
• Equipment operation and maintenance records

 

Date Adopted:  March 14, 2006

Initials of Chairperson: