Public Access Defibrillation Provider Packet Table of Contents

Transcription

1 431 New Karner Rad, Albany. NY (518) Fax (518) Getting started Checklist Public Access Defibrillatin Prvider Packet Table f Cntents 2. NYS DOH Ntice f Intent - Frm Cllabrative Agreement frm 4. Quality Imprvement Reprt 5. Sectin 3000-a, and Sectin 3000-b New Yrk Public Health Law 6. NYS DOH Plicy Statement REMO Rles and Respnsibilities fr PAD Prviders THE REGIONAL EMERGENCY MEDICAL SERVICES SYSTEM COUNCIL f the HUDSON MOHAWK VALLEYS, INC. ALBANY COLUMBIA GREENE SARATOGA RENSSELAER SCHENECTADY

2 431 New Karner Rad, Albany. NY (518) Fax (518) Public Access Defibrillatin Check List The fllwing is a guide t aid in the cmpletin f yur Public Access Defibrillatin Prgram 1. Review and cmplete material in the Public Access Defibrillatin packet 2. Determine feasibility f prject D we have sufficient resurces (~ $3,000) t cmplete the prject? Is there enugh management supprt t cmplete the prject? D we have enugh persnnel? 3. Evaluate and select equipment (cst, reliability, availability f repair/laner) 4. Evaluate and select training curse spnsr 5. Enter int a Cllabrative Agreement with an Emergency Health Care Prvider (EHCP) 6. Purchase equipment and cmplete training 7. Verify that all parts f the cllabrative agreement are cmpleted and implemented (written prtcls, plicies and prcedures as stated in DOH Plicy Statement 98-10) 8. File all frms and cllabrative agreement with REMO Any questins regarding this checklist shuld be directed t: REMO (518) remqi@nycap.rr.cm THE REGIONAL EMERGENCY MEDICAL SERVICES SYSTEM COUNCIL f the HUDSON MOHAWK VALLEYS, INC. ALBANY COLUMBIA GREENE SARATOGA RENSSELAER SCHENECTADY

3 New Yrk State Department f Health Ntice f Intent t Prvide Bureau f Emergency Medical Services Public Access Defibrillatin Entity Prviding PAD Original Ntificatin Update Name f Organizatin ( ) Telephne Number Name f Primary Cntact Persn Address City State Zip Address ( ) Fax Number Type f Entity (please check the apprpriate bxes) Business Fire Department/District Private Schl Cnstructin Cmpany Plice Department Cllege/University Health Club/ Gym Lcal Municipal Gvernment Physician s Office Recreatinal Facility Cunty Gvernment Dental Office r Clinic Industrial Setting State Gvernment Adult Care Facility Retail Setting Public Utilities Mental Health Office r Clinic Transprtatin Hub Public Schl K 6 Other Medical Facility (specify) Restaurant Public Schl 6-12 Other (specify) PAD Training Prgram American Heart Assciatin Natinal Safety Cuncil REMSCO f NYC, Inc American Red Crss Emergency Services Institute EMS Safety Service, Inc American Safety & Health Institute Medic First Aid Internatinal State University f NY Autmated External Defibrillatr Manufacturer f AED Unit Mdel f AED Pediatric Capable Number f Trained PAD Prviders Number f AEDs Emergency Health Care Prvider Name f Emergency Health Care Prvider (Hspital r Physician) Address City State Zip Telephne Number ( ) Fax Number Name f Ambulance Service and 911 Dispatch Center Name f Ambulance Service and Cntact Persn Telephne Number Name f 911 Dispatch Center and Cntact Persn Cunty Authrizatin Names and Signatures CEO r Designee (Please print) Signature Date Physician r Hspital Representative (Please print) Signature Date DOH-4135(5/06) Cmplete this frm and send it with yur cmpleted Cllabrative Agreement t the REMSCO fr yu area

4 431 New Karner Rad, Albany. NY (518) Fax (518) REGIONAL EMS COUNCIL OF THE HUDSON MOHAWK VALLEYS, INC. (REMO) Cllabrative Agreement Between Public Access Defibrillatin Prvider and Emergency Health Care Prvider Fr the Prvisin f Autmated External Defibrillatin in d REMO Regin (This dcument may be amended t meet lcal need) I, f Public Access Defibrillatin CEO/President/Designee Organizatin Name (PAD) Prvider, and I, Emergency Health Care Prvider Physician r Hspital designated physician Agree t abide by the fllwing terms and cnditins set frth by Sectin 3000-B f Article 30 f the Public Health Law f the State f New Yrk fr the prvisin f Autmated External Defibrillatin (AED) by the PAD Prvider. 1. The PAD Prvider and trained AED peratr(s) shall perate under apprpriate prtcls fr the use f an AED, as prmulgated fr the REMO Regin by the Reginal Emergency Medical Services Cuncil and the Reginal Emergency Medical Advisry Cmmittee (REMAC) f the Hudsn-Mhawk Valleys. 2. The PAD Prvider shall ensure that all persns designated t perate an AED successfully cmplete an AED training curse which has been apprved by the New Yrk State Department f Health. 3. Prir t the peratin f an AED, the PAD Prvider shall ntify REMO f the existence, lcatin, quantity and type f all mbile and statinary AED(s) n the premises f the PAD Prvider. 4. The PAD Prvider shall cmply with Sectin 3000-B f Article 30 f the Public Health Law f the State f New Yrk. 5. The PAD Prvider shall ensure that an ambulance service is immediately called. 6. The PAD Prvider shall ensure that the Emergency Health Care Prvider is ntified within 24 hurs f each use f an AED. 7. The PAD Prvider shall ensure that all AEDs are maintained and tested accrding t the manufacturer and/r gvernmental standards. 8. The respnsibilities f the Emergency Health Care Prvider shall include, but will nt be limited t the fllwing: a. Participating in the Reginal EMS Cuncil/REMAC f the Hudsn Mhawk Valleys Quality Assurance Prgram via reprting t the Reginal EMS Cuncil within 5 (five) business days f each use f an AED. Minimum required infrmatin t be reprted shall include the names f the PAD Prvider, date and time f the incident, patient age and sex, estimated time frm arrest t the 1 st AED shck, estimated time frm arrest t CPR, number f shcks administered t the patient, name f transprting ambulance service, and patient utcme at the incident site, and b. Mnitring f the quality f patient care prvided by the PAD Prvider. Page 1 f 2

5 9. The PAD Prvider and the Emergency Health Care Prvider agree t file a Cllabrative Agreement every 2 (tw) years frm the date f the initial Cllabrative Agreement. If the Emergency Health Care Prvide changes, a new Cllabrative Agreement shall be filed within 5 (five) business days. Additinally, if the Emergency Health Care Prvider resigns, they shall immediately ntify REMO in writing. Date: PAD Prvider s Designee s Signature Date: Emergency Health Care Prvider s Signature Please use this space fr additinal cmments f amendments t the agreement. Please cmplete this frm and send it with yur Ntice f Intent t: REMO 431 New Karner Rd Albany, NY (Fax) qirem@gmail.cm Page 2 f 2

6 PUBLIC ACCESS DEFIBRILLATION PROGRAM AGENCY QUARTERLY REPORT Agency Name/Entity Prviding PAD: Quarter: Jan. - March April June Year: (Circle Quarter) July Sept. Oct. Dec. Males <1 year ld defibrillated: Males 1-7 years ld defibrillated: Males 8-17 years ld defibrillated: Males18-64 years ld defibrillated: Males > 65 years ld defibrillated: Females <1 year ld defibrillated: Females 1-7 years ld defibrillated: Females 8-17 years ld defibrillated: Females18-64 years ld defibrillated: Females > 65 years ld defibrillated: Remained Unrespnsive Became Respnsive Outcmes Spntaneus Return f Pulse Spntaneus Return f Pulse & Respiratin Dead n Arrival in Emergency Department Died in Emergency Department Died Within 24 Hurs f Admissin Died Mre Than 24 Hurs After Admissin Discharged Alive Males < 1 Females < 1 Males 1 7 Females 1 7 Males 8 17 Females 8 17 Males Females Name f EHC Prvider (Medical Directr): Agency Cntact Persn (PAD Crdinatr): Males Over 65 Females Over 65 Daytime Phne Number: FAX Number: address: Thank yu fr yur cntinued cperatin in this matter. Please return t: REMO ( remqi@nycap.rr.cm) FAX: Phne:

7 Sectin Declaratin f plicy and statement f purpse. The furnishing f medical assistance in an emergency is a matter f vital cncern affecting the public health, safety and welfare. Prehspital emergency medical care, the prvisin f prmpt and effective cmmunicatin amng ambulances and hspitals and safe and effective care transprtatin f the sick and injured are essential public health services. It is the purpse f this article t prmte the public health, safety and welfare by prviding fr certificatin f all advanced life supprt first respnse services and ambulance services; the creatin f reginal emergency medical services cuncils; and a New Yrk state emergency medical services cuncil t develp minimum training standards fr certified first respnders, emergency medical technicians and advanced emergency medical technicians and minimum equipment and cmmunicatin standards fr advanced life supprt first respnse services and ambulance services. Sectin 3000-a. Emergency medical treatment. 1. Except as prvided in subdivisin six f sectin six thusand six hundred eleven, subdivisin tw f sectin six thusand five hundred twenty-seven, subdivisin ne f sectin six thusand nine hundred nine and sectins six thusand five hundred frtyseven and six thusand seven hundred thirty-seven f the educatin law, any persn wh vluntarily and withut expectatin f mnetary cmpensatin renders first aid r emergency treatment at the scene f an accident r ther emergency utside a hspital, dctr's ffice r any ther place having prper and necessary medical equipment, t a persn wh is uncnscius, ill, r injured, shall nt be liable fr damages fr injuries alleged t have been sustained by such persn r fr damages fr the death f such persn alleged t have ccurred by reasn f an act r missin in the rendering f such emergency treatment unless it is established that such injuries were r such death was caused by grss negligence n the part f such persn. Nthing in this sectin shall be deemed r cnstrued t relieve a licensed physician, dentist, nurse, physical therapist r registered physician's assistant frm liability fr damages fr injuries r death caused by an act r missin n the part f such persn while rendering prfessinal services in the nrmal and rdinary curse f his r her practice. 2. i. Any persn wh, r entity, partnership, crpratin, firm r sciety that, purchases, perates, facilitates implementatin r makes available resuscitatin equipment that facilitate first aid, an autmated external defibrillatr r an epinephrine aut-injectr device as required by law r lcal law, r ii. the emergency health care prvider with a cllabrative agreement under sectin three thusand-b f this article with respect t an autmated external defibrillatr, r iii. the emergency health care prvider with a cllabrative agreement under sectin three thusand-c f this article with respect t use f an epinephrine aut-injectr device, shall nt be liable fr damages arising either frm the use f

8 that equipment by a persn wh vluntarily and withut expectatin f mnetary cmpensatin renders first aid r emergency treatment at the scene f an accident r medical emergency, r frm the use f defectively manufactured equipment; prvided that this subdivisin shall nt limit the persn's r entity's, partnership's, crpratin's, firm's, sciety's r the emergency health care prvider's liability fr his, her r its wn negligence, grss negligence r intentinal miscnduct. Sectin 3000-b. Autmated defibrillatrs: Public access prviders. 1. Definitins. As used in this sectin, unless the cntext clearly requires therwise, the fllwing terms shall have the fllwing meanings: A) "Autmated external defibrillatr" means a medical device, apprved by the United States Fd and Drug Administratin, that: (I) is capable f recgnizing the presence r absence, in a patient, f ventricular fibrillatin and rapid ventricular tachycardia; (II) is capable f determining, withut interventin by an peratr, whether defibrillatin shuld be perfrmed n the patient; (III) upn determining that defibrillatin shuld be perfrmed, autmatically charges and requests delivery f an electrical impulse t the patient's heart; and (IV) then, upn actin by an peratr, delivers an apprpriate electrical impulse t the patient's heart t perfrm defibrillatin. B) "Emergency Health Care Prvider" means: (I) a physician with knwledge and experience in the delivery f emergency cardiac care; r (II) a hspital licensed under article twenty-eight f this chapter that prvides emergency cardiac care. C) "Public access defibrillatin prvider" means a persn, firm, rganizatin r ther entity pssessing r perating an autmated external defibrillatr pursuant t a cllabrative agreement under this sectin. D) "Natinally-recgnized rganizatin" means a natinal rganizatin apprved by the department fr the purpse f training peple in use f an autmated external defibrillatr. 2. Cllabrative agreement. A persn, firm, rganizatin r ther entity may purchase, acquire, pssess and perate an autmated external defibrillatr pursuant t a cllabrative agreement with an emergency health care prvider. The cllabrative agreement shall include a written agreement that incrprates written practice prtcls, and plicies and prcedures that shall assure cmpliance with this sectin. The public access defibrillatin prvider shall file a cpy f the cllabrative agreement with the department and with the apprpriate reginal cuncil prir t perating the autmated external defibrillatr.

9 3. Pssessin and peratin f autmated external defibrillatr. Pssessin and peratin f an autmated external defibrillatr by a public access defibrillatin prvider shall cmply with the fllwing: A) N persn may perate an autmated external defibrillatr unless the persn has successfully cmpleted a training curse in the peratin f an autmated external defibrillatr apprved by a natinally-recgnized rganizatin r the state emergency medical services cuncil, and the cmpletin f the curse was recent enugh t still be effective under the standards f the apprving rganizatin. Hwever, this sectin shall nt prhibit peratin f an autmated external defibrillatr, (I) by a health care practitiner licensed r certified under title VIII f the educatin law r a persn certified under this article acting within his r her lawful scpe f practice r (II) by a persn acting pursuant t a lawful prescriptin; r (III) by a persn wh perates the autmated external defibrillatr ther than as part f r incidental t his r her emplyment r regular duties, wh is acting in gd faith, with reasnable care, and withut expectatin f mnetary cmpensatin, t prvide first aid that includes peratin f an autmated external defibrillatr; nr shall this sectin limit any gd samaritan prtectins prvided in sectin three thusand-a f this article. B) The public access defibrillatin prvider shall cause the autmated external defibrillatr t be maintained and tested accrding t applicable standards f the manufacturer and any apprpriate gvernment agency. C) The public access defibrillatin prvider shall ntify the reginal cuncil f the existence, lcatin and type f any autmated external defibrillatr it pssess. D) Every use f an autmated external defibrillatr n a patient shall be immediately reprted t the apprpriate lcal emergency medical services system, emergency cmmunicatins center r emergency vehicle dispatch center as apprpriate and prmptly reprted t the emergency health care prvider. E) The Emergency Health Care Prvider shall participate in the reginal quality imprvement prgram pursuant t subdivisin ne f sectin three thusand fur-a f this article. F) The public access defibrillatin prvider shall pst a sign r ntice at the main entrance t the facility r building in which the autmated external defibrillatr is stred, indicating the lcatin where any such autmated external defibrillatr is stred r maintained in such building r facility n a regular basis. 4. Applicatin f ther laws. A) Operatin f an autmated external defibrillatr pursuant t this sectin shall be cnsidered first aid r emergency treatment fr the purpse f any statute relating t liability. B) Operatin f an autmated external defibrillatr pursuant t this sectin shall nt cnstitute the unlawful practice f a prfessin under title VIII f the educatin law.

10 N New Yrk State Department f Health Bureau f Emergency Medical Services POLICY STATEMENT Supercedes/Updates: 98-10, 06-03, Date: March 6, 2009 Re: Public Access Defibrillatin Page 1 f 5 The purpse f this plicy is t assist a persn, firm, rganizatin r ther entity in understanding the ntificatin prcess fr perating an autmated external defibrillatr pursuant t a cllabrative agreement under the prvisins f Chapter 552 f the Laws f 1998 authrizing Public Access Defibrillatin. A Public Access Defibrillatin (PAD) prgram is designed t encurage greater acquisitin, deplyment and use f autmatic external defibrillatrs (AED) in cmmunities arund the state in an effrt t reduce the numbers f deaths assciated with sudden cardiac arrest. Since the enabling legislatin s inceptin, there have been 4,889 PAD prgrams established, with ver 156,167 peple trained and 21,692 AED machines in public sites acrss the state. This prgram has been successful in saving many lives all acrss New Yrk State. At present, the fllwing facilities r rganizatins must have trained prviders and an AED n site: Public schls ( 1 f the Educatin Law); State wned public buildings (Title 9 f Executive Law Subtitle G 303.1); Health clubs with a membership f greater than 500 peple (General Business Law 627-A); Public gathering lcatins (PHL 225 5(b)), and Public surf beaches with lifeguards (PHL 225 5(c)). T be authrized t use an AED under this statute an individual r rganizatin needs t make specific ntificatin f intent t establish a PAD prgram t the apprpriate Reginal Emergency Medical Services Cuncil (REMSCO) and the New Yrk State Department f Health (DOH). There are n apprvals r certificatins required. Public Access Defibrillatin Prgram Requirements Original Ntificatin Prcess T be authrized t have a PAD prgram and utilize an AED, the fllwing steps must be cmpleted: Identify a New Yrk State licensed physician r New Yrk State based hspital knwledgeable and experienced in emergency cardiac care t serve as Emergency Health Care Prvider (EHCP) t participate in a cllabrative agreement; Select an AED that is in cmpliance with the Article 30, sectin 3000-B (1)(A). The AED must be prgrammed t the current Emergency Cardivascular Care (ECC) Guidelines, capable f defibrillating bth adult and pediatric patients. Please check the shaded bx n the Ntice f Intent t Prvide PAD (DOH-4135) if the machine is apprved fr pediatric use; Select and use a SEMAC/DOH apprved PAD training curse fr AED users. At present, the 12 apprved prgrams are as fllws: American Heart Assciatin American Red Crss American Safety & Health Institute Emergency Care and Safety Institute Emergency First Respnse Emergency Services Institute EMS Safety Service, Inc Emergency University Medic First Aid Internatinal Natinal Safety Cuncil REMSCO f NYC, Inc State University f NY Wilderness Medical Assciates Plicy Statement Page 1 f 5

11 Develp with the EHCP, a written cllabrative agreement which shall include, but nt be limited t the fllwing items: Written practice prtcls fr the use f the AED; Written plicies and prcedures which include; Training requirements fr AED users; A prcess fr the immediate ntificatin f EMS by calling f 911; A prcess fr identificatin f the lcatin f the AED units; A prcess fr rutine inspectin f the AED unit(s) as well as regular maintenance and which meet r exceed manufacturers recmmendatins; Incident dcumentatin requirements, and Participatin in a reginally apprved quality imprvement prgram. Prvide written ntice t the 911 and/r the cmmunity equivalent ambulance dispatch entity f the availability f AED service at the rganizatin s lcatin; File the Ntice f Intent (NOI) t Prvide PAD (DOH 4135) and a signed Cllabrative Agreement with the apprpriate Reginal Emergency Medical Services Cuncil (REMSCO), and File a new NOI and Cllabrative Agreement with the REMSCO if the EHCP changes. Reprting a PAD AED Use In the event that the PAD prgram uses the AED t defibrillate a persn, the prgram must reprt the incident t the apprpriate REMSCO. The REMSCO may request additinal infrmatin regarding the incident, but the PAD must reprt, at a minimum, the fllwing infrmatin: Prvide written ntificatin f AED usage t the REMSCO within 48 hurs f the incident; The name f the PAD prgram; Lcatin f the incident; The date and time f the incident; The age and gender f the patient; Estimated time frm arrest t CPR and the 1st AED shck; The number f shcks administered t the patient: The name f the EMS agency that respnded, and The hspital t which the patient was transprted. A cpy f the usage reprt shuld als be prvided t the EHCP. Reginal EMS Cuncil Respnsibility in Public Access Defibrillatin Each REMSCO is respnsible fr receiving and maintaining ntificatin and utilizatin dcumentatin. The REMSCOs must develp and implement the fllwing plicies and prcedures: Insure that a cpy f each new r updated Ntice f Intent (DOH 4135) is frwarded t the Bureau f EMS; Maintain a cpy f the Ntice f Intent and the Cllabrative Agreement; Cllect utilizatin dcumentatin and infrmatin; Prvide detailed quarterly reprts t the DOH n PAD prgrams in the regin, and Develp Quality Assurance participatin, data submissin and dcumentatin requirements fr participating rganizatins. Data Cllectin Requirements REMSCO quality imprvement prgrams are encuraged t use the data elements frm the Utstein Guidelines fr Prehspital Cardiac Arrest Research (Cumming RO, Chamberlain DA, Abramsn NS, et al, Circulatin 1991; 84: ). Plicy Statement Page 2 f 5

12 The fllwing minimum data set is t be develped and cllected as a part f the reginal PAD QI prcess. A cpy f the data set is t be prvided by each regin t the DOH Bureau f EMS quarterly: Name f rganizatin prviding PAD; Date f incident; Time f Incident; Patient age; Patient gender; Estimated time frm arrest t 1st AED shck; Estimated Time frm arrest t CPR; Number f shcks administered t the patient; Transprt ambulance service, and Patient utcme at incident site (remained unrespnsive, became respnsive, etc). Ambulance and ALS First Respnse Services Ambulance r ALSFR services may nt participate in PAD prgrams fr emergency respnse. Certified EMS agencies must apply fr authrity t equip and utilize AEDs thrugh their lcal Reginal Emergency Medical Advisry Cmmittee (REMAC). Please nte that the Prehspital Care Reprt (PCR) has a check bx fr EMS prviders t indicate that a patient has been defibrillated prir t EMS arrival by a cmmunity r by-stander PAD prvider. Dcumenting this infrmatin is required s that the DOH may mnitr the effectiveness f these cmmunity based prgrams Attachments 1. Ntice f Intent t Prvide Public Access Defibrillatin 2. Reginal EMS Cuncil Listing Plicy Statement Page 3 f 5

13 431 New Karner Rad, Albany. NY (518) Fax (518) Public Access Defibrillatin (PAD) REMO Rles and Respnsibilities The rles and respnsibilities with respect t Public Access Defibrillatin fall int three primary categries: Administrative: Pursuant t sectin 3000-b f the New Yrk State Public Health Law and NYS DOH Plicy Statement 98-10, the reginal EMS Cuncils are assigned Administrative and Quality Imprvement respnsibilities including receiving the Ntice f Intent.DOH 4135 and a signed Cllabrative Agreement frm the prvider agency. A cpy f the letter f intent is t be frwarded t the DOH. REMO will perfrm these tasks and maintain an apprpriate, up t date file n all PAD activity in the regin. REMO will cllect and develp a QI data set which will meet r exceed the requirements delineated in Statute and Plicy. Public Educatin and Infrmatin: REMO will serve as a resurce fr infrmatin regarding PAD, including but nt limited t training, training sites and dates, equipment, and medical cntrl/invlvement. REMO will cmpile and distribute a Prvider Packet cntaining current infrmatin and guidelines and make it readily available t any prspective prvider agency. REMO will prmte the PAD cncept via the media, direct mailing, and persnal cntact. Prmtinal materials will be made available t the public, business cuncils, public service rganizatins, and the medical cmmunity. REMO will prvide Cunty EMS Cuncils with prmtinal infrmatin fr encuragement f further lcal prmtin. Training: REMO will develp training curse materials and ffer State-apprved PAD training. REMO will cnduct training fr prvider agencies including initial prvider training, in-service training, and instructr training. The REMO training prgram will wrk in cncert with ther vlunteer and prfessinal training agencies in the regin. PAD training will be incrprated int the REMO training and administrative prgrams. Staff will be assigned by the Executive Directr, and jb descriptins will be created and/r mdified as necessary t include these new areas f respnsibility. THE REGIONAL EMERGENCY MEDICAL SERVICES SYSTEM COUNCIL f the HUDSON MOHAWK VALLEYS, INC. ALBANY COLUMBIA GREENE SARATOGA RENSSELAER SCHENECTADY