Automated External Defibrillator (AED) Policy and Procedure 207
Juan Querubin, OMS-III Danielle Allen OMS-III 2
TABLE OF CONTENTS Photos.02 Table of Contents.03 The Purpose of the Automated External Defibrillator (AED) 05 AED Policy.05 AED Action Plan...05 AED Program management..07 AED Tennessee Liability & Good Samaritan Law..08 AED selection and placement.09 AED maintenance and support equipment Transfer of Patient Care.. AED documentation following use..2 AED use by trained responder(s)..3 Appendix A Tennessee Liability & Good Samaritan Law..7 Appendix B Tennessee AED Law.8 Appendix C Reserved 22 Appendix D AED Monthly Check Sheets 24 Appendix E Reserved..26 3
Appendix F Campus Map Harrogate 28 Appendix G Summary of Requirements...3 Appendix H AED Incident Report Form...32 Appendix I CPR Skills Forms 35 4
PURPOSE The purpose of the Automated External Defibrillator (AED) Program is to increase the rate of survival of individuals who have experienced a sudden cardiac death. AEDs make it possible for successfully currently trained personnel to administer defibrillation to the sudden cardiac death victim. This AED program will provide equipment and training for faculty, staff and students to enhance the life safety response measures. The American Heart Association has determined that time to defibrillation is the single most important factor in the survival of a sudden cardiac death victim. The time of elapse before resuscitation is the most critical time according to researchers. The standard of care for resuscitation is early defibrillation as soon as possible and correlates with higher survival rates increasing the need for more automated external defibrillators. Lincoln Memorial University is committed to the health and safety of its students, staff, faculty and visitors. This policy establishes an AED program for the Lincoln Memorial University oncampus that will: meet Tennessee regulatory compliance implement enhanced life safety response measures establish AED user training requirements provide continuity and consistency on and off campuses in AED installation, maintenance and use identify approved user of the AED POLICY Lincoln Memorial University departments and other units on and off campuses that acquire and AED must comply with this policy and are hereafter referred to as an AED owner. This policy and procedures set forth the standards and responsibilities for the installation, modification, replacement, repair, inspection, maintenance, and non-medical response of the AED on the Lincoln Memorial University on campuses. PROCEDURE The procedure follows the recommendation of the American Heart Association s critical skills description adult & child/ CPR AED skills (Appendix I). AED ACTION PLAN. The AED must be accessible. 2. The AED should be located within a 90-second brisk walk 5
3. Everybody should know the AED by its appearance, know their locations, and how to turn it on 4. At a minimum, at least a core group of individuals should be CPR trained. Those who are most likely to respond to the emergency should receive the training. Optimally, everybody should be trained. 5. Know the other tasks that may need to be performed: a. Call 9: The dispatcher can provide help over the phone if you need it. b. Use the most direct route to obtain the closest AED: It s easier to figure this out when there isn t an emergency taking place-plan ahead! c. Alert other trained individuals in nearby work areas to assist with CPR: Again, plan ahead-do these people carry pagers, cell phones? Is there a company paging system? d. Somebody to meet EMS at the entrance. Rarely do employees collapse at the entrance-rather; they collapse in remote areas of a building or complex. Campus police should also be notified and assist in the direction of EMS vehicles. e. Making emergency contact notification according to the policy: Have emergency contact persons respond to the hospital, not to workplace. Your message should be simple-that the employee has experience a medical emergency and is being transported to the receiving hospital. f. After the incident, conduct a debriefing session: Participants will want and need to talk after the incident. This can be accomplished in one of several ways-your resource could be an Employee Assistance Program. 6
COORDINATOR RESPONSIBILITIES Review the AED Policy on an annual basis Coordination of equipment and accessory maintenance Communicate with Medical Director, Dr. Kenneth Trzil, on issues related to training and post event reviews Coordination of training for CPR and AED through the American Heart Association Manage a list of trained AED responders Participate in case reviews, training and retraining, data collection and other quality assurance activities CONTACT Johnathan Greene, RN, BSN, NREMTP, BSOM American Heart Association Training Coordinator Center for Simulation & Training Coordinator Co-Author of LMU AED Policy & Procedure 204 Johnathan.greene@LMUnet.edu 7
MEDICAL DIRECTOR RESPONSIBILITIES The AED program, management, medical direction and quality monitoring will be overseen by Dr. Kenneth Trzil, MD. Providing medical direction for the use of the AED at Lincoln Memorial University Writing a prescription for the AEDs Reviewing and approving guidelines for emergency procedures related to the use of the AEDs and CPR Evaluation of post-event review forms and digital files downloaded from the AED Kenneth Trzil, MD Assistant Professor of Internal Medicine & Department Chair of Int Medical Director for Simulation Labs Medical Director, Physician Assistant Program Lincoln Memorial University DeBusk College of Osteopathic Medicine 6965 Cumberland Gap Parkway Harrogate, Tennessee 37752 Office: 423.869.6690 Fax: 423.869.7078 Kenneth.trzil@LMUnet.edu TENNESSEE LIABILITY & GOOD SAMARITAN LAW Tennessee law allows for the use of an AED during an emergency for the purpose of attempting saving a life of another person who is, or who appears to be, in cardiac arrest. See Appendix A & B for the Tennessee Good Samaritan Act TCA 63-6-28. 8
LOCATIONS OF AEDS AEDs are located in the following areas: Location Number Trained Peak/Non-Peak Type Number of Units Cedar Bluff Main Hallway Powerheart G# LMU University Medical Clinic/Harrogate DSOL Phillips LMU-DCOM Floor Phillips Headstart LMU-DCOM Floor 3 Philips MANS Floor Philips MANS Floor 2 Philips MANS Floor 3 Philips MANS Floor 4 Philips Mary S. Annan Natatorium/Pool Philips near the water fountain Tex Turner Arena/Lower Concourse Philips by Athletic Training Office Tex Turner Arena/Upper Concourse-on wall Philips when you go in middle doors to concourse Tex Turner Arena/Athletic Training Clinic ZOLL AED 2 Plus LMU University Medical Clinic/New Tazewell Philips Carnegie Vincent Library/Lobby Philips Business Education Building/Lobby Philips LMU Golf Training Center Philips Beside the Pro Shop Farr Hall/JFWA Portable Abraham Lincoln Library & Museum Philips Gift Shop Area Campus Police & Security Vehicles Portable Student Center/Lobby Philips University Inn/Lobby Philips DVM-Small Animal Clinical Skills Area In hallway by the labs Philips 9
DVM-Student Center near the Security desk DVM-Bovine Teaching Center Entrance area Future locations are listed below. Philips Philips Location Type Number of Units Avery Hall DAR-Whitford Hall Dorothy Neely Softball Field House Duke Hall Grant Lee Hall Kresge Hall Lamar Hennon Baseball Field House LMU-DCOM Floor 2 LMU-DCOM Floor 4 LMU-Knoxville North & South Buildings 4 LMU Lacrosse Complex LMU Tennis Complex Maintenance Shop Organic Garden Center Residential Housing 2 Schenck Center for Allied Health Sciences Sigmon Communications Center W.H. Smith Manor (President s Office) IMPLEMENTATION OF AEDs All of the AEDs are placed at their designated locations and registered with the Claiborne County 9 system. Although AEDs can be found in many schools, businesses, churches, and public buildings throughout the region, they are still rarely used on cardiac arrest victims. One reason is that nobody knows to look for them until after the emergency. AED MAINTENANCE & AFTER EACH PATIENT USE Automated external defibrillators are easy to use and maintain. Failing to maintain your AED can lead to disaster on the day it is needed. Universally, all AED s need the following to be operational when an emergency occurs: 0
. The AED should be checked that it is physically in the proper location. 2. The AED pads should be checked for expiration and/or broken package. If it is opened or out of date then it must be replaced. 3. The battery should be checked. For most AEDs, there is an indicator light or symbol that indicates if the battery is OK or if it needs service. Know the battery check mechanism for your AED. If the battery is low, you should have both visual and audible warning (many generate a beep like a smoke detector with a low battery). 4. Most AEDs have a small pouch or packet of supplies you might need when using the AED. This pouch may include a face mask for rescue breathing, a small towel, scissors, protective gloves, and a razor. Be sure this kit is ready. The AED owner s manual contains valuable information specific to checking and maintaining your AED-be sure to read and follow the instructions. AEDs are very reliable devices and problems are rare, they can happen. Your owner s manual is also a valuable resource for correcting problems with your AED. It is helpful to have a documented, periodic check of the AED. Your AED may have come with a checklist for a weekly or monthly check. See the manufacturer or vendor information for repairs or purchase of replacement and new products. CLEANING When necessary, clean the defibrillator using recommended cleaning agents, per the AED Instructions for Use. TRANSFER OF PATIENT CARE Once EMS arrives, the responder transfers patient care to the EMS agency for appropriate advanced medical treatment and provides a report including: The initial time of the event Any care given prior to the arrival of the responder Patient s condition upon the responder s arrival All treatment rendered by the responder Any available medical information about the patient Post-use equipment check Replacement of necessary supplies used Return of the AED to its designated location
MEDICAL RESPONSE DOCUMENTATION FOLLOWING A CARDIAC ARREST It is mandatory and essential to document each use of the emergency response system and AED. The forms found in the Appendix H should be filled out as complete as possible and forwarded to the medical director for review. Medical emergencies involving the use of an AED must be collected into the patient s confidential file. The AED Incident Report is a part of the patient medical record and is confidential to both the patient and facility. A copy of the AED Use information shall be presented to the medical director of the AED Program within 48 hours post event. EXTERNAL POST-EVENT DOCUMENTATION A copy of the AED use information shall be presented within 24 hours of the emergency to the following: Medical Director of the AED Program Local EMS, county, state officials as designated in state AED requirements and local regulations 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 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 health a safety committee. The health and safety coordinator according to the record retention policy shall maintain a copy of the post-event review summary. 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 the system procedure is expected to be very infrequent, other measures of effectiveness are required. 2
ANNUAL SYSTEM ASSESSMENT Once each calendar year, the AED Program Coordinator or designee shall conduct and document a system readiness review. This review shall include review of the following elements: Training records Equipment operations and maintenance records AED TRAINED USERS The AED may be used by: Employees that have been trained in American Heart Association Heartsaver CPR/AED class and successfully completed Additional faculty/staff as identified by administration Any student who has successfully completed the American Heart Association Heartsaver CPR/AED class OTHER RESPONDER RESPONSIBILITIES Activating internal emergency response system and providing prompt CPR and AED according to their 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, at their discretion, can provide voluntary assistance to victims of medical emergencies and not be an approved faculty, staff, student or other approved responder. The extent to which these individuals respond shall be appropriate to their training and experience. These responders are encouraged to contribute to the emergency response only to the extent they are comfortable. INITIAL AND RENEWAL TRAINING REQUIREMENTS Any AED user, students, faculty, staff, and other employees are encouraged to take the American Heart Association Heartsaver CPR/AED course. These courses are taught and made available, FREE, to all faculty, staff, and other employees at the LMU-DCOM Center for Simulation and Training. Renewal training will be provided every two years or before if deemed necessary by administration. 3
RESERVED 4
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APPENDIX A 6
Tennessee Good Samaritan Act Tennessee Code Annotated 63-6-28. (a) This section shall be known and cited as the Good Samaritan Law. (b) Any person, including those licensed to practice medicine and surgery and including any person licensed or certified to render service ancillary thereto, or any member of a volunteer first aid, rescue or emergency squad that provides emergency public first aid and rescue services, who in good faith: () Renders emergency care at the scene of an accident, medical emergency and/or disaster, while en route from such scene to a medical facility and while assisting medical personnel at the receiving medical facility, including use of an automated external defibrillator, to the victim or victims thereof without making any direct charge for the emergency care; or (2) Participates or assists in rendering emergency care, including use of an automated external defibrillator, to persons attending or participating in performances, exhibitions, banquets, sporting events, religious or other gatherings open to the general public, with or without an admission charge, whether or not such emergency care is made available as a service, planned in advance by the promoter of the event and/or any other person or association, shall not be liable to such victims or persons receiving emergency care for any civil damages as a result of any act or omission by such person in rendering the emergency care, or as a result of any act or failure to act to provide or arrange for further medical treatment or care for the injured person, except such damages as may result from the gross negligence of the person rendering such emergency care. (c) A receiving medical facility shall not be liable for any civil damages as a result of any act or omission on the part of any member of a volunteer first aid, rescue or emergency squad that provides emergency public first aid and rescue services while such person is assisting medical personnel at the receiving medical facility. (d) If: () A volunteer fire squad is organized by a private company for the protection of the plant and grounds of such company; (2) Such squad is willing to respond and does respond to calls to provide fire protection for residents living within a six (6) mile radius of the county surrounding such plant; and (3) The plant is located in a county that does not otherwise provide fire protection to such residents; then the members of such volunteer fire squad, while providing fire protection within such area outside the plant, shall be liable to suit under the provisions of the Governmental Tort Liability Act, compiled in title 29, chapter 20, part 2. 7
APPENDIX B 8
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APPENDIX C 22
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APPENDIX D 24
AED MAINTENANCE CHECK SHEET MODEL # SERIAL # MANUFACTURER LOCATION YR: DATE AED CONDITION BATTERY PADS/ EXP. DATE SUPPLY KIT COMMENTS SAMPLE JAN 3/3 GOOD /30/203 FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC NOTES: 25
APPENDIX E 26
APPENDIX F 27
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APPENDIX G 29
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APPENDIX H 3
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APPENDIX I 34
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