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SAN DIEGO PROJECT HEART BEAT
AUTOMATIC EXTERNAL DEFIBRILLATOR (AED) PROGRAM
STANDARD OPERATING PROCEDURES
TABLE OF CONTENTS
Page Numbers
Record of Amendments
iii.
Internal Distribution List
iv.
Program Management Contacts
v.
Definitions and Acronyms
vii.
Section 1 – Introduction
1.1
1.2
Overview
Automatic External Defibrillator (AED) Purposes
Section 2 – AED Program Requirements
2.1
2.2
2.3
Program Approval
Documentation
Training Compliance
Section 3 – Training Requirements
3.1
3.2
3.3
3.4
3.5
3.6
State of California Regulations
Public Safety Regulations
Lay-Rescuers Regulations
Cardiopulmonary Resuscitation (CPR) Training
Automatic External Defibrillator (AED) Training
Training Protocol
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Section 4 – Standard Operating Procedures
4.1
4.2
4.3
4.4
4.5
4.6
4.7
4.8
Roles and Responsibilities
Policy
Automatic External Defibrillator (AED) Locations
Procedure
Post Incident
Maintenance
Record Keeping Requirements
Automatic External Defibrillator (AED) Equipment
Inspections
APPENDICES
Appendix A:
Reference List
Appendix B:
Automatic External Defibrillator (AED) Incident Form
Public Access Defibrillation (PAD) Activation Report Form
Appendix C:
Automatic External Defibrillator Maintenance Check List
Appendix D:
Assembly Bill 2041 - Good Samaritan Law
Appendix E:
California Code of Regulations, Title 22, Division 9, Chapter
1.5, First Aid Standards for Public Safety Personnel
Appendix F
California Code of Regulations, Title 22, Division 9, Chapter
1.8, Training Standards for Use of the Automated External
Defibrillator by Non-Licensed or Non-Certified Personnel
Appendix G
PAD Program Site and Liaison Responsibilities
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Page iii.
SAN DIEGO PROJECT HEART BEAT
AUTOMATIC EXTERNAL DEFIBRILLATOR (AED) PROGRAM
STANDARD OPERATING PROCEDURES MANUAL
RECORD OF AMENDMENTS
Effective
Date
Section
Number
Page
Number
Action
Person
Page iv.
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SAN DIEGO PROJECT HEART BEAT
AUTOMATIC EXTERNAL DEFIBRILLATOR (AED) PROGRAM
STANDARD OPERATING PROCEDURES MANUAL
INTERNAL DISTRIBUTION LIST
Distribution
Position
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Date
Issued
Page v.
SAN DIEGO PROJECT HEART BEAT
AUTOMATIC EXTERNAL DEFIBRILLATOR (AED) PROGRAM
STANDARD OPERATING PROCEDURES MANUAL
PROGRAM MANAGEMENT CONTACTS
Program Medical Director
James Dunford, MD
City of San Diego Medical Director
1010 Second Avenue
San Diego, CA 92101
Phone: (619) 533-4359
Pager: (619) 232-2237 id# 0701
E-mail: [email protected]
San Diego County AED Coordinator
Patti Murrin
EMS Specialist
County of San Diego Emergency Medical Services
6255 Mission Gorge Rd.
San Diego, CA 92120
Phone: (619) 285-6451
Fax: (619) 285-6531
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SAN DIEGO PROJECT HEART BEAT
AUTOMATIC EXTERNAL DEFIBRILLATOR (AED) PROGRAM
STANDARD OPERATING PROCEDURES MANUAL
PROGRAM MANAGEMENT CONTACTS
Program Coordinator
Maureen O’Connor
San Diego Medical Services Enterprise
10405 San Diego Mission Road, Suite 100
San Diego, CA 92108
Phone: (619) 243-0911
Fax: (619) 243-0913 Pager: (619) 232-2237 id# 1279
E-Mail: [email protected]
PAD Program Marketing Manager
San Diego Medical Services Enterprise
10405 San Diego Mission Road, Suite 100
San Diego, CA 92108
Phone: (619) 243-0912
Training Center Coordinator
Dan Beebe
San Diego Medical Services Enterprise
10405 San Diego Mission Road, Suite 100
San Diego, CA 92108
Phone: (619) 243-0910
Fax: (619) 243-0913
Pager: (619) 232-2237 id #1278
E-mail: [email protected]
AED Marketing Analyst
Glenn Thomas
Phone: (619) 243-0200
Pager: (619) 232-2237 id#1324
Fax: (619)243-0913
E-mail: [email protected]
Website
www.sdmse.com/projectheartbeat
AED Consultant
Karen McElliott
San Diego Medical Services Enterprise
10405 San Diego Mission Road, Suite 100
San Diego, CA. 92108
Phone: (858) 271-0514
Fax: (858) 271-0514 Cell: (619) 889-0514
E-mail: [email protected]
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SAN DIEGO PROJECT HEART BEAT
AUTOMATIC EXTERNAL DEFIBRILLATOR (AED) PROGRAM
STANDARD OPERATING PROCEDURES MANUAL
DEFINITIONS AND ACRONYMS
ABC’s:
This refers to determining if an individual has “Airway,
Breathing, Circulation (pulse).” This must be established prior
to rendering cardiopulmonary resuscitation (CPR).
AHA:
American Heart Association. An organization devoted to
fighting heart disease and stroke through educational
programs. These programs increase awareness by promoting
safe and effective lifestyles.
AED:
Automatic External Defibrillator. A device capable of cardiac
rhythm analysis, which will charge and deliver a shock either
automatically or by user interaction after electronically detecting
and assessing ventricular fibrillation or rapid ventricular
tachycardia.
BLS:
Basic Life Support. A method of providing life support and
assistance to an individual in need.
CISD:
Critical Incident Stress Debriefing. Briefing session that outlines
the details of an incident involving the deployment of an AED
unit. The session(s) are conducted by trained counselors.
CPR:
Cardiopulmonary Resuscitation. A means of establishing and
maintaining adequate respiration and circulation. This is done
by ensuring the patient has an open airway. Administering
rescue breathing and maintaining the victims circulation by
means of closed chest cardiac compressions.
Defibrillation:
A method using an AED to reestablish normal contraction
rhythms in a heart that is not beating properly.
EMS:
Emergency Medical Services. Medical authorities qualified to
provide medical services and take authority of an incident.
PAD:
Public Access Defibrillation.
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Program
Coordinator:
Program Liaison:
Program Medical
Director:
A medically qualified person who has been fully trained in AED
and oversees the AED Program to ensure high quality and
proper procedures are followed. Reports directly to Program
Medical Director.
The main contact person(s) who will maintain quality of the site
AED/PAD program and communicate all pertinent information
in regard to their AED/PAD program with SDPHB staff.
A medically qualified person who has been fully trained in AED
use and oversees the AED training and program operations to
ensure high quality and proper procedures are followed.
SDPHB:
San Diego Project Heart Beat.
access defibrillation program.
San Diego County’s early
AB 2041:
Assembly Bill 2041 (Good Samaritan Laws). Laws that have
been passed by the State of California legislature designed to
protect those operators who follow certain specified conditions
in the use of an AED from civil and damage lawsuits.
SCA:
Sudden Cardiac Arrest. A condition where the heart and
breathing functions stop abruptly and the victim may lose
consciousness.
VF:
Ventricular Fibrillation. An abnormal heart rhythm that can
prevent the heart from pumping blood. This leads to sudden
cardiac arrest. By using defibrillation, VF can be corrected
causing a normal heart rhythm to resume.
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SAN DIEGO PROJECT HEART BEAT
AUTOMATIC EXTERNAL DEFIBRILLATOR (AED) PROGRAM
STANDARD OPERATING PROCEDURES MANUAL
SECTION 1 - INTRODUCTION
1.1 Overview
An estimated 465,000 Americans die each year of sudden cardiac arrest (SCA). SCA is usually caused
by a heart rhythm disturbance called ventricular fibrillation (VF). Each minute is critical in helping the
patient to restore a normal heart rhythm. It has been estimated that for each minute that passes without
defibrillation available, the patient’s chances of surviving drop by 10 percent.
The key to survival is the speed of response. In addition to Cardiopulmonary Resuscitation (CPR), most
cardiac arrest victims need immediate electrical shock to restore the heart’s normal rhythm. When victims
received that shock within a minute, there is a 90 percent chance of resuscitation. When it takes 10
minutes, the odds fall to less than 5 percent.
The installation of AED’s is a new measure taken by San Diego Project Heart Beat to demonstrate the
importance of community safety in public facilities. In addition, San Diego Project Heart Beat is proud to
join in the City of San Diego’s “Heart Safe Community” efforts.
1.2
Automatic External Defibrillator (AED) Purposes
Automatic External Defibrillators (AED’s) are life saving devices through which an irregular heart rhythm
can be detected. If necessary, a shock can be administered to restore the heart’s normal rhythm. It is
hoped that these AED’s will be installed in strategically selected locations throughout San Diego County
communities to enhance the response levels to cardiac emergencies.
The AED is a user-friendly device that is lightweight and small in size. Training sessions should be
provided to identified rescuers in the proper use of an AED to ensure that the best possible assistance is
given to SCA victims.
The operational use of the AED is discussed in greater detail in Section 4, Operational Procedures.
Section 2 discusses the AED Program compliance requirements.
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SAN DIEGO PROJECT HEART BEAT
AUTOMATIC EXTERNAL DEFIBRILLATOR (AED) PROGRAM
STANDARD OPERATING PROCEDURES MANUAL
SECTION 2- AED PROGRAM REQUIREMENTS
2.1
Program Approval
Prior to the implementation of an AED Program, San Diego Project Heart Beat is required as a provider
agency to provide documentation to San Diego County Emergency Medical Services (EMS). The County
of San Diego EMS will then review the documents provided and approve the AED Program. The
necessary documentation is outlined in the next subsection.
2.2
Documentation
The Program Coordinator is to provide the County of San Diego EMS with a signed letter of commitment
giving his/her name and qualifications. This letter should express a willingness to comply with all the
applicable policies and procedures established by the County of San Diego EMS in coordinating the AED
Program.
A detailed written statement should be included describing the specific type (automatic or semi-automatic)
and brand name of defibrillation equipment to be used. This statement should outline the geographic
areas where defibrillation will be utilized. The procedures for creating and maintaining patient care
records and data collection must be included in this written statement. If necessary, the Program
Coordinator is to acquire this information from the proposed Program Medical Director.
A letter identical to the above mentioned letter should be prepared by the proposed Program Medical
Director expressing his/her willingness to comply with all the applicable policies and procedures
established by the County of San Diego EMS in coordinating the AED Program. This letter should also
include a written statement on the quality improvement processes taken on the AED Program through
data collection and evaluation, defining standards, monitoring training, and utilizing evaluation results.
2.3
Training Compliance
The Program Liaison and the Program Coordinator are responsible for ensuring that all initial and
refresher training guidelines and course objectives meet the requirements as defined under Title 22,
Chapter 1.5, Training Standards in the California Code of Regulations found in Appendix G.
The initial training must consist of a minimum of four (4) hours of didactic and skills education. The
Program Liaison, the Program Coordinator, and Trainers must provide the Program Medical Director with
a written plan that outlines the methods of training used, the topics discussed, and the expected length of
the session(s). Prior to implementation of the AED training sessions, the Program Medical Director or
their designated representative must approve the training session.
Additionally, the Trainers must furnish proof to the Program Medical Director and the Program Coordinator
that he or she has successfully completed an approved AED training instructor course that qualifies them
to provide training. The next section, Section 3 - Training Requirements, discusses the content of the
AED training and requirements that must be met by the first responder.
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SAN DIEGO PROJECT HEART BEAT
AUTOMATIC EXTERNAL DEFIBRILLATOR (AED) PROGRAM
STANDARD OPERATING PROCEDURES MANUAL
SECTION 3 - TRAINING REQUIREMENTS
3.1
State of California Regulations
Sections 1797.107 and 1797.190 of the Health and Safety Code under the State of California Regulations
outline that only those individuals who have successfully completed the AED training standards
established in this manual and maintained their certification may use the AED units available at their site.
3.2
Public Safety Regulations
The following California Code of Regulations pertaining to public safety can be found in appendix E:
1. Title 22. Social Security. Division 9, Pre-hospital Emergency Medical Services.
2. Chapter 1.5 First Aid Standards for Public Safety (Article 1 through Article 4).
San Diego County EMS imposes additional requirements, which include additional curriculum regarding
the San Diego County Division of Emergency Services AED Policy and Procedure Protocols and standing
orders regarding the use of the AED by Public Safety Defibrillation.
AED skills’ proficiency
demonstrations are required every six (6) months and must be documented as required by San Diego
County EMS.
3.3
Lay-Rescuers Regulations
The following California Code of Regulations pertaining to public safety can be found in appendix D:
1. Title 22. Social Security. Division 9, Pre-hospital Emergency Medical Services.
2. Chapter 1.8 Training Standards for Use of the Automated External Defibrillator by Non-Licensed or
Non-Certified Personnel (Article 1 through Article 4).
3. Assembly Bill 2041 Good Samaritan Law
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3.4
Cardiopulmonary Resuscitation (CPR) Training
Prior to beginning AED training, the individual must fulfill all CPR training requirements. This proficiency
in CPR practices must be demonstrated during the initial AED course. If an individual has already
received CPR training and has maintained his or her certification, they may forego this training
requirement in fulfilling the AED training requirements provided they furnish proof of CPR certification to
the Program Coordinator and the Program Liaison.
By providing the proper Basic Life Support (BLS), the operator will be more capable of using his or her
ventilation and compression skills to circulate oxygen-rich blood to the brain. AED units will prompt if a
“no-shock” advised decision is made and will advise the operator to check Airway, Breathing, and
Circulation (ABC’s) and to provide CPR if indicated. The AED will continue to monitor and advise the
operator if additional shocks are indicated.
3.5
Automatic External Defibrillator (AED) Training and Certification
Individuals who use an AED must undergo AED training and be familiar with the Standard Operating
Procedures covered in Section 3 of this manual. The initial AED training will be approximately four (4)
hours in duration and covers the required topics listed in Title 22, Division 9, Chapters 1.5 and 1.8 of the
California Code of Regulations.
To maintain AED certification, mandatory refresher training will be required every six (6) months for Public
Safety (Title 22) personnel and every *twelve (12) months for remaining (non Title 22) personnel,
according to the Program Medical Director. *New legislation as of May 30, 2002.
3.6
Training Protocol
For the purposes of all involved with San Diego Project Heart Beat’s Automatic External Defibrillator
Program, the Program Medical Director establishes the training protocol.
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SAN DIEGO PROJECT HEART BEAT
AUTOMATIC EXTERNAL DEFIBRILLATOR (AED) PROGRAM
STANDARD OPERATING PROCEDURES MANUAL
SECTION 4 – STANDARD OPERATING PROCEDURES
4.1
Roles and Responsibilities
Program Coordinator
The Program Coordinator oversees the site AED Program and coordinates the development and
maintenance of the AED program by ensuring compliance that all legal requirements are met on all issues
related to AED operations. The Program Coordinator has the responsibility of assuring that the Program
Liaison who assures that the AED equipment is operating properly successfully completes all AED
equipment inspections. A copy of the AED Maintenance Form can be found in Appendix C and is required
to be sent in on a monthly basis to the SDPHB office.
Program Medical Director
The Program Medical Director is responsible for the medical standards for the use of AED units and for
review of all deployment of AED units. The Program Medical Director is responsible for maintaining the
high quality standards of training for use of AED units within the program.
Program Liaison
The Program Liaison is responsible for all initial and refresher training to any individual the program site
wishes to pursue and/or maintain AED certification. This training must meet the AED training
requirements as defined by the State of California and to the satisfaction of the Program Medical Director.
Upon the conclusion of each AED training session, the Program Liaison is responsible for providing to the
Program Medical Director a list of individuals who have successfully completed the AED training. The list
should include the date of training, the type of course certification completed and the instructor of the
course. Copies of individual course certification cards (front and back) or course training rosters can
suffice as verification. A maintenance checklist must be kept on either a daily or weekly basis and faxed
in to the SDPHB office at the end of each month.
AED Trainers
The AED Trainers will provide all initial and refresher training to individuals who wish to maintain their
AED certification. This training shall meet the AED training requirements as defined by the State of
California and San Diego County EMS.
AED Certified Individuals
An AED Certified Individual is responsible for deploying AED units as trained.
Individual must ensure their AED certification is current.
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The AED Certified
4.2
Policy
It is the policy of San Diego Project Heart Beat to maintain the highest quality AED program.
After each use of the AED, all resuscitation information recorded on the AED data card will be
converted to hard copies for the patient event files. The San Diego County Defibrillation Report
will be completed and filed with San Diego County EMS. The Program Liaison or his/her designee
will complete the AED Incident Form. All hard copy reports will be made in triplicate and
distributed to the Program Medical Director, County EMS and SDPHB. SDPHB staff will see to the
distribution of these reports as coordinated between the Program Liaison and acting Program
Coordinator.
4.3
AED Locations
All persons actively involved with the AED Program, including first responders and AED certified
individuals, shall be familiar with the locations of AED units on site.
The Program Liaison will notify first responders and AED certified individuals when AED location changes
are made.
4.4
Procedure
The key to survival is the speed of response. When responding to a victim who may be in SCA and in
need of assistance, the primary objective is to ensure that medical personnel are enroute to the scene.
CALL 911 FIRST, THEN APPLY AED.
The first responder(s) are responsible for following the steps outlined below.
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Procedure for AED Deployment:
In case of SCA, initiate the Chain of Survival
1.
Early access
2.
Early CPR
3.
Early Defibrillation (AED)
4.
Early Advanced Care
Early Access
*
Assess scene safety.
Assess responsiveness: Tap shoulders and shout, “Are you OK?”
Activate 9-1-1. Take the closest AED to the victim.
Use phone, to tell dispatchers where the victim is.
Check ABC's
*
Assess airway. Perform head-tilt; chin lift to open the airway.
Assess Breathing. Look, Listen and Feel. If Breathing is absent,
Use the barrier device attached to the AED case to deliver two
rescue breaths.
Check Pulse. Place two fingers on the carotid artery, check for
pulse, if no pulse is present begin CPR.
CPR
*
Perform CPR until the AED arrives. (If the AED is there, do not start CPR begin with applying the AED).
Compress and release chest wall 15 times (rate 100 compressions/minute).
Ventilate. Give two rescue breaths.
Continue CPR. 15 compressions / two breaths. Check for a pulse after one minute and every few
minutes thereafter.
Defibrillation (AED)
Instructions for one-rescuer approach:
*
When AED arrives:
Place AED near head of patient on same side as the rescuer.
Turn on the AED by simply opening the lid.
Bare and prepare the chest (cut or tear away clothing, if excessive chest hair, shave, dry the chest if
wet).
Follow AED verbal and visual prompts.
Apply electrodes (follow drawings on pads).
Allow AED to analyze.
If indicated, deliver shock by pressing the button.
Continue care per AED instructions.
Note: At the scene, all trained employees and on-site patrons who follow the specified conditions in administering
AED assistance are protected under Assembly Bill 2041 (Good Samaritan Law) from any civil and damage lawsuits
related to the incident. A copy of Assembly Bill 2041 can be found by referring to Appendix D.
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4.5
Post Incident
Every event in which an AED is used (or could have been used) must be reviewed by the Program
Medical Director (or his or her designee). This means that every incident must be reviewed to establish
whether the patient was treated according to the established protocol. Other aspects of performance that
can be evaluated include scene safety, efficiency, speed, ability to troubleshoot and interactions with
professionals and bystanders.
The case-by-case review is done by written report and review of the recorded data made by the AED.
The following steps shall be taken as soon after an AED incident:
1. The data card must be pulled from the AED for data download (SDPHB staff can perform this duty as
outlined under Program Management). This data card information must be forwarded to the Program
Medical Director, Program Coordinator, and EMS within 48 hours. Review the case with the
overseeing physician, EMS and involved rescuers.
2. Return the AED unit to a state of readiness at its assigned location. Replace the pads, pocket mask
and other peripheral supplies that were used.
3. The AED unit must be inspected and found ready for use by the Program Liaison(s).
All AED uses must be reported to San Diego Project Heart Beat within 48 hours, who in turn will furnish
the information to the Program Coordinator and Program Medical Director. This is accomplished by
completing and submitting an AED Incident Form and an Activation Report Form. A copy of the AED
Incident Form and Activation Report Form can be found by referring to Appendix B.
Once the incident has concluded, the Program Liaison should be responsible for arranging a Critical
Incident Stress Debriefing (CISD) with the affected individuals involved in the incident if they feel the
need.
1. The first responder or AED certified rescuer should complete an AED Incident Form and an Activation
Report Form. Any operational deficiencies should be immediately reported to the Program Liaison. If
necessary, the AED unit may be taken out of service and repaired or replaced.
2. The Program Liaison should see that the CISD is conducted as soon as possible. The CISD should
outline the details of the incident.
3. Additional follow-up sessions will be conducted on a case-by-case basis, as deemed necessary.
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4.6
Maintenance
The AED maintenance will be done according to the manufacturer’s instructions.
Weekly:
1.
Check status indicator. Verify indication of readiness for use. The AED unit has an indicator
light to indicate readiness for use.
2.
Verify that all supplies, accessories and spare pads are present.
Confirm that all accessories are operational and electrode pads are within the date of
expiration.
After each use: (Contact SDPHB staff to assist with the following):
Inspect the exterior for cracks and signs of damage.
1. Remove data PC card and replace it with a spare.
2. Download data card information for hard copy using Code Runner software.
3. Complete County EMS Defibrillation form for copy and delivery to County EMS.
4. Complete patient information forms (see appendix B) for tracking and maintaining of
records for a minimum of three years.
5. Clean AED by using cleaning agents recommended by the manufacturer.
6. Replace contents of rescue pack as needed.
4.7
Record Keeping Requirements
As established by SDCEMS.
4.8
AED Equipment Inspections
The Program Liaison and Program Coordinator or his or her designated representative will conduct
inspections of all AED maintenance records and equipment at least once every month and immediately
following each AED deployment incident. These inspection requirements are subject to change under the
State of California regulations. Upon completion of each AED Equipment Inspection, the results of the
inspection will be summarized on an AED Maintenance Check List that must be provided to the Program
Coordinator. A copy of this form can be found in Appendix C (AED Maintenance Check List). Also see
Maintenance; Section 4.6.
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APPENDIX A-Reference List
“Automatic External Defibrillators for Public Access Defibrillation: Recommendations for Specifying and
Reporting Arrhythmia Analysis Algorithm Performance, Incorporating New Waveforms, and Enhancing
Safety”, Available: www.americanheart.org/Scientific/statements/1997/039701.html
California Code of Regulations. Title 22, Social Security. Division 9, Pre-hospital Emergency Medical
Services. Training Standards for Use of the Automated External Defibrillator by Non-Licensed or NonCertified Personnel. Available: www.emsa.cahwnet.gov
Chicago HeartSave Program, Standard Operating Procedures for Chicago Airport System. Chicago
O’Hare International and Midway Airports.
“Defibrillation” American Heart Association, Available:
www.americanheart.org/Heart_and_Stroke_A_Z_Guide/defib.html
San Jose State University Standard Operating Procedure. Automated External Defibrillator. San Jose
State University.
“Studies Highlight Need for Defibrillators in Public Places”. California Aviation Alliance: Legislative Update.
Available: www.californiaaviation.org
“Studies: Putting Defibrillators in Crowded Places Saves Lives”. Available:
www.airportnet.org/depts/federal/press/articles/postdefib.htm
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APPENDIX B – AED Incident and Activation Report Forms
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AED INCIDENT REPORT FORM
Incident Details
Incident ID #:___________ Incident Date: __________ Incident Time: ____________
Shocks Delivered: _______ AED Model: ___________ AED Serial #: ____________
Patient Information
Last Name: ___________________ First Name: ________________ Middle Initial: __
DOB: ________________ Age: _______
Gender: M / F
Address: ________________________________________
Race: ____________
Phone #: ________________
Patient Identification: _________________
Known Illnesses: _____________________
Next of Kin: ________________________
Contact Phone Numbers: _______________
Additional Information
AED Operator: ______________________
Contact Phone Numbers: _______________
By-Standers Involved: _______________________ Phone Numbers: _______________
_______________________
_______________
Brief Description of Event:
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________
Report Completed By: _______________________________
Date: _____________
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APPENDIX C – AED Maintenance Check List
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AED MAINTENANCE CHECKLIST
MONTH/YEAR:
Site Name:
Primary Liaison:
Backup Liaison:
Site Address:
Site Phone:
Type of Unit:
Portable *
Specific Location of Unit:
Wall Mounted *
Electrode Expiration Date:
SERIAL # OF AED:
Date of
Check
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Yes
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
Green Light
No
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
Initials of Liaison
Performing Daily Check
Submitted By (Signature of AED/PAD Program Liaison)
Comments (Optional)
Date Submitted
FAX THIS FORM ON THE LAST DAY OF THE MONTH TO THE PAD PROGRAM OFFICE: 619-243-0913
Direct questions/inquiries to Maureen O’Connor, Fire Department: 619-243-0911
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APPENDIX D – Assembly Bill 2041 – Good Samaritan Law
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APPENDIX E - California Code of Regulations, Title 22, Division 9,
Chapter 1.5, First Aid Standards for Public Safety Personnel
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APPENDIX F - California Code of Regulations, Title 22, Division 9,
Chapter 1.8, Training Standards for Use of the Automated External
Defibrillator by Non-Licensed or Non-Certified Personnel
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APPENDIX G – PAD Program Site and Liaison Responsibilities and Site
Specific Information Sheet
5/03
Copyright 2002, San Diego Project Heart Beat and SDMSE
PUBLIC ACCESS DEFIBRILLATION (PAD) PROGRAM
SITE LOCATION RESPONSIBILITIES
1. SITE LOCATION MUST HAVE A PAD PROGRAM LIAISON(S) TO MAINTAIN AND PERFORM
DUTIES OF PAD PROGRAM ON SITE.
SAN DIEGO PROJECT HEART BEAT (SDPHB) MUST BE INFORMED OF THE NAME AND PHONE
NUMBERS OF THIS PERSON(S).
2. SITE LOCATION MUST HAVE A TRAINED RESCUER ON THE PREMISES DURING NORMAL
BUSINESS HOURS. ALL PERSONNEL SHOULD BE MADE AWARE OF THE TRAINED
RESCUERS.
3. LOCATION OF AUTOMATIC EXTERNAL DEFIBRILLATOR (AED) SHOULD BE CENTRALLY
LOCATED AND EASILY ACCESSIBLE. ALL PERSONNEL MUST BE AWARE OF AED LOCATION.
4. AED UNIT MUST BE VISUALLY INSPECTED ON A DAILY OR WEEKLY BASIS. THIS VISUAL
INSPECTION MUST BE DOCUMENTED ON THE MAINTENANCE CHECK OFF LIST. THE PAD
PROGRAM LIAISON WILL BE RESPONSIBLE TO REPORT THIS INFORMATION TO SDPHB
STAFF EITHER BY FAX, POSTAL SERVICE, INTER-OFFICE MAIL OR E-MAIL ON A MONTHLY
BASIS.
5. STANDARD OPERATION PROCEDURES (SOP) MANUAL MUST BE AVAILABLE TO ALL
PERSONNEL SO THAT THEY MAY HAVE A THOROUGH UNDERSTANDING OF THE PAD
PROGRAM IN PLACE AT THEIR SITE.
6. ALL SITE LOCATION RESCUERS ARE RESPONSIBLE FOR MAINTAINING THEIR
CERTIFICATIONS AND NEED TO MAINTAIN COMMUNICATIONS WITH THE PAD PROGRAM
LIAISON IN THIS REGARD.
7. ALL PAD PROGRAM SITES MUST COMPLY WITH THE REGULATIONS AND PROTOCOLS THAT
GOVERN AUTOMATIC EXTERNAL DEFIBRILLATION USE AND APPLICATIONS.
5/03
Copyright 2002, San Diego Project Heart Beat and SDMSE
PAD PROGRAM LIAISON(S) RESPONSIBILITIES
8. MAINTAIN COMMUNICATIONS WITH SDPHB STAFF REGARDING ALL PERTINENT
INFORMATION IN REGARD TO THEIR SITE PROGRAM.
9. NOTIFY SDPHB STAFF IN THE EVENT OF AN AED DEPLOYMENT SO THAT THEY CAN
RESPOND TO THE SCENE.
10. MAINTAIN COMMUNICATIONS ON A MONTHLY BASIS FOR MAINTENANCE OF THE AED
UNIT.
11. INSURE THAT ALL PAD PROGRAM RESCUERS ON SITE MAINTAIN THEIR CERTIFICATIONS
THROUGH TRAINING AND RELAY THAT INFORMATION TO SDPHB STAFF FROM THE CLASS
ROSTERS. ROSTER SHEETS MAY BE FAXED OR MAILED TO SDPHB OFFICE.
FAX: (619) 533-4499.
SAN DIEGO PROJECT HEART BEAT CONTACT PHONE NUMBERS
MAIN OFFICE NUMBER TOLL FREE: 1-866-4HEARTU OR 1-866-443-2788
MAUREEN O’CONNOR
PROGRAM COORDINATOR: *(O) 619-243-0911
*(Pager) 619-232-2237 #1279
(Cell) 619-726-6527
MARKETING MANAGER. (O) 619-243-0912
*(Pager) 619-232-2237 #1277
(Cell) 619-279-2521
GLENN THOMAS
AED MARKETING ANALYST (O) 619-243-0200
*(Pager) 619-232-2237 # 1324
(Cell) 619-454-5080
DAN BEEBE
TRAINING CENTER COORDINATOR. (O) 619-243-0910
(Pager) 619-232-2237 #1278
(Cell) 619-726-6529
WEBSITE
www.sdmse.com/projectheartbeat
TABATHA BOWERS
ADMINISTRATIVE TECHNICIAN
(619) 243-0909
*MAIN CONTACT NUMBER FOR DEPLOYMENT NOTIFICATION
5/03
Copyright 2002, San Diego Project Heart Beat and SDMSE
AED/PAD LIAISONS – SITE SPECIFIC
DATE:
SITE NAME:
SITE ADDRESS:
SITE FAX:
SPECIFIC LOCATION OF AED:
SERIAL NUMBER OF AED UNIT:
SITE PHONE:
EXPIRATION OF SERVICE LEVEL AGREEMENT:
DATE COPY OF SLA MAILED:
DATE SLA INVOICED:
AED/PAD LIAISONS
PRIMARY LIAISON
NAME:
PHONE:
FAX:
E-MAIL:
BACKUP LIAISION
NAME:
PHONE:
FAX:
E-MAIL:
Trained Personnel
Expiration of
Certification
5/03
Copyright 2002, San Diego Project Heart Beat and SDMSE
Training Provider Name
Circle Appropriate
Type of Training
CPR
AED
First Aid
CPR
AED
First Aid
CPR
AED
First Aid
CPR
AED
First Aid
CPR
AED
First Aid
CPR
AED
First Aid
CPR
AED
First Aid
CPR
AED
First Aid
CPR
AED
First Aid
CPR
AED
First Aid
Additional Comments
(deployment, history, etc.)