POLICY 10.  AUTOMATED EXTERNAL DEFIBRILLATOR (AED) POLICY
August 7, 2006
PURPOSE:
The purpose of this policy is to provide guidance in the management and administration of a workplace AED program for the Town of Middletown
BACKGROUND:
Sudden Cardiac Arrest (SCA) is a condition that occurs when the electrical impulses of the human heart malfunction causing 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 and do not have a 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 advise the operator to deliver an electric shock.
Accordingly, the Town of Middletown has adopted this policy to assist trained lay rescuers to be better prepared in the event of a sudden cardiac arrest situation.
AED PROGRAM COORDINATOR:
To assist all employees in understanding the requirements of the AED Policy, the Middletown Fire Chief/EMA Coordinator has been designated as the AED Program Coordinator and is available to answer any questions that may arise concerning the AED Policy. The Fire Chief may be contacted as follows:
               Middletown Fire Department
               Address: 239 Wyatt Road  Middletown, RI 02842
               Phone: 401-846-7888  Fax: 401-845-0499 Website: www.middletownri.com
COORDINATOR RESPONSIBILITIES:
1.   Selection of equipment.
2.   Selection of employees for AED training.
3.   Distribution of AED-trained employee lists.
4.   Coordination of training for emergency responders.
5.   Coordinating equipment and accessory maintenance.
6.   Maintain on file a specifications/technical information sheet for each approved AED model assigned or donated to the Town of Middletown.
7.   Consulting and coordinating of local Emergency Medical Services (EMS).
8.   Revision of this policy in coordination with the Town Safety Committee, as required.
9.   Monitoring the effectiveness of this program.
10.   Communication with the medical advisor on issues related to medical emergency response program including post-event reviews.
MEDICAL ADVISOR:
The medical advisor for the AED program is:
      Attending Physician, Newport Hospital Occupational Health Center
      19 Friendship Street, Newport RI 02840
      401-845-1245
The Newport Hospital Occupational Health Center will provide medical oversight of the AED program including:
   1.   Writing prescriptions for AEDs.
   2.   Reviewing and approving guidelines for emergency procedures related to the use of AEDs and CPR in accordance with state and local laws.
   3.   Evaluation of Post-Event with all rescuers involved.
LOCAL EMS NOTIFICATION:
EMS in the Town of Middletown is responsible for on-scene delivery of emergency care. The AED Program Coordinator will notify rescue personnel of deployment and location of AEDs.
AUTHORIZED AED USERS:
The following certified personnel may use the AEDs:
   1.   Any trained volunteer responder who has successfully completed an approved AED/CPR training program and holds a current Health Care Provider Card or a Heart saver/AED course completion card.
   2.   Any professional rescue personnel who are currently certified according to the guidelines of a nationally recognized program such as the American Heart Association, the American Red Cross or the National Safety Council.
TRAINING:
Training classes should meet the guidelines of a nationally recognized program, such as the American Heart Association, the American Red Cross, or the National Safety Council. The Town of Middletown provides the American Heart Association “Heart saver AED for Lay Rescuers and First Responders” course, which teaches volunteers to recognize the warning signs of heart attack, perform CPR and use an AED. All participants successfully completing the course receive an American Heart Association Heart saver AED course completion card with a recommended renewal date of two years from the date of issue.
Employee retraining for AED/CPR shall occur at least every two years, or sooner if the town’s equipment, policies or procedures change. Trained volunteers are strongly encouraged to renew their AED/CPR training at least every two years.
The Program Coordinator, in coordination with the Town of Middletown Safety Committee, will identify all employees of the Town’s Response Team. (See Program Coordinator for current list of Response Team Members including all trained certified employees).
A mock “Cardiac Arrest Drill” will take place at each facility with an AED. The annual drill will be scheduled and monitored by the Program Coordinator. See Attachment A for the form to be used.
AED-TRAINED EMPLOYEE RESPONSIBILITIES:
In the event of an emergency medical situation, the trained employee is to activate the external emergency response by directing someone to call 911. Trained employees should recognize the signs of sudden cardiac arrest, start CPR immediately, locate and use the defibrillator, and care for the victim until the EMS team arrives.
EQUIPMENT:
The Town of Middletown Program Coordinator has chosen the LifePak 500 Plus AED as the preferred AED. The town has also purchased Zoll AED Plus models for use at Sachuest Beaches. These models have both been approved by the Food and Drug Administration (FDA) and include product features that add speed, reliability, and confidence to the responder team. A list of FDA approved AEDs is available at www.americanheart.org/cpr.
ADDITIONAL RESUSCITATION EQUIPMENT:
Each AED will have one set of defibrillation electrodes connected to the device and one spare set of electrodes with the AED. It is also recommended to include a set of infant/child electrodes in the kit. 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.
LOCATION AND QUANTITY OF AEDs:
Middletown Town Hall - 1st floor at the entry to the Council Chambers (1)
Middletown Public Library - 1st floor Circulation Desk (1)
Middletown Senior Center - 1st floor at the entry to the kitchen (1)
Middletown Police Station - 1st floor Dispatch Office (1)
Middletown Fire Station - On apparatus vehicles (3)
Middletown Department of Public Works - On Sewer Department vehicle (1)
Middletown Campground - Campground Office (1)
Sachuest Beaches - First Aid Office (1) / 2nd Beach “Rock” and 3rd Beach ramp (2) portable units for use during the beach season (Memorial Day through Labor Day).
EQUIPMENT MAINTENANCE:
All equipment and accessories necessary for supporting medical emergency response shall be maintained in a state of readiness. 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 manufacturer’s operating instructions.
The AED will perform a self-diagnostic test that includes a check of battery strength and an evaluation of the internal components. The Program Coordinator or designee shall perform a monthly AED routine check following the Maintenance Checklist provided by the manufacturer, initial the checklist and post it with the AED.
   1.   If the OK icon is NOT present on the readiness display, contact the AED Program Coordinator or designee immediately.
   2.   If the battery icon is visible, the CHARGE-PAK charging unit needs to be replaced. You may continue to use the AED if needed.
   3.   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.
   4.   If the expiration date on the electrode is near, notify the AED Program Coordinator or designee immediately.
Following the use of emergency response equipment, the Program Coordinator or designee will ensure that all equipment is cleaned and/or decontaminated as required, and replace pads, pocket masks and other peripheral supplies that were used. In addition, the AED Maintenance Checklist will be completed and the AED will be returned to a state of readiness.
POST-EVENT REVIEW AND DOCUMENTATION:
Following each AED deployment, 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, strategies for improvement, and critical incident stress debriefing. A summary of the post-event review shall be sent to the AED Program Coordinator or designee and the Newport Hospital Occupational Health Center. The AED Program Coordinator or designee shall maintain a copy of the post-event review summary.