Agenda Special 03-15-00CITY OF DELRAY BEACH, FLORIDA - CITY COMMISSION
SPECIAL MEETING & WORKSHOP - MARCH. 15, 2000
6:00 P.M. - FIRST FLOOR CONFERENCE ROOM
The City will furnish auxiliary aids and services to afford an
individual with a disability an opportunity to participate in and
enjoy the benefits of a service, program or activity conducted by
the City. Contact Doug Randolph at 243-7127 (voice) or 243-7199
(TDD), 24 hours prior to the event in order for the City to accom-
modate your request. Adaptive listening devices are available
for meetings in the Commission Chambers.
(1)
(2)
(3)
SPECIAL MEETING AGENDA
Municipal Election Results: Canvass the returns and de-
clare the results of the March 14, 2000 municipal election.
Replacement Appointment/South County Jury Trial Feasibility
Committee: Consider appointing a replacement for Commis-
sioner Wright to serve on the South County Jury Trial
Feasibility Committee.
Amendment to the License Aqreement for Tennis Center Spe-
cial Event/Major League Volleyball, Inc.: Approve the
amended license agreement between the City and Major League
Volleyball, Inc. to allow the Association of Volleyball
Professionals to hold a volleyball tournament in the Tennis
Center on April 28, 29 and 30, 2000.
(1)
(2)
WORKSHOP AGENDA
Public access to Automatic External Defibrillator (AED)
program that is being implemented in the community by the
Fire Rescue Department.
Commission comments.
Please be advised that if a person decides to appeal any decision
made by the City Commission with respect to any matter consid-
ered at this meeting, such person will need to ensure that a
verbatim record includes the testimony and evidence upon which
the appeal is based. The City neither provides nor prepares such
record.
MARCH 15, 2000
A Special Meeting of the City Commission of the City of Delray Beach, Florida, was called
to order by Mayor Jay A1perin in the First Floor Conference Room at City Hall at 6:00 p.m. on
Tuesday, March 15, 2000.
Roll call showed:
Present - Commissioner Pa~cia Archer (arrived 6:15 p.m.)
Commissioner David Randolph
Commissioner David Schtnidt
Commissioner Bill Schwartz
Mayor Jay A1perin
Absent - None
Also present were City Manager David T. Harden and C~ty Attorney Susan A. Ruby.
Mayor Alpema called the special meeting to order and stated that it had been called for the
purpose of considering the following items:
1. M0nlcipal Election Results: Canvass the returns and declare the results of the March 14,
2000 murucipal election.
Commission Member/Seat #1:
Jeff Perlman 6,416 Regular + 180 Absentee = 6,596 Total Votes
Kenneth S. Rubin 1,411 Regular + 70 Absentee - 1,481Total Votes
Mr. Randolph moved to approve the total votes for each candidate for Commission
Member/Seat #1, including all of the regular and absentee votes as presented, and that it is hereby
declared, based upon the above and foregoing results, that Jeff Perlman is elected as Commission
Member/Seat #1 for the unexpired one year term commencing on the 3ffh day of March, 2000, and
ending in accordance with the City Charter. The motion was seconded by Mr. Schrmdt. Upon roll
call the Commission voted as follows: Mt. Schrnidt - Yes; Mr. Schwartz - Yes; Mt. Randolph -
Yes; Mayor Alperin - Yes. Said motion passed wxth a 4 to 0 vote.
Commission Member/Seat #2:
Patricia Archer 5,200 Regular + 172 Absentee = 5,372 Total Votes
Irwin Rockoff 3,310 Regular + 87 Absentee = 3,397 Total Votes
Mr. Schwartz moved to approve the total votes for each candidate for Commission
Member/Seat #2, including all of the regular and absentee votes as presented, and that it is hereby
declared, based upon the above and foregoing results, that Patricia Archer is elected as
Commission Member/Seat #2 for a two (2) year term commencing on the 30~ day of March, 2000,
and ending in accordance with the City Charter. The motion was seconded by Mt. Randolph. Upon
roll call the Commission voted as follows: Mr. Schwartz - Yes; Mt. Randolph - Yes; Mayor Alperm
- Yes; Mr. Schmidt - Yes. Said motion passed wxth a 4 to 0 vote.
Commission Member/Seat #4:
Alberta McCarthy
Unopposed
Mr. Schmidt moved that Alberta McCarthy, being the only candidate to qualify for the
office of Comrmssion Member/Seat #4, is hereby declared to be elected to that office in accordance
with Section 5.04(b)(2) of the City Charter, and shall serve for a term of two (2) years, commencing
on the 3ffh day of March, 2000, and ending in accordance with the City Charter. The motion was
seconded by Mr. Schwartz. Upon roll call the Commission voted as follows: Mr. Randolph - Yes;
Mayor A1perm - Yes; Mr. Schmidt - Yes; Mr. Schwartz - Yes. Said motion passed with a 4 to 0
vote.
Mayor/Seat #5:
Eugene Herring
1,341 Regular + 21 Absentee = 1,362 Total Votes
Rebecca Jennings
3,375 Regular + 100 Absentee = 3,475 Total Votes
David Schmidt
3,937 Regular + 145 Absentee = 4,082 Total Votes
Mr. Randolph moved to approve the total votes for each candidate for Mayor/Seat #5,
including all of the regular and absentee votes as presented, and that it is hereby declared, based
upon the above and foregoing results, that David Schmidt is elected as Mayor/Seat #5 for a two
(2) year term commencing on the 30th day of March, 2000, and ending in accordance with the City
Charter. The morion was seconded by Mr. Schwartz. Upon roll call the Comrmssion voted as
follows: Mayor A1perin - Yes; Mr. Schmidt - Yes; Mx. Schwartz - Yes; Mr. Randolph - Yes. Said
morion passed with a 4 to 0 vote.
Replacement Appointment/South County Jury Trial Feasibility Committee: Consider
appointing a replacement for Commissioner Wright to serve on the South County Jury Trial
Feasibility Committee.
Mayor Alperm expressed an interest in being considered to serve on the South County Jury
Trial Feasibility Committee.
Mr. Schmidt moved to appoint Mayor AIperin to serve on the South County Jury Trial
Feasibility Committee, seconded by Mr. Schwartz. Upon roll call the Commission voted as follows:
Mr. Schmidt - Yes; Mr. Schwartz - Yes; Mr. Randolph - Yes; Mayor A1perin - Yes. Said motion
passed with a 4 to 0 vote.
Amendment tO the License Agreement for Tennis Center Special Event/Major Lea~mae
Volleyball, Inc.: Approve the amended license agreement between the City and Major League
Volleyball, Inc. to allow the Association of Volleyball Professionals to hold a volleyball
tournament in the Tennis Center on April 28, 29 and 30, 2000.
The City Attorney stated that the term of the agreement is being amended from a two-day
event to a three-day event with the addition of Friday, April 28, 2000, along with clarification of the
hours during which the volleyball tournament will take place.
- 2 - 3/x5/00
Mr. Schmidt moved to approve Amet~dment No. 1 to Agreement between the City of
Delray Beach and Major League Volleyball, Inc., seconded by Mx. Randolph. Upon roll call the
Commission voted as follows: Mr. Schwartz - Yes; Mr. Randolph - Yes; Mayor Alperin - Yes; Mr.
Schmidt - Yes. Said motion passed with a 4 to 0 vote.
There being no further business, the special meeting was adjourned by Mayor Alperin at 6:06
p.m., at which time the workshop was convened.
- -- "City dlerl~
ATTEST:
The undersigned is the City Clerk of the City of Dekay Beach, Florida, and the information
provided herein is the minutes of the special meeting of the Dekay Beach Cxty Commission held on
March 15, 2000, which mutes were formally approved and adopted by the City Commission on
YTg .
-" City ~erk
NOTE TO READER: If the minutes you have received are not completed as indicated above,
this means they axe not the official minutes of the City Comm;ssion. They will become the official
minutes only after review and approval which may involve some amendments, additions or
deletions.
- 3 - 3115/00
MEMORANDUM
TO:
FROM:
SUBJECT:
DATE:
Mayor and City Commtssioners
city C erCp
Results of Municipal Election - March 14, 2000
March 15, 2000
Presented for your review are the cumulauve totals for the regular and absentee ballots as certified
by the Supervisor of Elections for Palm Beach County, indtcaung the results of the municipal
election held on Tuesday, March 14, 2000. The results are as follows:
COMMISSION MEMBER/SEAT ;gl:
Jeff Perlman
Kenneth S. Rubin
MOTION:
6,416 Regular + 180 Absentee = 6,596 Total Votes
1,411 Regular + 70 Absentee = 1,481 Total Votes
Approve the total votes for each candidate for Commission Member/Seat #1, including all of the
regular and absentee votes as presented, and that ~t is hereby &dared, based upon the above and
foregoing results, that Jeff Perlman xs elected as Comrmss~on Member/Seat #1 for the unexpired
one year term commencing on the 30t~ day of March, 2000, and ending in accordance with the City
Charter.
Patricia Archer
Irwin Rockoff
MOTION:
COMMISSION MEMBER/SEAT #2:
5,200 Regular + 172 Absentee = 5,372 Total Votes
3,310 Regular + 87 Absentee = 3,397 Total Votes
Approve the total votes for each candidate for Commissxon Member/Seat #2, including all of the
regular and absentee votes as presented, and that it xs hereby declared, based upon the above and
foregoing results, that Patricia Archer is elected as Cornrmssion Member/Seat #2 for a two (2) year
term commencing on the 30e' day of March, 2000, and ending in accordance w~th the Cxty Charter.
COMMISSION MEMBER/SEAT #4:
Alberta McCarthy Unopposed
MOTION:
That Alberta McCarthy, being the only candidate to qualify for the office of Commission
Member/Seat #4, is hereby declared to be elected to that office in accordance with Section
5.04(b)(2) of the City Charter, and shall se~e for a term of two (2) years, commencing on the 30th
day of March, 2000, and ending m accordance w~th the City Charter.
MAYOR/SEAT #5:
Eugene Herring
Rebecca Jennings
David Schmidt
MOTION:
1,341 Regular + 21 Absentee = 1,362 Total Votes
3,375 Regular + 100 Absentee = 3,475 Total Votes
3,937 Regular + 145 Absentee = 4,082 Total Votes
Approve the total votes for each candidate for Mayor/Seat #5, including all of the regular and
absentee votes as presented, and that it is hereby declared, based upon the above and foregoing
results, that David Schmidt is elected as Mayor/Seat #5 for a two (2) year term commencing on
the 30th day of March, 2000, and ending in accordance w~th the City Charter.
The motions framed above should be considered and voted upon separately.
AMH/m
Attachment
Copy:
City Manager
City Attorney
Deputy City Clerk
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PAt, R BEACH CCIJNTT, FLOe]DA
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CITY OF DELKAT BEACH
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CIMYASS
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PRESIDE#rIAL PREFERENCE PltlWY & WNIClPAI. ELECTIONS
PALI't BF. ACH CCZJNTY, FLOR[GA
NAI~CH ~&, ZOOQ
A. Pmtricfi Archer
B. Zrvin Kockoff 3,397
Preclrct A. 7,~. B.
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Page 70
STATE OF FLORIDA
COUNTY OF PALM BEACH
I. THERESA LePORE, SUPERVISOR OF ELECTIONS, HEREBY CERTIFY THAT THIS IS A
TRUE AND CORRECT COPY OF THE RECORDS ON FILE 1N THIS OFFICE·
WITNESS MY HAND AND SEAL. THIS __
-"-. ,'~,,
. . C - ,,,j))
· - . ~ -~--../,
--~_ ' -. ., -~ -~ ,;
..
15~ DAY OF MARCH, 20 00.
THERESA LePORE
SUPERVISOR OF ELECTIONS
PALM BEACH COUNTY, FLORIDA
TOTRL P. 03
MEMORANDUM
TO:
FROM:
SUBJECT:
DATE:
MAYOR AND CITY COMMISSIONERS
~CITY MANAGER
AGENDA ITEM'~a,~ - SPECIAL MEETING OF MARCH 15, 2000
REPLACEMENT APPOINTMENT TO SOUTH COUNTY JURY TRIAL
FEASIBILITY COMMITTEE
MARCH 10, 2000
On July 6, 1999, the City Commission nominated Commissioner Michael Wright for appointment to
the South County Jury Trial Feasibility Comrmttee. Mr. Wright was subsequently appointed and
served on that comrmttee until his recent resignation. We have been contacted by Palm Beach
County about a replacement appointment.
The Board of County Comnussxoners established this committee to review and provide
recommendations regarding the feasibility of estabhshmg adchtional Jury Districts m Palm Beach
County.
At the meeting of February 1, 2000 thts ztem was postponed to a later date. Recommend Commission
consideration.
Re f'Agmemo 12ARepl.Appt. SouthCountyJutyComrmttee
[ITY (IF DELAFlY BEROt
CITY ATTORNEY'S OFFICE
DELRAY BEACH
200 NW 1st AVENUE · DELRAY BEACH, FLORIDA 33444
TELEPHONE 561/243-7090 · FACSIMILE 561/278-4755
Writer's Direct Line (561) 243-7090
City
1993
DATE:
March 10, 2000
TO:
FROM:
SUBJECT:
City Commission
T. Jambeck, Assistant City Attorne~
Jay
Amendment No. 1 to Agreement with
Attached is an amendment to the license agreement with AVP for a Volleyball
tournament to be held in the Tennis Center. The term of the agreement is being
amended from a two-day event that was to be held on April 29 and 30, 2000 with two
move-in days and one move-out day, to a three-day event to be held as set forth in the
attached memo from Brahm Dubin. AVP will still be entitled to two days for move-in
and one day for move-out.
Please place this item on the agenda for the March 15, 2000 City Commission
meeting. If I can be of further assistance, please do not hesitate to contact me.
Attachments
CC:
David T. Harden, City Manager
Alison MacGregor Harty, City Clerk
Bob Barcinski, Assistant City Manager
Brahm Dubin
03/09/2000 22:03 5612437386
DELRAY BEACH GOLF CL
PAGE 01
Golf & Tennis Manegement, DevelOpment & Consultation
MEMORANDUM
D,~TE:
T,il;
F;tOM:
RE:
CC:
March I0, 2000
Dave Harde~
Brahm Dubin
AVP Volleyball
Bob Barcinsld
Major League Volleyball, Inc. d/Wa AVP is requesting changing its event times
as follows:
'Previous:
Sat April 29, 2000
Sun April 30, 2000
10:00 A.M. - 5:00 P.M.
12:00 P.M. - 5:00 P.M.
Amended:
Fri April 28, 2000
Sat April 29, 2000
Sun April 30, 2000
5:00 P.M. - 9:00 P.M.
3:00 P.M. - 9:00 P.M.
12:00 P.M. - 5:00 P.M.
1: have,~oken to Bill Wood from the Chamber of Commerce and GeoffWilliams
from th~; police department. They both concur with these changes.
'We are requesfin.'g that you present this item on Wednesday, March 15, for City
Commission approval. '~
v'"P"~4~I~~A~e · Deiray Beach, FL 33445 · (561) 243-7084 - Fax (561) 243-7386
AMENDMENT NO. 1 TO AGREEMENT BETWEEN THE CITY OF
DELRAY BEACH AND MAJOR LEAGUE VOLLEYBALL, INC.
THIS AMENDMENT NO. 1 to the agreement between the CITY OF DELRAY
BEACH (City) and MAJOR LEAGUE VOLLEYBALL, INC. d/b/a AVP (AVP) is made this
~ day of ,2000.
WITNESSETH:
WHEREAS, the City and AVP entered into an agreement dated February 16, 2000 (the
Agreement); and
WHEREAS, the Agreement provides that the term of the Agreement shall be for a two
day event to occur Saturday, April 29, 2000 from 10:00 a.m. to Sunday, April 30, 2000, at 5:00
p.m.; and
WHEREAS, the term of the Agreement must be altered to reflect a change of schedule.
NOW, THEREFORE, for good and valuable consideration, herein provided, the City and
AVP agree as follows:
1. Recitations.
forth herein.
2.
The recitations set forth above are hereby incorporated as if fully set
Term. The term of the Agreement between the City and AVP shall be for a three
day event, plus two move-in days and one move-out day as follows:
ao
Friday, April 28, 2000
Saturday, April 29, 2000
Sunday, April 30, 2000
5:00 p.m. - 9:00 p.m.
3:00 p.m. - 9:00 p.m.
12:00 noon - 5:00 p.m.
AVP shall be entitled to move in on April 26, 2000 and shall be completely moved out by
May 1, 2000.
3. ' Entire Agreement. The original agreement dated February 16, 2000 and this
Amendment No. 1 to the Agreement constitute the entire agreement between the parties with
respect to the subject matter hereof and supercedes all prior verbal or written agreements
between the parties with respect thereto. The Agreement dated February 16, 2000 remains in full
force and effect except as expressly modified herein.
4. Effective Date of Amendment to Agreement. This Amendment No. 1 to the
Agreement dated February 16, 2000 shall be effective upon the approval and execution of the
Agreement by AVP and the City.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the day and
year first above written.
ATTEST:
By:
City Clerk
Approved as to legal sufficiency
and form:
By:
City Attorney
CITY OF DELRAY BEACH, FLORIDA
By:
Jay Alperin, Mayor
WITNESSES:
Prim Name:
MAJOR LEAGUE VOLLEYBALL, INC.
By:
Print Name:
Title:
(SEAL)
2
STATE OF
COUNTY OF
The foregoing instrument was acknowledged before me this
2000, by
or agent, title of officer or agent), of
corporation acknowledging), a
corporation, on behalf of the corporation.
, as
day of ,
(name of officer
(name of
(state or place of incorporation)
He/She is personally known to me or has produced
(type of identification) as identification.
Notary Public
3
Request to be placed on:
__ Consent Agenda
When: March
Description of agenda item:
AGENDAITEM NUMBER:
AGENDA REQUEST
March 15, 2000
__ Special Agenda
X
Date: February 4, 2000
Workshop Agenda
Fifteen (15) minute presentation of the public access to Automatic Defibrillator program that is
being implemented in the Community by the Fire Rescue Department
ORDINANCE/RESOLUTION REQUIRED: YES
Draft Attached: YES
NO X
NO X
Recommendation:
Department Head Signature: ~
Determination of Consistency with Comprehensive Plan:
City Attorney Review/Recommendation (if applicable):
Budget Director Review (required on all items involving expenditure of funds):
Funding available' Yes No
Funding alternatives:
Account Number:
Account Description:
Account Balance:
City Manager Review:
Approved for agenda: Yes No
Hold Until:
Agenda Coordinator Review:
(if applicable)
Received:
Action:
Approved Disapproved
P.O. #
The Case for
Public Access Defibrillation
(PAD) Programs
American Heart 0
Association,
Fighting Heart Disease and Stroke
About 250,000 people die each year from
sudden cardiac arrest. That's 700 a day -- about
the equivalent of three 747s crashing each day.
Cardiac arrest usually results from some
underlying form of heart disease. Most cardiac
arrests are due to abnormal heart rhythms called
arrhythmias. Ventricular fibrillation (VF) is the
most common arrhythmia that causes cardiac
arrest. VF is a condition in which the heart's elec-
trical impulses suddenly become chaotic, often
without warning. That causes the heart's pumping
action to abruptly stop. When cardiac arrest
occurs, the victim loses consciousness, has no
pulse and stops breathing normally. Death follows
within minutes.
Defibrillation is the only known therapy for
VF. This technique of giving an electrical shock
can restore the heart's normal rhythm if it's done
within minutes of the arrest. For every minute that
passes without defibrillation, a victim's chances of
survival decrease by 7-10 percent. After as little
as 10 minutes, very few resuscitation attempts
are successful.
Traditionally, the ability to defibrillate was
solely in the hands of emergency medical
personnel. They were trained to interpret
arrhythmias and determine when a shock was
needed. Survival depended on the emergency
medical services (EMS) system being contacted
and ardving quickly.
Unfortunately, quick EMS response isn't
always possible. Even the very best EMS
systems experience delays from heavy traffic,
secured buildings, gated communities, large
building complexes and high-rises. For example,
in New York City where emergency response
teams fight extreme traffic, the average arrival
time for emergency vehicles is about 12 minutes.
Not surprisingly, the cardiac arrest survival rate is
less than 2 percent.
Today a new generation of defibrillators,
called automated external defibrillators (AEDs)
make it possible for trained lay rescuers to deliver
defibrillation. The new AEDs are safe, effective,
lightweight, Iow maintenance, easy to use and
relatively inexpensive (about $3,000 each). Having
trained lay rescuers equipped with AEDs in set-
tings where large numbers of people congregate
saves precious minutes and improves survival
rates for cardiac arrest victims. Facilities such as
high-security companies, sports arenas, large
hotels, concert halls, high-rise buildings, gated
communities, sprawling manufacturing plants and
remote sites can benefit from obtaining AEDs and
training employees to use them as part of a public
access defibrillation (PAD) program.
The American Heart Association strongly
encourages establishing PAD programs as an
important way to save the lives of thousands of
cardiac arrest victims. The materials in this
package will help you make a decision about
obtaining AEDs and making them safe and
effective to use'by establishing a public access
defibrillation program.
~q ggg American Head Association
Quick Overview on
Establishing a PAD
Program
American Heart
Association.
Fighting Heart Disease and Stroke
The American Heart Association has a
goal of helping businesses and other facilities
establish public access defibrillation (PAD) pro-
grams to reduce the time to defibrillation and
improve the cardiac arrest survival rate. This
overview briefly summarizes issues involved in
implementing a PAD program. Detailed informa-
tion on each item mentioned below can be found
in the pockets of the folder (see the contents list-
ing in the center of the folder). In providing infor-
marion about automated external defibrillators,
the AHA does not recommend one device over
another. Information on AEDs is just a guide for
making informed decisions about choosing the
appropriate device for an emergency action plan.
The decision to establish a PAD program and
purchase the proper AED should be based on the
particular needs of a company or other facility.
Elements of a PAD Program
(See left folder pocket)
1. Training designated rescuers in CPR and
how to use an AED.
· Anyone expected to use an AED should be
trained in how to use it and in CPR.
· The Amedcan Heart Association has
developed the Heartsaver AED course,
which is available through Community
Training Centers in most cities.
· The course lasts about 4 hours with
participants receiving a course completion
card after successfully demonstrating skills
proficiency through wdtten and performance
evaluation.
· To obtain information on course availability,
call your nearest American Heart Association .
or 1-800-AHA-USA1.
2. Having physician oversight to help ensure
quality control.
· The Federal Drug Administration (FDA)
requires a physician's prescription to buy
an AED.
· The American Heart Association recommends
further physician involvement to provide
medical oversight of the PAD program and
to help ensure the program's safety and
effectiveness.
· Obtain suggestions for identifying a physician
to provide medical oversight by contacting
your local EMS system or the American
Head Association.
Integrating with the local Emergency
Medical Services (EMS) system.
· Before establishing a PAD program, check
with your local EMS system to determine the
requirements that may apply. In some states
requirements might include an application
and filing a facility's plan to respond to a
cardiac emergency.
· The local EMS needs to know where AEDs
are placed in a facility. The public dispatch
office may be able to add the AED's location
to their 911 computer screen.
· Communicating ahead of time with the local
EMS will save crucial seconds (or minutes) in
a cardiac emergency, improving the chances
of survival.
4. Using and maintaining AEDs according to
the manufacturer's specifications.
· All AEDs work in a similar fashion. However,
it's important for users to be trained to use
their specific device the way it was intended
to be used.
· AEDs require faidy Iow upkeep, but regularly
scheduled maintenance will ensure their
"readiness" in the event of an emergency.
· Reviewing the manufacturer's maintenance
agreement will provide more information on
maintenance requirements.
999 American Heart Association
Additional Information
(See right folder pocket)
Selecting an AED
Three manufacturers make AEDs suitable
for PAD programs. Each model can be bought
with different features. The three basic models
are the Forerunner distributed by H-P HeartStream
and Laerdal; the LifePack 500 distributed by
Physio-Control; and the FirstSave distributed by
SurVivaLink. Other models may become available
as technology changes.
· All these devices have FDA market clearance.
· All are acceptable to the AHA.
· All have memory of its use.
· All have the capability to download use records.
· All are EASY TO USE.
A chart outlining the general characteris-
tics of the devices and the 800 numbers for each
distributor is included in the right pocket of this
folder. Contact them for the name of a local rep-
resentative.
Buying an AED for
Your Facility
· Study the AED chart in the right pocket and
other information in this packet.
· Contact the manufacturers' representatives and
ask for more information about the AEDs in
which you're interested.
· For each device that seems to meet your
needs, ask a sales representative to meet with
you to demonstrate the device, give more
information and answer questions.
· Prepare your questions and other needs for
your visit with the representative. Be sure to
review in detail with the representative each of
the features listed, plus information such as
warranties, service contracts, liability coverage,
etc.
· The average cost of an AED is $3,000. This
pdce will vary depending on how many units
are purchased and the features included.
Placement of AEDs in
Your Facility
· Place AEDs in central locations near a telephone
where they can be easily accessed.
· Place AEDs so any victim can be reached in
less than three minutes.
· Place AEDs close to the person(s) trained to
respond to an emergency.
· Notify everyone of AED locations.
· When placing AEDs, consider whether trained
rescuers will have to use more than one
elevator. If so, locating AEDs at different levels
may make access more convenient.
Legal Issues
· Many states have recently provided limited
liability for lay rescuers trained to use AEDs.
Some states also provide limited liability for the
entity (company or other facility) that purchases
the AEDs, the physician providing oversight and
the persons providing training. Check to see
what the law is in your state.
· Establishing a PAD program with the four
elements recommended by the American Heart
Association can minimize risk.
· The growing trend toward PAD programs may
eventually increase liability for companies and
facilities not prepared to respond appropriately
to a cardiac emergency.
Element I of a PAD Program
Lay Rescuer Training
American Heart '0
Association,
Fighting Heart D,sease and Stroke
As the PAD initiative grows, the issue of
lay rescuer training becomes more important.
Earlier manual defibrillators required lots of training.
Users of these models had to be able to visually
interpret the patient's heart arrhythmia displayed
on a screen attached to the defibrillator. Through
proper analysis of the rhythm, the user would
determine if the rhythm required defibrillation, and
if so, the user would manually deliver the shock.
Due to the intense training needed, defibrillation
was a skill reserved for highly trained emergency
care professionals such as paramedics, nurses
and physicians. But in the early 1990s, thanks to
advances in technology, the development of
automated external defibrillators (AEDs) made it
possible for lay people with minimal training to
use an AED to restore proper head rhythm and
save lives.
Why is training needed if AEDs are so
advanced now? AEDs can analyze the electrical
activity of the victim's head and determine if a
shock is needed. However, more skills are needed
to make sure the device is used most effectively
and to ensure the safety of the user and
bystanders. Training ensures that the AED is
used properly to give the greatest benefit and the
highest chance of survival to the patient. Training
also teaches the user:
· How to recognize the waming signs of head
attack and stroke.
· Why and how to activate the emergency med-
ical system (EMS).
· How to buy time by performing one-rescuer
adult CPR until the AED arrives.
· How to assess the patient and determine if
using an AED is warranted.
· How to attach the AED pads if needed and
ensure proper use.
· How to follow safety protocols to protect the
user and any bystanders.
· How to deal with unusual situations (such as a
victim with an implanted defibrillator or using an
AED on a victim lying in water).
The American Heart
Association AED Course
To meet the need for lay rescuer training,
the American Head Association has developed a
course called Heartsaver AED for Lay Rescuers
and First Responders. This 3½- to 4-hour course
prepares lay rescuers -- including non-traditional
first responders such as police, firefighters, airline
personnel, secudty guards, senior care facility
workers and other laypeople -- to perform the
essential CPR skills and to use an AED.
Headsaver AED uses a motivational video, several
practice-after-watching videos, a scenario-based
practice session, integrated skills evaluation and
a case-based evaluation to reinforce the essential
knowledge needed to propedy use an AED.
This course offers a diversified educational
model based on existing research that was tested
in several national pilot programs. The resulting
course is:
Criteria-based
Video-based
Instructor-based
Scenario-based
Hands-On
Flexible
Satisfactory course comple-
tion is based on written and
skills evaluations.
Motivational and practice-
after-watching videos ensure
consistent, efficient course
delivery.
The instructor communicates
cognitive objectives, super-
vises skills, corrects skills
performance and gives sup-
plemental explanation to
questions.
Scenario-mediated practice
sessions use multiple cases
that replicate real-life events.
The course design allows sig-
nificant time for skills practice.
The course can be modified
to accommodate various
student populations and
types of AEDs used.
999 Amer,can Heart Assooation
The Heartsaver AED course teaches the
basic adult CPR techniques and how to use an
^ED. It also covers using barder devices and
giving first aid for a choking victim. Upon comple-
tion, participants will be able to achieve specific
cognitive objectives of the course, which include:
· Describing the links in the AHA chain of survival.
· Describing how to activate the local emergency
medical services (EMS) system.
· Recognizing the signs and symptoms of four
major emergencies -- heart attack, cardiac
arrest, stroke and foreign body airway obstruction.
Using an adult manikin, an AED, pocket
face mask and telephone, participants will also be
able to achieve several major skills objectives of
the course including:
· How to call 911 or the local EMS system.
· How to pedorm rescue breathing using mouth-
to-mouth and mouth-to-mask techniques.
· How to perform one-rescuer adult CPR.
· How to relieve adult foreign body airway
obstructions.
· How to provide defibrillation with an AED in less
than 90 seconds from placement at the training
manikin's side.
The format of the Heartsaver AED course
also greatly simplifies the learning process. The
presentation and practice of critical psychomotor
skills are divided into distinct compbnents using
short practice-after-watching videos. CPR is
taught one component at a time (rescue breath-
ing and chest compressions) before the student
integrates the individual skills. Students practice
using AEDs individually before adding CPR skills.
Course Completion
Documentation
Successful completion of the course
requires a score of 85 percent or higher on a 20-
question multiple choice wdtten evaluation and
successfully completing a skills evaluation. The
skills evaluation integrates the two core skills of
Heartsaver AED -- CPR and using an AED.
Remediation and re-evaluation is provided when
needed. All successful students receive an
Amedcan Heart Association Heartsaver AED
course completion card with a recommended
renewal date of two years from the date of issue.
On-going Training
Refresher training should occur at least
once every two years. More frequent training is
recommended and may be dictated by local poli-
cies or regulations. The AHA recommends that a
review of CPR and AED skills be done regularly
for all potential AED users. This helps participants
retain skills.
AED Plus First Aid Training
In some companies, lay rescuers may be
called on to respond to a vadety of accidents in
addition to cardiac emergencies. The Amedcan
Heart Association has joined with the National
Safety Council to create the Heartsaver FACTS
course. This course includes a first aid training
module that meets OSHA requirements in
addition to the CPR and AED training of the
Heartsaver AED course. This 8-hour course is
available through the AHA's Community Training
Centers and the National Safety Council.
Training Locations
The American Heart Association has over
4,000 Community Training Centers (CTCs)
throughout the country. They offer a variety of
AHA programs, including Heartsaver AED,
Heartsaver FACTS, basic CPR and advanced
life support courses. These CTCs are located in
every state and are equipped to offer courses
both at their own location as well as on-site at
your location. To learn more about providing
Heartsaver AED training for your employees:
· Contact the nearest AHA office in your
community or state (check the telephone book
white pages or your local telephone information
services) for a referral to the closest CTC.
· Contact the AHA Customer Support Center at
1-800-AHA-USA1 (800-242-8721) for the
closest CTC.
° Visit the AHA Web site at www. americanheartorg
to locate the closest CTC.
When contacting a Community Training
Center, be prepared to ask these questions:
· Can the CTC arrange for a course at your
location?
Most CTCs will send instructors to your location
if enough students are enrolled.
· What does the Heartsaver AED program
cost?
The fees for these courses are determined by
the Community Training Center, not the
American Heart Association. It might be wise to
check with more than one CTC to compare
costs. Per AHA policy, none of these course
fees constitutes income to the AHA. They are
used by the CTC to pay for direct course costs,
which include a personal take-home Heartsaver
AED manual, supplies (including a personal
face mask that's kept for future use), instructor
fees and other course expenses. The average
cost per person for Heartsaver AED training is
about $50-75. However, costs may vary by
location and Community Training Center.
· What types of AEDs do you use in your
training?
The AHA program trains your employees on the
AED that will be available on your premises or
the one that your employees are expected to
use. Most CTCs can arrange for your training to
be conducted using the right type of AED for
your facility.
Element 2 of a
Physician
PAD Program
Oversight
American Heart 0
Association,
Fighhng Heart Disease and Stroke
The U. S. Food and Drug Administration
(FDA) has given market clearance so AEDs can
be made available with a physician's prescription.
To ensure a safe and effective PAD program, it's
essential to provide additional physician oversight.
The role and time commitment of the physician
varies depending on the size and characteristics
of the program. The physician's main duties are to
· Provide medical leadership and expertise.
· Serve as an advocate and spokesperson for
the program.
· Coordinate the program with the local EMS.
· Ensure rescuers are properly trained and their
skills are maintained.
· Assume responsibility for how the program is
planned and conducted.
Having a physician oversee a PAD
program brings authority and expertise to the
program team. The physician's role will be
heaviest at the beginning of the program. Once
it's set up, someone else designated as the PAD
program coordinator may actually do most of the
day~to-day work associated with operations
(similar to standing orders), but active physician
oversight enhances the program.
Successful AED programs involve a
physician as an advocate and teacher. As an
advocate, the physician should provide the energy
and dedication needed to help get the program
started, and then provide ongoing guidance and
oversight. He or she can also serve as a visible
spokesperson for the program.
As a teacher, the physician approves the
initial AED training. The level of involvement in
hands-on-training often depends on the size of
the program, the availability of other appropriate
instructors and the physician's management style.
In some programs the physician may be directly
involved in training sessions. In others he or she
may simply provide guidance to the program
coordinator.
Coordinating the PAD program with the
local EMS system is an important aspect of the
physician's role. Ensuring that the EMS system is
notified of a facility's PAD program and providing
follow-up data on any use of the AED are elements
of this responsibility. In states where a registration
or application process is required for PAD
programs, the physician would complete that
process. See Element 3: Integrating With the
Emergency Medical Services (EMS) System
which follows for additional details.
The physician providing medical oversight
is also a guardian of quality. A protocol for the
facility that specifies details such as the location
of AEDs and how bystanders alert rescuers
should be developed by the physician. Follow-up
after an AED is used is also the physician's
responsibility. Each time an AED is used, a
review should be conducted. The main purpose
of this review is to give rescuers positive feedback
and practical suggestions for improving when
necessary. Talking to rescuers about their feelings
after the experience is also important. In addition,
the review process also allows for problems in
the program to be quickly spotted and fixed.
(-
~1999 American Hear1 Association
In many large corporations, plants or public
facilities, a physician already on staff or associated
with the site in some other way may be the logical
choice to oversee the PAD program. If such a
person is not available, contact the local EMS for
suggestions. In many areas the EMS Medical
Director has agreed to function in this capacity.
Other possible sources for identifying a physician
to provide oversight are emergency physicians,
cardiologists, occupational health physicians and
AHA ACLS Regional Faculty physicians. In some
cases physician entrepreneurs may offer their
services for a fee. In others, AED manufacturers
may have names of physicians who will fill this
role. In these latter two situations it's important to
be sure that the physician is located in the city
where the PAD program is implemented.
The most important criterion for selecting
a physician to provide oversight are:
· Willingness to serve in this capacity.
· Appropriate medical training (ideally in
Emergency Medicine) and a current medical
license.
· Commitment to the cause of improving survival
from sudden cardiac arrest.
· Ability to communicate well with team members.
Benefits to the Physician
Providing Oversight
· It's satisfying to serve in a position requiring
responsibility and commitment.
· It's an opportunity for the physician to support a
lifesaving initiative.
· It provides for precise and detailed review of
incidents and a case review of incidents with
the rescuers.
· Much of the operational work can be delegated
to a program director or training coordinator.
· It's a way to be part of a proactive community
initiative to save the lives of friends, relatives
and co-workers.
Roles and Responsibilities
of the Physician Providing
Oversight
Key roles and duties of the overseeing
physician are:
1. Assume responsibility for all medical control
aspects of the program.
2. Review, as needed, the defibrillation training
program developed by the AHA.
3. Participate in the training process to instruct
rescuers in how to perform CPR and use an
AED.
4. Help the PAD site review and use treatment
protocols for automated extemal defibrillators
used by lay rescuers who are authorized to
respond to emergencies.
5. Help the PAD site participate in a quality-
improvement program that provides for
· eady identification of system flaws.
· ongoing education,
· regular evaluation of the lay rescuers'
knowledge and skills to ensure that they
stay prepared.
6, Help the PAD site establish a plan to improve
· emergency response preparedness.
· the effectiveness of the defibrillation program.
Roles and Responsibilities of
the PAD Program Site
Key roles and duties of the PAD program
site are:
1. Maintain communication with the physician
providing oversight and the AHA Community
Training Center. Also, keep on file an up-to-
date roster of all lay rescuers currently
employed by the PAD site who are trained to
respond to cardiac emergencies.
2. Participate in all quality assurance/quality
improvement procedures established by the
physician including case reviews, skill compe-
tency evaluations and submission of data
recordings.
3. Use and abide by the wdtten guidelines for
performing CPR and using AEDs.
4. Establish written policies for regularly inspect-
ing and maintaining all defibrillation equipment
and battery support.
5. Use only equipment approved by the physician.
6. Establish protocols that ensure appropriate
interaction between the lay rescuers and the
local EMS system.
7. With the physician, establish a plan to improve
employee and visitor access, emergency
response preparedness and the effectiveness
of the defibrillation program.
Element 3 of a PAD Program
Integrating With the
Emergency Medical
(EMS) System
Services
American Heart 0
Association.
Fighting Heart Disease and Stroke
The Emergency Medical Services system
in each community is ultimately responsible for
delivering emergency care. To make a Public
Access Defibrillation (PAD) program most effective,
the EMS system should be an active partner in
planning a program and in the follow-up of any
emergency within the program.
Dudng the planning phase, the EMS sys-
tem should be contacted to discuss these issues:
Any state or local requirements for
establishing a PAD program.
In some states, law requires entities establish-
ing a PAD program to apply or register with
the state and/or local EMS. This process may
include filing a "plan" for your program to
include provisions for training, physician over-
sight, notification of the EMS and maintenance
of the ^EDs.
In other situations the EMS may simply want
to know that an AED is on the premises.
In any case, there's benefit to making the
EMS aware of a PAD program. In some areas
the 911 dispatch system can record the pres-
ence of an AED in the caller-ID fields of their
computer system. This lets the information be
relayed by dispatchers to the responding EMS
personnel. With this information, the EMS
responders will be better prepared to work
with the lay rescuers and to appropriately take
over treatment of the victim. Dispatchers can
also tell callers in a facility who don't know that
an AED is on the premises that one is available.
Possible sources of a physician to provide
medical oversight for a PAD program.
The EMS Medical Director in some areas is
willing to provide physician oversight to PAD
programs established in high-risk areas of
their community. Even if that's not the case,
the EMS system may know emergency
physicians who are available to be involved
with PAD programs. Other possible sources of
overseeing physicians are identified in the
previous section.
Sharing event documentation after using
an AED.
The PAD program plan should include "down-
loading" the information on the "event" from
the AED and giving it to the EMS. Depending
on the AED used, this information is recorded
on a removable data card or can be obtained
by connecting the AED to an off-site computer
via modem. This process is important so that
complete records are available to include in
outcome data for the entire community.
999 American Heart Association
Element 4 of a PAD Program
Using and
Maintaining an AED
American Heart
Association.0
Fighting Heart Disease and Stroke
Using an AED
AEDs appropriate for lay rescuers to use
are simple. They all use these universal steps:
1. POWER ON the AED first.
2. ATTACH the AED to the victim's bare chest
(AED, cables, pads).
3. ANALYZE rhythm.
4. SHOCK (if shock indicated).
Although these steps are followed with all
AEDs, there are variations in models that change
how the steps are carded out. Because of this, it's
important for lay responders to train on the specific
model they'll be using in the PAD program. In
addition, training is required to make sure that
responders are prepared to make contact with
the emergency system and integrate AED use
with performing CPR, if needed.
Maintaining an AED
Appropriately maintaining AEDs is vital to
ensure a continuous state of readiness. The
majority of malfunctions in AEDs are due to
improper maintenance or battery failure.
To limit potential problems, the manufac-
turers have developed AEDs that perform auto-
matic self-testing, which saves time, improves
testing consistency and minimizes unnecessary
battery expenditure. Battery options now include
a rechargeable lead acid battery and a high-
capacity, extended shelf-life lithium sulfate battery
that needs no recharging and no maintenance.
Maintenance checklists provide for a
standardized inspection and should be used to
ensure that the AEDs are kept in a state of
readiness. Inspections and checklists help identify
and prevent deficiencies not just by providing a
uniform way to inspect devices, but also by
increasing the user's familiarity with the equipment.
Regular use of a defibrillator checklist is a critical
part of an AED program. AED operators should
refer to the AED manufacturers for guidance
about maintaining their specific AED.
Recommendations may vary, depending on the
device. A sample maintenance checklist is included
in the right pocket of this folder.
~1999 American Heart Association
Additional Information
Placing AEDs
Where and How
Many?
American Heart {~
Association~ ~
F~ghhng Heart Disease and Stroke
Local officials, management and physicians
providing oversight are best able to determine an
organization's need for AEDs and where they
should be placed. An efficient PAD program
optimally achieves a 3-minute response time from
collapse of patient to on-scene arrival of the AED
with a trained lay rescuer. When making these
decisions, use this 3-minute response time as a
guideline to help you determine where and how
many AEDs to place in your location. The
following points may help you decide where to
place AEDs:
Response Time
Address locations at which defibrillation
can't be administered in a timely manner. The
AHA notes that for every minute that defibrillation
is delayed, the chance for survival decreases by
about 10 percent. An efficient PAD program
would optimally be able to achieve a 3-minute
response time from collapse of patient to arrival
on-scene of the AED with a trained rescuer.
Incidence Rate
Based upon historical data, identifying
locations at which the incidence of cardiac arrest
is high, or higher, is important in identifying AED
placement sites. Companies should determine if
there are locations within the site where the inci-
dence may be higher (such as corporate health
clubs). Other areas to consider include those with
a high population density such as cafeterias.
Volume and Risk of
Visitors/Employees
Identifying the number of visitors and/or
employees at a location can be helpful in deter-
mining the need for an AED. No research is yet
available that shows a threshold number for
placing AEDs. However, common sense indicates
that locations with large numbers of employees,
visitors or both have a greater need for an AED
than locations with lower numbers. Additionally,
determining whether a location needs an AED
based upon the "high risk" of visitors/employees
should also be considered.
High. Risk Activity
Assessing the "high risk" activity at a loca-
tion can be helpful in determining the need for an
AED. Obviously, a health/exercise facility with an
aging population has a higher risk for incidence
than a location with minimal physical activity.
~1999 American Head Associat,on
Vertical Response Time Physical Placement
Response time should be calculated
based upon how long it takes to reach a potential
victim, not the time it takes medical help to reach
a particular street location. Large office complexes
or high-rise buildings present often-challenging
obstacles to providing early defibrillation. The
presence and location of AEDs in these settings
can greatly impact survival rates.
Multiple Placements in Large
Areas or High-Traffic Locations
Consider placing more than one AED at a
location that covers a large area, has multiple
buildings or floors or has a significantly high
number of employees or visitors. Each location
should determine whether one AED will be able
to provide timely and eady defibrillation. Currently
there's no research that indicates a recommended
coverage area for an AED, however achieving a
3-minute response time should be the pdmary
guide to making placement decisions.
Give heavy consideration to the actual
location of the AED at the facility to ensure that
the AED is accessible to trained rescuers if it's
needed. Determine a location where the AED is
both secure and accessible. Be sure a nearby
phone can be used to call the EMS system and
that it has easy access to an outside line. All
trained users should know of this location and be
assured access upon need. Potential locations
may include secudty posts, first aid stations, the
main receptionist area and fitness/exercise rooms.
Other Placement Considerations
Be sure to take into consideration the
potential need for defibrillation capability at off-site
business meetings, conferences and special
events such as company social gatherings.
Making an AED accessible for traveling execu-
tives may also be a consideration.
With survival rates decreasing 7-10
percent for every minute defibrillation is delayed,
having an AED at your location with trained
rescuers can significantly impact the lives of your
employees if this intervention is needed.
Additional Information
Follow-up After
an AED Is Used
American Heart ~
Association, ~,
Fighting Heart Disease and Stroke
Every event in which an AED is used (or
could have been used) must be reviewed by the
physician providing oversight (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
wdtten report and review of the recorded data
made by the AED. Innovative approaches to
event documentation and data management have
been incorporated into AEDs. Case reviews that
use written reports and AED-acquired data seem
to offer the most complete information.
These steps should be taken as soon
after the resuscitation as possible:
· Return the AED to a state of readiness.
· Replace the pads, pocket mask and other
peripheral supplies that were used.
· Help transmit data to the physician.
· Review the case with the overseeing physician,
EMS and involved rescuers.
~rl999 American Heart Association
Additional Information
PAD Program
Legal Issues
American Heart
Association,,
F~ghtmg Heart Disease and Stroke
State Laws Supporting Public
Access Defibrillation
There have been no known lawsuits
against lay rescuers providing CPR as Good
Samaritans, nor any against AED users. However,
the perceived potential for a suit against a lay
rescuer using an AED has in some cases been a
deterrent for companies or organizations consid-
ering establishing a public access defibrillation
(PAD) program.
To help overcome these concerns, the
American Heart Association, together with other
interested organizations, has led an effort to
provide limited liability to lay users of AEDs. In
most cases state Good Samaritan laws have
been amended. In some others, new statutes
have been passed or regulations modified to
provide coverage. As of June 1999, these states
have provisions to protect lay users of AEDs:
Alabama Montana
Alaska Nevada
Arizona New Jersey
Arkansas New Mexico
Colorado New York
Connecticut North Dakota
Florida Ohio
Georgia Oklahoma
Hawaii Oregon
Idaho Pennsylvania
Illinois Rhode Island
Indiana South Carolina
Iowa Tennessee
Kansas Texas
Louisiana Utah
Maryland Virginia
Massachusetts Washington
Minnesota West Virginia
Mississippi Wisconsin
Missouri Wyoming
The model legislation created by the AHA
to provide lay rescuer coverage is also intended
to make it easier to establish PAD programs by
providing comprehensive coverage to everyone
playing a key role in the safety and effectiveness
of the program. Ideally, new state legislation also
covers the "acquirers" (the business owners or
managers who approve establishing the program)
and the "enablers" (the physicians who provide
medical oversight and the trainers who train the
users). Including these categories helps ensure
safer, more effective programs. AHA's model
legislation also encourages notifying the local
EMS when a PAD program is established, and
involving a physician to ensure the quality of the
program and the CPR and AED training for all
designated AED users.
States with comprehensive legislation that
includes all the above elements are:
Alabama Oregon
Arizona South Carolina
Arkansas Tennessee
Illinois Texas
Louisiana Virginia
Montana Washington
New Mexico West Virginia
New York Wisconsin
North Dakota Wyoming
It's recommended that you check the laws
in your state to determine any specific elements
that may apply to your situation. Laws can often
be researched via state Web sites. See
www. csg.org\Links\ for a list of states' Web sites.
The state EMS Department (usually part of the
State Health Department) can also provide
information.
999 American Head Association
Assessing Your Legal Risk
When considering the establishment of a
PAD program, it's important for a company or
organization to consult its own legal advisors.
However, the following information should be
taken into account:
· Cardiac arrest victims are essentially already
dead. They lose consciousness, have no pulse
and stop breathing in a matter of only a few
moments. Most often the heart's rhythmic
contractions become ineffective, chaotic
spasms so the head can't pump blood to the
brain and the rest of the body. The only thing
that can change this condition is defibrillation.
Using an AED can only help, not harm.
· Modem AEDs are safe and easy to use. The
internal computer uses a system of analysis
algorithms to determine whether to shock. The
AED will make the correct "shock" decision 90
out of 100 times and a correct "no shock indi-
cated" decision more than 95 out of 100 times.
This level of accuracy is greater than that of
trained emergency medical professionals.
· To successfully sue an AED user or purchaser,
four essential elements must be proven. These
include duty, breach of duty, causation of injury
and legally recognized damages. (Lazar, RA.
Defibrillators Enter the Business Marketplace.
Occupational Health & Safety. August, 1997).
Common carriers (such as airlines, cruise
ships, etc.), innkeepers, hotel and motel opera-
tors and commercial establishments open to
the public do have special responsibilities
defined by law to provide a minimum of care
and summon medical assistance.
· Training targeted rescuers in the AHA's
Heartsaver AED course provides the essential
knowledge of how to do CPR and use an AED.
The course also has instruction on minimizing
risks to the user and victim in unusual cases
(such as when the victim is lying in a pool of
water, has an implantable defibrillator or is on a
metal surface).
· Most AED manufacturers offer some type of
insurance to purchasers of their devices.
For companies and organizations consid-
ering having AEDs on site, a good offense may
be the best defense. Implementing a public
access defibrillation program that includes training
lay rescuers in CPR and AED use, physician
oversight, integrating with the EMS system and
maintaining the AEDs according to the manufac-
turer's specifications establishes an intent to
provide a safe and effective response to cardiac
emergency.
A Changing Trend
As awareness of the new generation of
AEDs grows, companies and organizations may
face greater threat of liability if they aren't propedy
prepared to respond in a timely manner to a
cardiac emergency. This trend can be seen in
three cases in which lawsuits were filed against
companies that weren't prepared. In 1996 Busch
Gardens was found negligent for not being
prepared and equipped (including not having a
defibrillator) to respond to the cardiac arrest of a
13-year-old guest. Lufthansa Airlines was also
found negligent because it failed to provide
appropriate treatment to a passenger who suffered
a cardiac arrest. A similar lawsuit against United
Airlines is now pending.
Additional Information
Promoting a Public Access
Defibrillation (PAD) Program
American Heart e~
Associafon,Q
Fighting Heart Disease and Stroke
Promotion Within the
PAD Program Facility
Once a PAD program has been established
in a facility, it's important to make sure that
anyone regularly on the premises knows about it.
They also need to know how to alert the trained
rescuers in the event of a cardiac emergency.
Ideally PAD program information will be
communicated through group meetings within the
facility. This allows the AED to be demonstrated,
the program to be explained and emergency
action to be taken by those not trained to use the
AED described. Providing this information in
writing for future reference is important, too.
Including an article about the PAD program
in internal publications is a good way to spread
the word. Interviews with someone saved in a
similar program and one of the trained rescuers
can make this more interesting.
Promotion Outside the
PAD Program Facility
After establishing a PAD program, credit
for taking this important step can be taken with
clients, customers, vendors and the outside
community as a whole.
Company or facility publications distributed
outside the organization should include articles
about the program and the commitment to provide
access to emergency care when needed. Again,
interviews with someone saved in a PAD program
and one of the trained responders may make this
appealing.
Depending on the size and presence of
the facility in the community, local newspapers
and/or other media may be interested in the PAD
program. News releases highlighting the facility's
commitment to providing access to emergency
care can be distributed with follow-up calls made
to key media representatives.
A sample news release is included in the
dght folder pocket.
999 American Heart Association
Additional Information
Questions and Answers About
AEDs and Defibrillation
American Heart
Association.
F,ghtmg Heart Disease and Stroke
General
What does AED stand for?
AED stands for automated external defibrillator.
What's an AED?
An AED is a device used to administer an electric
shock through the chest wall to the heart. Built-in
computers assess the patient's head rhythm,
judge whether defibrillation is needed and then
administer the shock. Audible and/or visual
prompts guide the user through the process.
How does an AED work?
A microprocessor inside the defibrillator interprets
(analyzes) the victim's heart rhythm through
adhesive electrodes. (Some models of AEDs
require you to press an ANALYZE button.) The
computer analyzes the head rhythm and advises
the operator whether a shock is needed. AEDs
advise a shock only for ventricular fibrillation and
fast ventricular tachycardia. (Fast ventricular
tachycardia is a life threatening arrhythmia in which
the contractions of the head are ineffective. As in
VF, an electrical shock can correct this condition.)
The electric current is delivered through the victim's
chest wall through adhesive electrode pads.
Why are AEDs important?
AEDs strengthen the chain of survival. They can
restore a normal heart rhythm in sudden cardiac
arrest victims. Also, new, portable models allow
more people to respond to a medical emergency
where defibrillation is required. When a person
suffers a sudden cardiac arrest, for each minute
that passes without defibrillation, their chance
of survival decreases by 7-10 pement. AEDs
save lives!
Who'd use an AED?
Most AEDs are designed to be used by nonmed-
ical personnel such as police, fire service person-
nel, flight attendants, security guards and other
lay rescuers who've been properly trained.
Having more people in the community who can
respond to a medical emergency by providing
defibrillation will greatly increase sudden cardiac
arrest survival rates.
Why does someone having a heart attack
need an AED?
When a heart attack becomes a full cardiac arrest.
the heart most often goes into uncoordinated
electric activity called ventricular fibrillation. The
heart twitches ineffectively and can't pump blood.
The AED delivers electric current to the head
muscle, momentarily stunning the head and
stopping all activity. This gives the head an
opportunity to resume beating effectively.
Will an AED always resuscitate someone in
cardiac arrest?
An AED only treats a fibrillating heart. In cardiac
arrest without ventricular fibrillation, the heart
doesn't respond to electric currents but needs
medications and breathing support instead. Also,
AEDs are less successful when the victim has
been in cardiac arrest for longer than a few
minutes, especially if no CPR was provided.
999 American Heart Associat,on
AED Use
Is an AED safe to use?
An AED is safe to use by anyone who's been
trained to operate it. Studies have shown the
devices to be 90 percent sensitive (able 90 per-
cent of the time to detect a rhythm that should be
defibrillated) and 95 percent specific (able to
recommend not shocking when defibrillation is
not indicated). Because of the wide variety of
situations in which they will typically be used,
AFDs are designed with multiple safeguards and
warnings before any energy is released. AEDs
are programmed to deliver a shock only when
they have detected an irregular heart rhythm
called ventricular fibrillation (VF) or fast ventdcular
tachycardia. However, there are potential dangers
associated with AED use. That's why training --
including safety and maintenance -- is important.
The AHA recommends that anyone who lives or
works where an AED is available for use by lay
rescuers participate in a Heartsaver AED course.
AEDs are so user-friendly that untrained rescuers
can generally succeed in attaching the pads,
pressing ANALYZE (if required), and delivering
shocks. Untrained rescuers, however, may not
know when to use an AED, and they may not use
an AED safely, posing some danger of electric
shock to themselves and others. Also, untrained
rescuers wouldn't know how to respond to the
victim when the AED prompts "no shock indicated."
An operator needs only to follow the illustrations
on the electrode pads and the control panel, and
listen and follow the voice prompts (for example,
"Do not touch the patient."). An AED will deliver a
shock only when a shock is advised and the
operator pushes the SHOCK button. This prevents
a shock from being delivered accidentally.
Are AEDs safe to use on children?
An AED should not be used on a child younger
than eight years old.
Will I get zapped if I shock a victim in the rain
or near water?
It's remotely possible to get shocked or to shock
bystanders if there's standing water around and
under the patient. Try to move the patient to a dry
area and cut off wet clothing. Also be sure that
the skin has been toweled off so the electrode
pads will stick to the skin. At the moment you
press the SHOCK button, you must make sure
that no one, including yourself (the AED operator),
touches any pad of the victim.
Can an AED make mistakes?
An AED will almost never decide to shock an
adult victim when the victim is in non-VF. AEDs
"miss" fine VF only about five percent of the time.
The internal computer uses complex analysis
algorithms to determine whether to shock. If the
operator has attached the AED to an adult victim
who's not breathing and pulseless (in cardiac
arrest), the AED will make the correct "shock"
decision more than 90 times out of 100 and a
correct "no shock indicated" decision more than
95 times out of 100. This level of accuracy is
greater than the accuracy of emergency
professionals who must read and interpret
the rhythms.
AED Placement
What's public access to defibrillation?
Public access to defibrillation (PAD) is the concept
of placing AEDs in public and/or private settings
where large numbers of people are found or
where people generally considered at high risk for
head attacks live or are found.
What's the AHA's position regarding the
placement of AEDs?
The Amedcan Head Association strongly
advocates that all EMS first response vehicles
and ambulances be equipped with an AED or
another defibrillation device (semiautomatic or
manual defibrillator).
The Amedcan Head Association also supports
placing AEDs in targeted public areas such as
sports arenas, gated communities, office com-
plexes, doctor's offices, shopping malls, etc.
When AEDs are placed in a community, the AHA
strongly encourages that they be pad of a defibnl-
lation program that includes these elements:
1. Persons or entities that acquire an AED notify
the local emergency medical services (EMS)
office.
2. A licensed physician or medical authority
provides medical oversight to ensure quality
control.
3. Persons responsible for using the AED are
trained in CPR and in how to use the AED
Why is notifying the local EMS office
important?
It's important because it lets the local EMS system
know where AEDs are located in the community.
In the event of a sudden cardiac arrest emergency,
the 911 dispatch service will know if an AED is on
the premises and can notify the EMS system as
well as the responders already on the scene.
Why should a licensed physician or medical
authority be involved with a person or entity
that acquires an AED?
This is a quality-control mechanism. The licensed
physician or medical authority will make sure that
all designated responders are properly trained
and that the AED is properly maintained.
Can anyone buy an automated external
defibrillator (AED)?
Automated external defibrillators are devices
manufactured and sold under guidelines
approved by the FDA. Current FDA rules require
a physician's prescription to buy an AED.
How much does an AED cost?
The price of an AED varies by make and model.
Most AEDs cost around $3,000.
Which AED model does the AHA recommend?
The AHA doesn't recommend a specific device.
All the AED models available have similar features,
but the slight differences allow them to meet a
vadety of needs. The AHA encourages any
potential purchasers to consider all the models
and make a choice based on their own needs.
The local EMS office can help you in this decision.
AED Training
Why should people responsible for operating
an AED receive CPR training?
Eady CPR is an integral part of providing lifesaving
aid to people suffering sudden cardiac arrest. The
ventilation and compression skills learned in a
CPR class help to circulate oxygen-rich blood to
the brain. Most AEDs, after they have delivered a
series of three electric shocks to a person, will
prompt the operator to continue CPR while the
machine continues to analyze the patient.
If AEDs are so,easy to use, why do people
need formal training on how to use them?
An AED operator must know how to recognize
the signs of a sudden cardiac arrest, when to
activate the EMS system and how to perform
CPR. It's also important to receive formal training
on the AED that will be used. That way the user
becomes comfortable with the device and can
successfully operate it in an emergency. Training
also teaches the user how to avoid potentially
hazardous situations.
Additional Information
Automated External
Defibrillators' Basic
Features
American Heart
Association.0
F~ghhng Heart Disease and Stroke
SurVivaLink Physio-Control Heartstream
FirstSave LifePack 500 Forerunner
FDA Market Clearance Yes Yes Yes
Acceptable to AHA Yes Yes Yes
Easy To Use Yes Yes Yes
Number of Buttons I 2 or 3 2
Voice Prompts Yes Yes Yes
Easily Readable Controls Yes Yes Yes
Manual Override No No Yes
(Optional for
EMS and Fire)
Lithium Battery Yes Yes Yes
Battery Level Indicator Yes Yes Yes
Memory of Event Yes Yes Yes
Automated Self Test Yes Yes Yes
Indemnity Clause Yes Yes Yes
Company Provides
Device Orientation Yes Yes Yes
ECG Monitor No No Yes
(Optional for
EMS and Fire)
Corporate Headquarters Minneapolis, Seattle, Seattle,
Minnesota Washington Washington
Company Phone Number (800) 985-1440 (800) 442-1142 (800) 263-3342
(612) 939-4181 (o) (206) 867-4000 (o) (206) 664-2060 (o)
(612) 939-4191 (f) (206) 867-4146 (f)
NOTE: Due to rapidly developing technology, AED features change qmckly and new devices may be produced.
999 American Heart Assoc~abon