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AEDs at Arizona State University Why Automated External Defibrillators Are Needed In Public Facilities Someone goes into sudden cardiac arrest every two minutes in the United States. In cardiac arrest, the heart’s rhythm becomes erratic and the heart can’t pump oxygenated blood to the brain or other vital organs. The victim collapses. Unless a normal rhythm is restored almost immediately, death is practically inevitable. Automated External Defibrillators (AED), a compact, portable battery operated version of the kind used in hospitals, can now be used to deliver measured shocks to reestablish the heart’s normal rhythm. Portable defibrillators have been in use the past twenty years but were restricted to “first responders” emergency medical technicians, police or fire departments. The new AED’S moderate price and simple operation make them suitable for public places. A growing number of building safety officers, security guards, flight attendants and other non-medical personnel are trained to use the AED’S. According to the American Heart Association (AHA), making AED’S standard equipment in stadiums, airports, office buildings, shopping malls and other public places could save more than 50,000 lives a year. History Defibrillation is a process in which an electronic device, called an automated external defibrillator, or AED, helps reestablish normal contraction rhythms in a heart that is not beating properly by delivering an electric shock to the heart. The AED is a lightweight portable device containing a battery, capacitors, and circuitry designed to analyze cardiac rhythm and inform the operator whether a shock is indicated. Information is transmitted to the device by electrode pads used for both monitoring and shock therapy. Once activated, AEDs have voice and text prompts to guide the user through a few simple steps. Early bystander cardiopulmonary resuscitation (CPR) and rapid defibrillation are the two major contributors to survival of adult victims of sudden cardiac arrest. The American Heart Association believes that efforts to provide prompt access to defibrillation for victims of cardiac arrest are the next step in strengthening the chain of survival. However, it must be combined with other elements such as early access to Emergency Medical Services, early CPR and early access to Advanced Cardiac Care (Paramedics). "Use of AEDs by first responders and laypersons has reduced time to defibrillation and improved survival from sudden cardiac arrest in several communities," one report from the AHA states. The initiatives at the state and federal level are paving the way for more widespread access to defibrillation, as legal barriers to public access defibrillation (PAD), both perceived and real, are slowly eliminated. The incorporation of the use of AEDs requires the development of intense training programs, the purchase of costly equipment and provisions for maintenance and replacement equipment. Respiratory arrest, not cardiac arrest, is the leading cause of death in children. In addition, AEDs are not to be used on children under the age of eight or under 80 pounds. History of Implementation at Arizona State University In May of 1999, Governor Hull signed HB 2475 (Chapter 217 - 441R - S Ver of HB2475), which extended immunity from civil liability to certain AED users. SB 1070 requires that the Joint Legislative Budget Committee and the Governor's Office of Strategic Planning and Budgeting should include funding for the placement of automated external defibrillators in capital budgets for new state buildings each fiscal year. The provisions in the act became effective after June 30, 2003. Arizona State Law A person or entity that acquires an automated external defibrillator shall limit the use of an automated external defibrillator to trained responders. The physician, at ASU the director of campus health, shall ensure that each trained responder receives training in cardiopulmonary resuscitation and in the use of an automated external defibrillator by completing the heart saver automated external defibrillator course for the lay rescuer and first responder, as adopted by the American Heart Association or an equivalent course that meets the same objectives. The physician shall ensure that the automated external defibrillator is maintained and tested according to the manufacturer's guidelines. A person or entity that acquires an automated external defibrillator shall enter into an agreement with a physician who shall oversee all aspects of public access defibrillation, including training, emergency medical services coordination, protocol approval, standing orders, communications, protocols and automated external defibrillator deployment. The physician shall be proficient in emergency medical services protocols, cardiopulmonary resuscitation and the use of automated external defibrillators Require each trained responder who uses an automated external defibrillator on a person in cardiac arrest to submit a written report to the physician, within five working days after its use. The physician shall establish quality assurance guidelines that include a review of each use of the automated external defibrillator to evaluate performance. Indications For Field AED Use 1. Minimum patient age is 8 old Procedure
Care, Maintenance and Legal Issues Pertaining to ASU's AEDs
Program Management, Plans Review, Installation and Placement The ASU EH&S Fire Safety Division will perform plans review of construction and renovation projects to determine AED necessity and location as well as the necessity and location for non-construction/renovation. The Fire Safety Division will coordinate the installation and placement of all AED on all ASU campus locations. The appropriate project manager for either an initial construction project or a renovation project is responsible to coordinate the installation of the AED with the ASU Fire Marshal’s Office. Specific guidelines shall be met by Facilities to ensure a seamless transition from purchasing of the equipment to the placement of the AED. Purchasing Project managers are responsible for the coordination purchasing of the AED, AED soft case, AED cabinet and AED pads & mask thru the project budget. The purchasing of the AED and related items will be coordinated thru the EH&S Department. Installation and Placement The ASU EH&S Fire Safety Division will coordinate the installation and placement of all AED on all ASU campus locations. The appropriate project manager for either an initial construction project or a renovation project is responsible to coordinate the installation of the AED with the ASU Fire Marshals Office. Specific guidelines shall be met by Facilities to ensure a seamless transition from purchasing of the equipment to the placement of the AED. Installation Requirements Project managers are responsible to ensure that the ASU Fire Marshals office coordinates the proper placement of the AED cabinets to meet the requirements of all applicable building and fire safety codes. The designated Plan Review Official for the ASU Fire Marshals office will have to approve the placement location of the AED & AED cabinets. Installation The placement of the cabinet will have to be in accordance to the manufactures recommendations. ADA Requirements ADA (Americans with Disabilities Act) guidelines specify reach ranges for buildings occupants who require access to equipment such as fire extinguishers and other fire & life safety devices. For an unobstructed approach, the maximum forward reach to this equipment (the AED) is 48 inches above the floor. The maximum side reach for such an approach is 54 inches the actual mounting heights for cabinets housing the equipment can be determined by reviewing the exact dimensions of the specific cabinet and the positioning of the fire or life safety equipment within that cabinet. Please note that these ADAAG reach requirements fall within the NFPA (National Fire Protection Association) guidelines. The NFPA guidelines state that the distance from the floor to the top of the fire extinguisher (life safety device) to be no more than 5 feet. Inspection and Maintenance The Environmental Health and Safety Department for Arizona State University is responsible to ensure that every AED in service on all ASU campus locations are fully operational. The units will be inspected on a monthly basis, and a report of the inspection will be kept on file within the Environmental Health & Safety Department for Arizona State University. The monthly AED status report will be forwarded to the ASU Medical Director for review, and quality assurance purposes. All AED in operational service will be maintained and updated to the latest AHA standards, software updates are the responsibility of the AED program manager. The inspections will ensure that the AED is fully charged, and fully operational, to ensure that the defibrillation pads are current and ready for use. EH&S will be ultimately responsible to ensuring that the AED on all ASU campus locations have been inspected on a monthly basis. It is up to the discretion of the ASU EH&S Department, with proper training, to designate a responsible party for a specific designated area to perform the monthly inspections. This designated individual will ensure that the AED is fully operational. That individual will generate a monthly report to be kept on file with the EH&S Department. The EH&S AED program manager will ensure that the designated responsible party is performing his inspections correctly, by performing inspection audits. Designated Self Inspection Functional Area ASU Athletics These functional areas have a designated responsible individual assigned to ensure that the AED is inspected on a monthly basis. This responsible designated individual will generate an inspection report and forward it to EH&S for record keeping purposes. These functional areas will be randomly audited by the ASU EH&S program manager to ensure compliance. Alex Gutierrez, CEP
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