Emergency Medical Services
Public Access Defibrillation Project

Introduction

Thousands of people suffer sudden cardiac arrest (SCA) each year. SCA victims are often in the prime of life, many with no previous cardiac history. Averting such premature deaths is clearly the number one objective of the EMS System and in fact, the ability to potentially resuscitate many of these patients was a significant factor in the development and growth of early EMS programs.

However, despite great advances in resuscitation medicine and EMS's best efforts, the percentage of "out of hospital" initiated, successful "saves" has sadly been very low. For those who sustain sudden cardiac arrest — many who continue to have "hearts and brains too good to die"— the medical evidence is very clear: the sooner they are defibrillated the better their chance of many more years of productive life. But EMS can't always be everywhere fast enough.

As an integral and vital part of community EMS System operations, the obvious solution to this major public health dilemma is the immediate availability and use of an Automated External Defibrillator (AED). Public Access Defibrillation (PAD) — putting AEDs in public places where minimally trained, ordinary people can use them — is a growing and stunning success story with cardiac arrest survival rates as high as 50-75%.

To support and expand EMS involvement in promoting and assisting Public Access Defibrillation programs, the Initial Life Support Foundation (ILSF) in cooperation with state EMS agencies will provide a variety of free resources and services to the EMS community. Through the EMS Public Access Defibrillation Project (EMSPAD) local EMS agencies and services can assume or enhance their vital leadership role in this important Pre-EMS component of community EMS Systems.

PAD Implementation & Management

Placing an AED in a workplace, home or community setting should be a essential part of every community EMS System. While using an AED is fairly simple, implementing and managing a PAD program requires support and assistance from qualified individuals; within each community, EMS professionals are generally the ideal people to meet this need. A variety of activities and services are necessary to implement on-site emergency medical response (including PAD and AED) programs; these generally include:

• AED/PAD Program Promotion & Awareness
• Site Survey & Needs Analysis
• Emergency Medical Response Planning
• Emergency Care Equipment and Supplies
• AED Acquisition and Set-up
• Initial Emergency Care Training (First Aid, CPR and AED)
• Occasional On-site Drills & Scenarios
• Routine AED inspection and tracking
• Medical Control & Leadership
• Case Review & Analysis
• Post-Incident, Responder Support Services

A number agencies and organizations have developed and provide excellent guidelines for PAD program establishment and operation. Likewise there are a variety of well-established, Department of Health approved curricula for training people in basic CPR and AED use skills. Regardless of which guidelines are followed or curriculum utilized, the EMSPAD Project will offer EMS services and/or individual EMS professionals a variety of optional support services and resources.

EMSPAD Resources and Services

• PAD Promotional Brochure (to be distributed locally by EMS)
• AED PowerPoint Presentation CD (for community presentations)
• Instructor Resources (available via the ILSF website)
• Access to a low cost AEDs
• AED Program Guide and Sample Plan
• Instructor/Facilitator Workshops (conducted throughout the state)*

* There will be a nominal registration fee for instructor workshops.

EMSPAD Project Operation Responsibilities

The local EMS council/agency will oversee EMSPAD and will announce and promote this project to statewide EMS agencies and organizations via printed and electronic media. It will also work with ILSF to schedule, arrange and promote the planned instructor/ facilitator workshops and it will inform all who are interested in participating in or utilizing the resources of EMSPAD via the Initial Life Support Foundation. (Membership in ILSF will cost each participating EMS service a nominal fee of $100/yr.)

The Initial Life Support Foundation (general description attached) will provide needed staff support for this project and will develop EMSPAD brochures and an early defibrillation PowerPoint promotional presentation to be downloaded from the ILSF website and reproduced in needed quantities by the local EMS service. For interested participants, the Foundation will also conduct 6 hour instructor/facilitator workshops (see attached overview).

The current low cost AEDs available via the ILS Foundation are a special version of the new ZOLL AED Plus and the Heartsine Samaritan AED. (Other AEDs will be added as individual manufacturers choose to participate in this project.) However, participation in EMSPAD is not dependent on use of either of these AEDs and any FDA approved AED can be utilized or recommended in establishing a local AED or PAD program. It must be noted that there are some restrictions on eligibility to purchase the AED unit via the Foundation's "PAD Support Program^™". (Please see attached for more details.)

Local EMS entities that choose to participate will seek out local opportunities to promote/announce their ability and willingness to assist in PAD efforts. EMS personnel will distribute EMSPAD brochures and make requested public presentations in their communities. Each EMS participant will manage and operate PAD or institutional AED programs, in their own local communities, in accordance with all state and national AED regulations and requirements.

Additional Benefits to the EMS System

Clearly the priority for implementing and managing AED programs is to help significantly reduce mortality from SCA. But this important activity has many other benefits that will help to sustain the operation and enhance the growth of community EMS Systems.

ED programs provide those the EMS community an ideal opportunity to develop and/or reinforce our relationships with our constituency as we build strong community support for EMS services and activities. It also helps to meet overall EMS public education needs by teaching and/or reinforcing three important things:

1. When to call 911/EMS.
2. How to place that call and what to say during the call.
3. What to do to support life until EMS arrives.

AED program and life support training activities in the community have also been shown to enhance recruitment of much needed "new blood" into EMS. It can also produce additional revenue from businesses and entities willing to pay for or donate money for this life extending technology and vital service.

AED Instructor and Facilitator Workshops

The Initial Life Support Foundation has created an informative 6-hour workshop designed to explain the EMSPAD project, help CPR/AED instructors and EMS personnel enhance their presentation skills to non-emergency care professionals and to help facilitate Public Access Defibrillation promotion and leadership efforts.

Instructor Workshop Program Overview

• Emergency Medical Preparedness
• History of Initial Emergency Care and AEDs
• Preparing the Infrequent Responder for Medical Emergencies
• Planning an Onsite Emergency Response System
• Instructional Methodology: What makes a training program effective?
  The 7 C's of Initial Emergency Care Learning
• Context: Who are your students?
• Capabilities: What exactly do you want them to do?
• Content: What exactly do they need to learn?
• Comfort: What creates an effective learning environment?
• Credentials: Instructor and program "certification".
• Communication: The essence of education is learning.
• Confidence: Without confidence there is no action.
• Planning, Promoting and Managing PAD Programs
• The Role of AEDs in onsite Emergency Response & EMS Systems
• Available Support Services and Materials for Instructors
• Initial Life Support Foundation
• Purpose and Mission
• Members Only Website & Affiliation (available free of charge)
• Instructional & Marketing Tools
• Discussion List/"Chat Room"
• Recognition & Awards Programs
• "PAD Support Program^™" (low cost AEDs for underserved market)
• Other Resources
• NAEMSE Pre-EMS Forum
• National Center for Early Defibrillation
• PADL
• AED Manufacturers
• Training Program Material Developers/Vendors