California State University, East Bay AED Program

CALIFORNIA STATE UNIVERSITY, EAST BAY AED POLICIES AND PROCEDURES

I. Purpose: To establish Policies and Procedures for campus-wide utilization of the Automated External Defibrillator (AED).

II. Introduction: An Automated External Defibrillator (AED) is used to treat victims who experience sudden cardiac arrest. The AED must only be applied to victims who are unconscious, without a pulse, and not breathing.

The Automated External Defibrillator is used in conjunction with Cardio-Pulmonary Resuscitation (CPR) in cases of sudden cardiac arrest, in accordance with accepted protocols, including those developed by the American Heart Association or the American Red Cross, Title 22, California Code of Regulations and the manufacturer. Use of the AED and CPR will continue as appropriate during the course of emergency care, until the patient resumes pulse and respiration, and/or local Emergency Medical Services (EMS) paramedics arrive at the scene, and assume responsibility for emergency care of the patient. Generally, the AED should not be used on victims weighing less than 55 pounds or less than 8 years of age but refer to each AED manufacturer’s instructions for use with children.

III. References:

 California Code of Regulations, Title 22, Division 9, Chapter 1. 8: Training Standards and Utilization for Use of the Automated External Defibrillator by Non- Licensed or Non-Certified Personnel. See: http://www.emsa.ca.gov/laws/files/regs1_8.pdf

 California Health and Safety Code, Division 103, Section 104113: AED required in Health Studio. See: http://www.leginfo.ca.gov/cgi-bin/displaycode? section=hsc&group=104001-105000&file=104100-104140

 California Health and Safety Code, Division 2.5, Section 1797.196: AED Regulations. See: http://www.leginfo.ca.gov/cgi-bin/displaycode? section=hsc&group=01001-02000&file=1797.160-1797.197

 California Civil Code, Section 1714.2, 1714.21: Good Samaritan Laws Regarding AED Use. See: http://www.leginfo.ca.gov/cgi-bin/displaycode? section=civ&group=01001-02000&file=1708-1725

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 California Code of Regulations, Title 22, Division 9,Section 100020: First Aid standards for Public Safety personnel, optional skills (AED). See: http://www.emsa.ca.gov/laws/files/psregs2000.pdf

IV. Scope: A campus wide AED policy will be developed, reviewed and updated periodically by a campus AED committee under the direction of the Vice President for Administration and Finance. The committee will have representation from relevant departments such as Student Health, University Police, Environmental Health and Safety, Athletics/Kinesiology and Physical Education, Recreation and Wellness, Nursing Department, Risk Management, and Facilities Management.

V. AED Committee Responsibilities:

 Develop, review and update the campus AED policy periodically.

 Assure that the University is in compliance with all laws and regulations pertaining to the use and implementation of AED’s.

 Determine number, location and placement of AED’s. Evaluate implementation of AED’s for public access versus secured/limited access. May consider such factors as risk management, budget, security, accessibility and regulatory requirement in the decision.

 Coordinate vendor and AED selection, purchase, installation and ancillary features.

 Oversee all AED’s on campus and regularly notify/update the University community and Alameda (Contra Costa for the Concord campus) County EMS of their location and accessibility.

 Develop policies and procedures and assign responsibility for equipment inspection and maintenance based on legal, manufacturer and other requirements.

 Develop policies and procedures and assign responsibility for training of staff on the use of AED’s.

VI. Medical Director Responsibilities: The Medical Director of the AED Program is a physician designated by the SHS Director. The Medical Director is responsible for:

 Providing medical direction for the use of the AED device;

 Writing a prescription for use of the AED device;  Reviewing and approving guidelines and training requirements for emergency procedures related to the use of AED’s and CPR;  Evaluating post-event reviews;  Participating in the development of the campus emergency response plans;  Updating county EMS as per regulation requirements; and,  Reviewing laws and regulations that govern the use of AED’s

VI. Campus Program Coordinator Responsibilities:

 Organizing meetings periodically (at least annually) and as needed. A meeting may be called to discuss changes in law or regulatory requirements, an event or incident or to make a change in policy, equipment, etc.;  Working with the Medical Director and Department Coordinators to ensure that appropriate records are being kept, such as maintenance records, training records, AED guidelines and protocols, etc.;  Reviewing and revising the AED Policies and Procedures annually as needed in conjunction with the AED committee and other relevant campus personnel as needed;  Working with Medical Director to monitor the effectiveness of the AED program;  Working as a liaison between campus and AED manufacturer;  Communicating with the Medical Director on issues related to this medical emergency response plan including post-event reviews;  Discussing with the Medical Director any changes reported by the Department AED Coordinators; and,  Informing/updating the campus community on location and use of AED annually.

VII. Department AED Coordinator

 Responsible for maintaining and inspecting equipment per manufacturer’s recommendations;  Keeping all maintenance records for review by internal or external inspectors;  Ordering necessary equipment, supplies, and accessories;  Arranging, tracking and maintaining records for personnel training;  Notifying AED Program Coordinator of any changes in equipment and location;  Attending and representing their area at AED Committee meetings;  Developing and maintaining procedures for the use, maintenance, and training for the AED(s) in their area; and,  Discretion to assigning the above responsibilities to others who are properly trained.

VIII. Location of AED’s: For public access AED’s, placement in buildings on campus may depend on factors such as areas of risk, legal requirements, funding, and buildings with

employees who can comply with public access AED guidelines. Actual location in each building will consider such factors as easy accessibility and ADA compliance.

For limited access AED’s, individual departments will determine the location. The University community will receive periodic communication about the location of such devices and county EMS will be informed of any changes in the number and location of AED’s on campus.

Presently, the AED’s are located in the following campus areas:

Campus Location AED make and model Access UPD Patrol Car # 1 trunk Cardiac Science, Model: Power Heart AED G3 Limited UPD Patrol Car #2 trunk Cardiac Science, Model: Power Heart AED G3 Limited UPD Patrol Car # 3 trunk Cardiac Science, Model: Power Heart AED G3 Limited UPD Patrol Car, concord Philips Heartstart FRx Limited campus Nsg Dept, North Science Phillips, Model: HeartStart Onsite #M5066A ABA Instructional Room 111, Simulation Lab use only Nsg Dept, Concord Phillips, Model HeartStart Onsite, #M5066A ABA Instructional Campus Control Room, LB use only 140A KPE Swimming Pool Philips Heartstart FRx Limited Office KPE Main Gym lobby Philips Heartstart FRx Public KPE fieldhouse (athletic Philips Heartstart FRx Limited training) Health Center lobby Philips Heartstart FRx Public Recreation and Wellness Philips Heartstart FRx Public center first floor Recreation and Wellness Philips Heartstart FRx Public center second floor Recreation and Wellness Philips Heartstart FRx Limited center, room 139 University Union, 2nd floor Philips Heartstart FRx Public University Union, 3rd floor Philips Heartstart FRx Public New University Union, 1st Philips Heartstart FRx Public floor New University Union,2nd Philips Heartstart FRx Public floor

For public access AED’s, information on the proper use of the AED is posted with the unit.

IX. Equipment Maintenance: All AED equipment and accessories shall be maintained in a state of readiness and per manufacturer guidelines. At a minimum, the AED must be checked at least once every 30 days and after each use. Each department will develop policies and procedures on the equipment maintenance specific to the model/type of defibrillator they have and based on the recommendations of the manufacturer. Records of equipment checks will be kept by each department coordinator and made available for inspection to the Campus AED coordinator upon request. It is recommended that records be kept for at least 2 years.

X. Training: AED’s should only be used by persons trained in CPR and AED use, such as programs sponsored by the American Heart Association or American Red Cross. Each Department AED Coordinator, in conjunction with their department personnel and regulations that govern their area, will determine who needs to be trained. For public access defibrillators, trained personnel should be present in the building at all times that the building is open (during normal operating hours). In situations where the building is rented out and the building has a public access defibrillator, the rental contract/agreement should address the presence of the defibrillator and having trained personnel in how to use it. Training records will be maintained by the department coordinator and made available for inspection to the Campus AED coordinator upon request. It is recommended that records be kept for at least 2 years.

XI. Notification: Alameda county EMS will be notified of the specific location of all AED’s on campus and updated if there are any changes. Likewise, the campus community will be informed of the location of AED’s periodically. It is also recommended that Housing residents be informed of the campus location of AED’s and their use.

XII. Post Event Review: If an AED is used, a review of the incident by the Committee may be useful to assess the effectiveness of the AED program. See Appendix 1 for an AED Incident Report Form that could be used to report an event. As the result of an incident, the Committee may make recommendations to revise and improve the program including location, number, placement or type of AED and associated policies and procedures. The manufacturer of the AED may have to be contacted in order to download the post event information from the AED. For the Philips AED, contact Julianne Brawner from Health Education Services.

XIII. Prescription for Use of the Automated External Defibrillator

Use of the AED is for those persons who are trained in CPR and AED use.

1. Assess the scene for safety.

2. Determine the victim’s unresponsiveness.

3. Activate the emergency response system (dial 911).

4. Check for breathing. If no breathing, begin CPR (chest compressions). Health care workers should check for a pulse before starting chest compressions but do not take more than 10 seconds.

5. Perform CPR until AED available and ready for use.

6. A resuscitation kit is kept with the AED and contains two pairs of gloves, one razor, a pair of trauma shears, a towel, and one facemask barrier device. The razor may be used to shave any excess body hair that may inhibit adherence of the defibrillation pads. Likewise, the towel can be used to wipe off any sweat/moisture/other affecting adherence. Gloves and facemask offer protection to the rescuer (universal precautions).

7. Turn on the AED and follow the instructions provided by the voice prompts on how to apply and use the AED.

8. The Philips Heartstart FRx AED is for adults and children >=55 lbs, >=8 years old. Use the child key if available for children less than 55 pounds or less than eight years of age. The key reduces the shock energy. If the child key is not available, the defibrillator can still be used. In the case of the Philips Heartstart FRx for children less than 55 pounds or less than eight years of age in the absence of the child key, placement of the defibrillation pads is changed. One of the defibrillation pads should be applied to the center of the chest between the nipples and the other in the center of the back to perform the defibrillation.

9. Reminders: wipe area dry and remove any medicine patches and residual adhesive from the patient’s chest before applying defibrillation pads. Do not place pads directly over an implanted pacemaker or defibrillator, which may be seen as a noticeable lump or scar.

XIV. Program History:

ACTION DATE APPROVED BY: New Written Program 6/18/2010 Mark Khoo Revised 1/13/2011 Mark Khoo

Committee Checklist

Appendix 1: Notification

Date Date Date Date

County EMS (changes in # or location of AED’s)

Communication to University community of the location of AED’s annually

Housing residents informed of AED location.

Appendix 2: AED Maintenance Records

Health Center Athletics/KPE UPD RAW/UU

Date checked

Appendix 3: AED Training Records

Health Center Athletics/KPE UPD RAW/UU

Date checked

Appendix 4: AED Incident Report patient's name:______student’s ID number (if applicable)______

DOB:______AGE: ______sex: F M phone: ______allergies: ______current medications:______pertinent medical history: ______date and time of AED use:______location and description of incident:______

______

______witnesses and contact phone number: ______name of AED operator: ______other assisting responders:______patient was transported to (name of hospital):______time of transport:______any follow-up about patient outcome (if known): ______

______reported by:______date:______

AED Committee Members (as of January 2011)

Medical director/Department coordinator (SHCS) Mark Khoo Student Health and Counseling Services X-53673 Campus program coordinator Jill Millican Risk Management and Internal Control X-54227 Department coordinator (RAW) Krista Smith Recreation and Wellness Center X- 52685 Department coordinator (UU) Temporarily vacant Associated Students X-52333 Department coordinator (Athletics/KPE) Glen Borgeson Athletics/Kinesiology X- 53055

Bethany Helmus Kinesiology X-53061 Department coordinator (UPD Hayward and Concord) James Hodges University Police Department X-53643 Risk Management and Internal Control Nyassa Love Associate Vice President, Risk Management and Internal Control X-52743 Environmental Health and Safety Donna Placzek Director, Environmental Health and Safety X-52395 Kimberly Kim Nursing Department Professor, Nursing Department X-57502

Philips contact: Julianne Brawner Health Education Services 200 Waverley St. #8 Menlo Park, CA 94025 650-321-6500/800-754-9072 Cell: 650-823-6940 650-322-6865 fax [email protected]

PHILIPS HEARTSTART FRX DEFIBRILLATOR

Definition:

1. Philips HeartStart FRx is an automated external defibrillator (AED), capable of cardiac rhythm analysis, which will charge and deliver a shock after electronically detecting and assessing ventricular fibrillation or rapid ventricular tachycardia when applied to an unconscious patient with absent respirations and no signs of circulation. The automated defibrillator requires user interaction in order to deliver a shock.

2. “Lay Rescuer” means any person, not otherwise licensed or certified to use the automated external defibrillator, who has met the training standards and includes trained employees of the AED Services Provider

Basic Information:

Philips HeartStart FRx Defibrillator 861304 is an automated external defibrillator (AED). Received on Wednesday, December 15, 2010.

Battery: M5070A; 9 VDC, lithium manganese dioxide. Disposable. Shelf life: 5 years from date of manufacture. Recycle appropriately.

HeartStart SMART Pads II: 989803139261. Disposable; adhesive pads; provided in a disposable plastic case. Pads in case are designed to fit into carry case. The use pads may be contaminated with body tissue, fluid, or blood. Dispose of them as infectious waste. Recycle the case at an appropriate recycling.

The FRx is used to treat ventricular fibrillation, the most common cause of sudden cardiac arrest (SCA), (heart unexpectedly stops pumping).

The FRx treats VF by sending a shock across the heart, so it can start beating regularly.

Indications for Use:

A person in SCA:

 does not respond when shaken, and

 is not breathing normally.

If in doubt, apply the pads. Follow the voice instructions for each step in using the defibrillator.

Basic Steps for Using the Defibrillator

1. Press the green ON/OFF button. 2. Follow the FRx’s voice instructions. 3. Press the flashing orange shock button if instructed.

Care for After Each Use:

1. Check the outside of the unit for signs for damage, dirt, or contamination. If damaged call Philips. 2. Plug the cable connector for a new set of SMART Pads II into the FRx (do not open the pads case). 3. Do not remove the battery. The beeping may be stopped by installing a new set of pads. Removing the battery for more than 15 minutes will disturb the exact time and date of the event recording. Once the event data is downloaded from AED, the battery can be removed for five seconds, and then reinstall it to run the battery insertion self-test to check the operation of the defibrillator. When the test is complete, check that the green Ready light is blinking. 4. Return the FRx to its storage location so it will be ready for use when needed.

Routine Maintenance of the HeartStart FRx

 The FRx defibrillator performs an automatic self-test daily; thus eliminates the need for any manual calibration.  Do not leave the defibrillator without a set of pads connected; the defibrillator will start chirping and the i-button will start flashing.  As long as the green Ready light is blinking, it is NOT necessary to test the defibrillator by initiating a battery insertion self-test. This uses battery power.  Monthly checks*:  Monthly AED Checklist: 1. Take the AED from the cabinet; make sure to use the key to turn off the alarm during the inspection. 2. Visually inspect the status indicator (Ready Light) of the Philips AED on the upper right side of the face of the AED. . A blinking green light, also known as Ready Light, indicates that the AED is ready for use by passing its entire daily, weekly, and monthly self-tests, (this is an automated feature). . If the status indicator is solid, the FRx is in use or running a self-test.

. If the status indicator is off, the FRx is chirping, and the i-button is flashing. A self-test error has occurred, there is a problem with the pads, or the battery power is low. Press the i-button for instructions. . If the problem is the battery or the pads, insert the spare supplies into the AED so that is returns to service. If there is no spare battery, notify the appropriate staff or supervisor to take the AED out of service until the new parts are replaced. . Sometimes, cleaning the contacts on the battery and the AED will solve the problem, so try this first if the diagnosis is that the battery is low and needs to be changed. . When inserting new battery into the AED, indicate on the checklist the date of battery installation. . If the AED needs servicing, report this to the Department coordinator for follow up. Philips will FedEx, next day air, an AED, and retrieve the disabled AED to determine the problem. There is no fee if the AED is under the five year warranty. 3. Check battery and pads for expiration date. 4. Examine the AED and the case. If the case is excessively soiled, it can be cleaned with a cloth that has been soaked in any of the following solutions: isopropyl alcohol, soapy water, chlorine bleach solution, or glutaraldehyde-based cleaners. 5. Test the alarm on the cabinet by using the key to turn on the alarm an open the door part way until the alarm engages. The alarm should be ear piercingly loud, so make sure to turn the alarm off or close the door immediately. 6. Inspect the AED sign. This sign tells the location of the AED. If it is not present above the AED, inform the Department coordinator. 7. Record all findings on the checklist.

*The Philips FRx AED operates in a temperature range of 32-122 F. If the AED is exposed to temperatures outside that range, the AED should be checked.

Philips HeartStart FRx Defibrillator Serial Number: B10H-01292 MONTHLY CHECKLIST

Philips Spare Philips Battery Status FRx Unit Cabinet AED Sign K HeartStart HeartStart Indicator – n e o Model: d O i

s e t SMART PADS II Smart Pads Ready l a t a e

M5070A c c .

n b i u Date Checke i g Green b r c . t REF: Lot#: 01021- n m i e a s

d by REF: a

Blinking y d b t

989803139261 0957 r r o n

(initials 98980313930 m a

Light? o n r c c u

) Lot #: 00609- Exp: 04/2013 1 r a o & A o

t t t 0956 Yes No i r n i Exp: 05/2016 n e d u s

Exp: 12/2012 o b r t n

P t , n n e a s e l e r C p

e g a m a d

Department AED Training

Department coordinators or designes will assure that employees and other persons in their area are trained in a CPR/AED course approved by the American Heart Association or American Red Cross. Training shall be kept current. The decision for how many and which employees to be trained is guided by the importance to have trained persons available to respond to an emergency that may involve the use of an AED during normal operating hours.

Department Name: ______

CPR/AED Training tracking log

Name Date CPR/AED Training Completed

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