Section IV-3

 

Automated External Defibrillator Policy

 

Purpose:  To establish guidelines to be followed when a cardiac arrest is confirmed and Automated External Defibrillation (AED) operations is appropriate.

 

Scope:   Only Three Star Fire Department personnel who have successfully completed the required training course will be permitted to provide the care outlined in these protocols.

 

Policy:

 

An automated external defibrillator (AED) is used to treat victims who experience sudden cardiac arrest.  It is only to be applied to victims who are unconscious, not breathing normally and showing no signs of circulation, such as normal breathing, coughing and movement.  The AED will analyze the heart rhythm and advise the operator if a shockable rhythm is detected.  If a shockable rhythm is detected, the AED will charge to the appropriate energy level and advise the operator to deliver a shock.

 

The AED shall be used for patients older than 8 years of age or weighing more than 55 pounds in confirmed cardiac arrest.

 

The Ambulance Service responding must be advised immediately of a confirmed cardiac arrest.  This information must be relayed to the appropriate EMS agency.

 

1.            Assess the Airway.

 

2.            Assess Breathing.

 

3.            Assess Circulation.

 

4.            If no pulse, perform CPR until AED is attached.

 

5.            Stop CPR and press “analyze”.  DO TOUCH, MOVE, OR PERFORM CPR!

 

If no shock is indicated, check pulse, continue CPR for one minute, check pulse again, and then reanalyze.

 

6.            If “shock indicated” defibrillate up to 3 times if needed.

 

If “stack” of three shocks is interrupted by a “NO SHOCK INDICATED” message then check pulse, repeat one minute of CPR, check pulse again, & then reanalyze.  After three “NO SHOCK INDICATED” messages, repeat “ANALYZE”

 

7.            Check pulse.

 

If pulse is present, support airway & breathing.  Continually reassess ABC’s until arrival of the Ambulance Service.

 

NO PULSE

 

8.            CPR for 1 minute.

 

9.            Check pulse.  If absent:

 

10.         Press “ANALYZE”

 

11.         Defibrillate up to 3 times if needed.

 

12.         CPR for 1 minute.

 

Check pulse.  If absent:

 

13.         Press “ANALYZE”.

 

14.         Defibrillate up to 3 times if needed.

 

15.         Continue CPR until arrival of EMS, or return of spontaneous circulation.

 

If at anytime the patient regains a pulse but is not breathing, perform rescue breathing.

Training

 

Training must be ongoing in order to instill and maintain knowledge and skills regarding CPR and AED use.  Personnel trained in AED response and use will have annual updates to ensure the ability to adequately operate the equipment, should the need arise.  An approved training program will be utilized for recertification and refresher courses.

Maintenance & Checkout Guidelines

 

The Three Star Fire Department requires weekly maintenance checks of the AED equipment.  Personnel performing equipment inspection must complete a check of the AED during weekly equipment/apparatus checks.  The EMS Captain is to be immediately contacted if any equipment needs replacement or maintenance.

 

All AED’s shall have certain medical supplies provided with them.  These supplies shall include:  two sets of AED pads in sealed package, pocket mask with one-way valve, examination gloves, razors, and absorbent gauze or hand towels.

 

After a cardiac arrest occurs, it is critical to get the AED back into service as soon as possible.  However, before putting AED back into service, the Chief, Assistant Chief, and EMS Captain will be notified immediately.  The EMS Captain will obtain all data from the AED, using computer programming, and ensure all equipment is returned in ready condition.  This includes:

 

·        Check and replenish supplies as appropriate (includes electrode pads, towel, razor, barrier device, and disposable gloves). 

·        Clean and disinfect

·        Check the battery and replace if needed

·        Check the device housing for cracks or other damage

·        Return the AED to its designated place with appropriate supplies.

 

The EMS Captain will order supplies as needed.