Automated External Defibrillation Guidelines
Contents
1. AUTOMATED EXTERNAL DEFIBRILLATION Guideline mm Date 1ith June 2014 For review June 2016 Col iste Mhuire Co Ed Thurles Automated External Defibrillation Guideline Purpose To ensure all who may need cardiopulmonary resuscitation in Colaiste Mhuire Co Ed Thurles including the use of an automated external defibrillator receive high quality treatment in accordance with the Heartsaver CPR AED Programme as recommended by the Irish Heart Foundation American Heart Association or in accordance with the Cardiac First Response programme as recommended by the Pre Hospital Emergency Care Council Ireland Applicable to All staff in Colaiste Mhuire Co Ed Thurles who have completed the appropriate training as outlined in this guideline Compiled by Mary Ryan Maher Basic Life Support instructor Signature Date Approved by Chairperson Board of Management Signature _John Kennedy Chair Date 9 6 14 Principal _Denis Quinn Signature Date 9 6 14 Vice Principal Signature Clare Wallace Date 9 6 14 Definitions A E D Automated External Defibrillator An A E D is a computerised medical device that analyses heart rhythm and will advise the operator if a shockable rhythm is detected If a shockable rhythm is detected the A E D will charge to the appropriate energy level and advice the operator to deliver a shock It is only to be applied to victims who2. Power Head G3 AED Serial Number 9390E 1002 Sample Copy of Weekly After Use Checklist Y Date AED Event that Supplemental Event that Status Prompted Equipment Prompted indicator Check Stored with check weekly before weekly after use Ticky if use after use AER Tick if green supplemental Insert X equipment is if red present and in date Replace any missing items or items out of date Comments Signature In the event of any problem which renders the AED non Operational then the status must be reported to Principal Denis Quinn Appendix V111 A continued After use Maintenance check 1 Open the AED lid 2 Waiting for the AED to indicate status Observe the change of the STATUS INDICATOR to RED After approximately 5 seconds verify that the STATUS INDICATOR returns to GREEN 3 Listen for the voice prompts 15 Col iste Mhuire Co Ed Thurles Automated External Defibrillation Guideline 4 Close the lid and observe the change of the STATUS INDICATOR to RED After approximately 5 seconds verify that the STATUS INDICATOR returns to GREEN Sample copy of After use Maintenance check Year Month Tick y if 1 23 and 4 are performed as above Comments Signature Date Day Date Day Date Day Date Day In the event of any problem which renders the AED non Operational th
3. e Attach AED electrode pads e Analyze Clear e IF SHOCK Advised clear everybody Vv After 1 shock perform CPR for 2 minutes 5 cycles of 30 compressions and 2 breaths until AED analysis again EMS takes over care of patient or patient moves If No Shock indicated Y Perform CPR until EMS takes over or AED advises analysis or patient begins to move if Patient begins to move or starts breathing normally place in recovery position Leave pads in position and leave AED ON Col iste Mhuire Co Ed Thurles Automated External Defibrillation Guideline Appendix III AED CERTIFIED USERS Copy to be given to Reception AED Location Reception Model Power Heart G3 Serial No 9390E 1002 The following are certified users of the AED and Acknowledge competency in using the AED Names PRINT NAME Signature Occupation Telephone Caoimhe Geaney Teacher 0504 21734 Deirdre Ryan Teacher 0504 21734 Julianne Butler Teacher 0504 21734 Claire Kearney Special Needs Assistant 0504 21734 Rosino Matassa Caretaker 0504 21734 Mary Ryan Maher Teacher 0504 21734 Col iste Mhuire Co Ed Thurles Appendix IV DETAILS OF CERTIFICATION REVALIDATION AND RECERTIFICATION OF CERTIFIED USERS as per Appendix 3 Automated External Defibrillation Guideline t th th Name Course Date 1 7s 3 4 5 Revalid Revalid Revalid Revalid Re
4. The AED must only be turned on amp attached to a victim who is unresponsive not breathing 5 Pad Placement 5 1 Power the AED on before attempting pad placement 5 2 C P R is continued while pads are applied Right pad Mid clavicle line to the right of the breast bone below the collar bone and above the right nipple Left pad Mid Axillary Line lateral to the nipple upper edge of the pad several inches below the left armpit 5 3 5 4 5 5 5 6 5 7 5 8 5 9 For a casualty who is wearing pendants etc remove them from the area of pad placement before applying the pads If the pendants are not easily removable e g a nipple stud place the electrode pads at least one inch away from the object For a casualty wearing medication patches remove the patch and wipe the area clean and dry before applying pads Use gloves dispose safely Place AED electrode pads a least one inch away from any device such as an implanted pacemaker or an implanted defibrillator If the chest is wet or sweaty wipe it dry before powering on the AED and applying the pads If the casualty has excessive hair on the chest clip or shave prior to pad placement If the machine advises poor pad contact then press them firmly down on the chest If machine again advises poor pad contact remove pads wipe chest dry and apply second set of pads Cut the bra of female casualties Paediatrics Adult pads to be applied for anyone greater than 8 yea
5. are unresponsive and have no normal breathing S O P Standard Operating Procedure Adult From puberty upwards When in doubt treat as an adult Child Someone who is older than one year but has not reached puberty Puberty Breast development in a girl underarm hair in a boy Col iste Mhuire Co Ed Thurles Automated External Defibrillation Guideline I H F A H A Irish Heart Foundation American Heart Foundation E R N Emergency response number 999 or 112 C P R Cardiopulmonary Resuscitation S C A Sudden cardiac arrest CFRR Cardiac First Response Report E R N Emergency Response Number 999 or 112 E M S Emergency Medical Service C A B Compressions Airway Breathing Use of Automated External Defibrillator AED Within Colaiste Mhuire Co Ed School the staff may use the Powerheart AED G 3 with serial number 9390E 1002 provided The staff hold I H F A H A Heartsaver Adult C P R A E D card or equivalent qualification as certified by PHECC They follow the AED Operating Guideline as outlined in Appendix I They follow the AED Algorithm as outlined in Appendix II It is recommended that members should recertify every 2 years It is the responsibility of each individual who carries a current Heartsaver Adult C P R amp A E D card or equivalent to contact the Principal within Colaiste Mhuire Co Ed and arrange re certification as necessary Following qualification revalidation is recommended twice yearly Th
6. disposable gloves in AED case 1 8 Barrier eye protection 1 pairs of disposable goggles in AED case 1 9 Clinical Waste bag stored in AED case 1 10 Check list booklet beside AED 1 11 Cardiac First Response Report Formsx3 1 12 Instructions for Use Edition Manual beside AED 1 13 Operating guideline beside near AED AED Operating Guideline 2 REQUESTING THE AED IN THE EVENT OF AN EMERGENCY 2 1 The AED should be requested and taken to the side of the unresponsive adult or student 3 THE SAFETY OF THE AREA THE RESCUERS AND THE VICTIM 3 1 Before opening the AED the rescuer must ensure it is a safe area to use the AED 3 2 The victim must not be in or near standing water e g very wet pitches swimming pool 3 3 The victim who is in free standing water must be removed from the wet area and have their chest quickly but thoroughly dried before powering the unit on and attaching the electrodes 3 4 The immediate surrounding area must be completely free of petrol petrol vapours and solvents 3 5 The AED should only be used on those who are unresponsive and not breathing Col iste Mhuire Co Ed Thurles Automated External Defibrillation Guideline 3 6 The AED must not be used in explosive or volatile atmosphere 4 LOCATING TURNING ON AND ATTACHING THE AED TO THE VICTIM 4 1 The victim must be on his her back and on a firm unyielding surface 4 2 The AED should be located next to but not touching the victim s side 4 3
7. d batteries being tracked Have staff been trained in CPR and AED use Has the training been documented and is it in date Are AED operators revalidated twice yearly Post Cardiac Arrest audit Patient Condition upon your arrival circle Conscious Breathing Pulse Unconscious Not Breathing No Pulse What action did you take Was shock needed Yes No Was shock delivered Yes No Did pulse return Yes No Did breathing return Yes No Was CPR performed Yes No By whom Did patient become conscious Yes No Condition on arrival of EMS Outcome if known Names of all AED Responders Audit conducted by Date References Appendix XI1I 20 Col iste Mhuire Co Ed Thurles Automated External Defibrillation Guideline American Heart Association Guidelines CPR ECC 2010 Highlights of the 2010 American Heart Association Guidelines for CPC and ECC American Heart Association 2011 Heartsaver CPR Student Workbook American Heart association 2011 BLS for Healthcare Providers student manual OPERATOR AND SERVICE MANUAL Cardiac Science Powerheart AED G 3 serial number 9390E 1002 Pre Hospital Emergency Care Council Training Manual Cardiac First Response 2011 P H E C C website for clinical record management guidelines for storage of printed documentation www phecc ie 21
8. en the status must be reported to Principal Denis Quinn 16 Col iste Mhuire Co Ed Thurles Appendix V111 A continued Automated External Defibrillation Guideline Copy of Check Lists continued Monthly 5 Open the AED lid 6 Waiting for the AED to indicate status Observe the change of the STATUS Maintenance check of INDICATOR to RED After approximately 5 seconds verify that the STATUS INDICATOR returns to GREEN AED except during 7 Listen for the voice prompts holidays and after_each 8 Close the lid and observe the change of the STATUS INDICATOR to RED After use approximately 5 seconds verify that the STATUS INDICATOR returns to GREEN Annual 9 Open the AED lid 10 Remove Pads Maintenance of 11 Close the lid 12 Confirm the STATUS INDICATOR turns red AED 13 Open the lid and confirm that the Pad indicator is lit 14 Reconnect the pads and close the lid Perform the following 15 Make sure the expiration date is visible through the clear window of the lid tests annually to 16 Check to make sure that the STATUS INDICATOR is GREEN If the pads are not confirm that the installed properly the PAD indicator will illuminate call Customer Service for diagnostics are accictance functioning properly and 17 Open the lad and confirm that no diagnostic indicators are lit to verify the integrity of 18 Check the expiration date of the pads if expired replace them the case the integrity 19 Check the pads packagin
9. g integrity of the pads and 20 Close the lid circuitry Check the integrity of the Service Indicator LED and Circuitry 21 22 23 24 25 26 27 Immediately after opening the AED lid press and hold the Shock button and confirm that the Service LED is lit Release the Shock Continue button Close the lid Verify that the STATUS INDICATOR remains red Open the lid and confirm that no diagnostic indictors are lit Close the lid Verify that the status indicator turns green Sample copy of Monthly Maintenance check of AED Year Tick v if 5 6 7 and 8 as above performed Comments Signature 17 Col iste Mhuire Co Ed Thurles Automated External Defibrillation Guideline Appendix V111 A continued Copy of Check Lists continued Sample copy of Annual Maintenance check of AED Year Tick y if steps 9 27 on previous page are performed Comments Signature In the event of any problem which renders the AED non Operational then the status must be reported to Principal Denis Quinn Appendix X Cardiac Arrest Data Sheet AED Responder The Cardiac Report Form is a two part document Part 1 or top copy to go with patient to hospital destination facility The Responder should give the completed copy to the practitioner who is transporting the patient Part 2 or second copy to remain as a record with the Responder Organisation i e Colaiste M
10. huire Co Ed 18 Col iste Mhuire Co Ed Thurles Automated External Defibrillation Guideline TE RI NN eun iF Biip mmk is aes pi MEL ee a ae IH EE i 4 E Le E ioe Ell of ee a kho op agg ao rag 8 t ee l Ji o roa E E it Be la a BE am Oe i Ea ag Z NOLUGS LHOd3H SHV INAUA DO3Hd P00 NISLS1N 3ONTHRI3H Appendix XI Review of guideline This guideline will be reviewed every two years or more frequently if required to reflect changes in regional or national policies as well as in accordance with changes in legislation 19 Col iste Mhuire Co Ed Thurles Automated External Defibrillation Guideline Audit Tool Appendix XII Status Comment Action Does Colaiste Mhuire Co Ed have a written plan for the AED Does the plan accurately reflect current practice Is the AED located in an environment as per manufacturer s instructions Is the AED visible and accessible where provided Is the AED being inspected weekly monthly yearly Is the inspection process documented Are the expiration dates on the pads an
11. is ensures C P R and AED skill competency Authorized Users A list of certified users for Colaiste Mhuire Co Ed School Thurles can be found in Appendix III 2 Details of certification revalidation and re certification of certified users can be found in Appendix IV Responsibilities A E D User Responsibilities Appendix V BLS Instructor Responsibilities Appendix VI Col iste Mhuire Co Ed Thurles 2 Principal s Responsibilities A E D Operators Checklist Cardiac First Response Report form Review of Guideline Audit Tool References Automated External Defibrillation Guideline Appendix VII Appendix VIII amp VIIIA Appendix X Appendix XI Appendix XII Appendix XIII Col iste Mhuire Co Ed Thurles Automated External Defibrillation Guideline Appendix 1 AED Operating Guideline for Power Heart G3 1 0 Storage 1 1 The Cardiac Science Powerheart AED G3 with serial number 9390E is stored at RECEPTION for easy accessibility 1 2 One Laerdal Pocket mask with two valves are stored beside near the AED 1 3 One battery pack is fitted to the unit 1 4 Two pairs of in date adult External Defibrillator pads approved for use with Power Heart G3 one set of in date pads to be attached to AED and spare in date set of pads available within AED Case 1 5 One Paramedic shears stored in AED case 1 6 One large absorbent pad for drying the chest stored in the AED Case 1 7 Two pairs of
12. n Guideline Weekly Check amp After each use e Ensure the exterior of the G3 and the connector socket is free of cracks and signs of damage e Check that in date defibrillator pads are connected to the G3 plug when not in use e One set of in date defibrillation pads sealed amp undamaged stored in AED case e One paramedic shears stored in AED case e 2 pairs of disposable gloves in AED case One large absorbent pad for drying the chest stored in AED case example a face cloth One Laedal pocket mask Two valves for pocket mask Barrier eye protection x1 Clinical waste bag Instruction manual beside near AED Operating Guideline in place beside near AED Patient Report forms x3 After each use Perform maintenance check see next page for details of same Appendix V111 continued AED Operator s Check List and Scheduled Maintenance Make Power Head G3 Serial number 9390E 1002 Monthly Maintenance of AED except during holidays and after each use Open the AED lid Waiting for the AED to indicate status Observe the change of the STATUS INDICATOR to RED After approximately 5 seconds verify that the STATUS INDICATOR returns to GREEN Listen for the voice prompts Close the lid and observe the change of the STATUS INDICATOR to RED After approximately 5 seconds verify that the STATUS INDICATOR returns to GREEN 13 Col iste Mhuire Co Ed Thurles Automated Exte
13. or as per clinical record management guidelines set out by P H E C C Arrange Provide debriefing session if required 11 Col iste Mhuire Co Ed Thurles Automated External Defibrillation Guideline Appendix VII Principal Responsibilities Compile a rota for the AED operators to verify the operation status of the A E D on a weekly basis as per Appendix VIII and VIIIA to check the supplemental equipment that is stored with the A E D on a weekly basis in accordance with the Operator s Check List as in Appendix VIII and VIIIA to perform a monthly maintenance test See appendix VIII and VIIIA to perform an annual maintenance test see appendix VIII and VIIIA Appendix VIII AED Operator s Check List and Scheduled Maintenance Make Power Heart G3 Serial Number 9390E 1002 Weekly during school term Monday to Friday and after use if Monday is a Bank Holiday then it must be done on the following day i e Tuesday Check the status indicator of the AED When the indicator is GREEN the AED is Rescue Ready This means the AED self tests have verified the following e Battery has an adequate charge e Pads are properly connected to the AED and functioning e Integrity of the internal circuitry is good Check instructions for Use booklet for further instruction if status indicator not working 12 Col iste Mhuire Co Ed Thurles Automated External Defibrillatio
14. rnal Defibrillation Guideline Annual Maintenance of AED Perform the following tests annually to confirm that the diagnostics are functioning properly and to verify the integrity of the case the integrity of the pads and circuitry 1 Open the AED lid 2 Remove Pads 3 Close the lid 4 Confirm the STATUS INDICATOR turns red 5 Open the lid and confirm that the Pad indicator is lit 6 Reconnect the pads and close the lid 7 Make sure the expiration date is visible through the clear window of the lid 8 Check to make sure that the STATUS INDICATOR is GREEN If the pads are not installed properly the PAD indicator will illuminate call Customer Service for assistance 9 Open the lad and confirm that no diagnostic indicators are lit 10 Check the expiration date of the pads if expired replace them 11 Check the pads packaging integrity 12 Close the lid Check the integrity of the Service Indicator LED and Circuitry 1 Immediately after opening the AED lid press and hold the Shock button and confirm that the Service LED is lit Release the Shock Continue button Close the lid Verify that the STATUS INDICATOR remains red Open the lid and confirm that no diagnostic indictors are lit Close the lid Verify that the status indicator turns green OT ee 14 Col iste Mhuire Co Ed Thurles Automated External Defibrillation Guideline Appendix V111A Sample Copy of Check Lists Make
15. rs of age If child is less than age years of age and there is no paediatric AED pads then the adult pads may be used Make sure the pads do not touch other If a child is very small you may need to put 1 pad on the child s chest and the other on the child s back 6 ANALYSING THE RHYTHM AND DELIVERING A SHOCK 6 1 Follow the Power Heart G3 voice prompts and request of everybody Do not touch The Patient while the Power Heart G3 automatically analyses the rhythm Col iste Mhuire Co Ed Thurles Automated External Defibrillation Guideline 6 2 Assertively ensure that everybody will stand clear of the victim while the AED is charging 6 3 Before delivering a shock loudly and clearly state while visually checking I m clear you are clear everybody is clear or similar words and only when satisfied press the shock button 6 4 If you do not consider it safe to deliver a shock do not deliver it Power Heart G3 will dump the energy safely into its own capacitor after it is armed for approximately 30 seconds 7 POST SHOCK PROCEDURES 7 1 Follow the Power Heart G3 voice prompts 7 2 Following the delivery of a shock immediately resume compressions 7 3 If the AED indicates No Shock Advised continue CPR until the AED prompts you to stop for analysis or until victim moves or the Emergency Medical Services takes over If victim resumes normal breathing place the victim in the Recovery Position Reassess victim e
16. ted by the Principal to verify the operation status of the A E D ona weekly basis during school term in accordance with the Operator s Check List as in Appendix VIII and VIIIA It is the responsibility of the trained A E D member of staff who is delegated by the Principal to check the supplemental equipment that is stored with the A E D ona Weekly basis _in accordance with the Operator s Check List as in Appendix VIII and VIIIA Any items used out of date to be replaced It is the responsibility of the trained A E D member of staff who is delegated by the Principal to perform a monthly maintenance test see Appendix VIII It is the responsibility of the trained A E D member of staff who is delegated by the Principal to perform an annual maintenance test see appendix VIII and VITIA It is the responsibility of each AED operator who performs a check to sign and complete the checklist booklet Appendix VIII A Appendix VI BLS Instructor Responsibilities All documentation pertaining to proof of qualification revalidation and recertification will be responsibility of the Basic life Support Instructor within Colaiste Mhuire In the absence of a Basic Life Support Instructor the Principal will be nominee responsible for all training documentation Patient report form and downloaded data from A E D following an event to be stored in locked filing cabinet stored by Principal Basic Life Instructor Medical Direct
17. valid Caoimhe Geaney Heartsaver AED 27 03 14 Deirdre Ryan Heartsaver AED 27 03 14 Julianne Butler Heartsaver AED 27 03 14 Claire Kearney Heartsaver AED 27 03 14 Rosino Matassa Heartsaver AED 27 03 14 Mary Ryan Maher Basic Life 2009 2011 2013 2016 Support Instructor Appendix V A E D User Responsibilities e To activate the external response system by dialling 999 or 112 e To provide prompt B L S including A E D e To maintain a skill level commensurate with the safe and effective use of the A E D To contact the Principal re 2 year recertification To attend twice yearly revalidation To understand and comply with the requirements of this guideline It is the responsibility of the AED operator who uses_the AED to verify the operation status of the AED status indicator is green Before each use In accordance with the Operator s Check list as outlined in Appendix VIII and Appendix VIIIA 10 Col iste Mhuire Co Ed Thurles Automated External Defibrillation Guideline After using the AED It is the responsibility of the A E D operator to verify the operation status of the A E D perform a maintenance test and replace any items used from the supplemental equipment that is stored with the A E D in accordance with the Operator s Check List as outlined in Appendix VIII and VIIIA It is the responsibility of the trained A E D member of staff who is delega
18. very 2 mins 7 4QOnce the electrode pads were correctly placed and continue to make good contact they should not be removed until a higher level of care takes over 8 RETURNING THE AED TO SERVICE 8 1 As soon as possible following an arrest the data card stored in internal memory to be downloaded by the company Fleming Medical and all the relevant details of the arrest to be made available for audit and record purposes 8 2 Before the AED is returned to its normal location in order to stand by for further use the unit and all accessories must be inspected The unit should be clean and dry and all consumable parts that were used replaced Complete the Operator s checklist as outlined in Appendix VIII and VIIIA 8 3 Verify that the status indicator is green as indicate in appendix VIII and VIIIA Col iste Mhuire Co Ed Thurles Automated External Defibrillation Guideline Appendix II AED Algorithm Puberty onwards Heartsaver C P R amp A E D OPERATOR e Check if unresponsive If unresponsive e Call emergency number 999 or 112 and retrieve the AED Start the CAB NY Check Breathing if no breathing or only gasping Commence Compressions at a rate of at least 100 min Combine compressions and ventilations Ratio of 30 compressions to 2 breaths Perform C P R until A E D arrives and is ready to attach Attempt Defibrillation AED on scene Vv Power on the AED first and follow voice prompts
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