Background of Public Access Defibrillation

  • Public access defibrillation (PAD) programs are designed to improve survival from sudden cardiac arrest. PAD programs include placement of AED’s throughout the community and training people in CPR and AED’s.
  • If PAD programs are to improve survival from sudden cardiac arrest, they must significantly reduce 2 intervals:
    • Time between collapse and start of CPR
    • Time between collapse and delivery of first shock
  • Successful PAD programs require careful planning, lay rescuer training, quality assurance monitoring, and a strong link with the local EMS system.

**Note: River Falls EMS will take a large part in the following 3 steps!

1. Preliminary Steps: Preparation and Planning for PAD Program

  • Identify a licensed physician to serve as PAD medical director
  • Provide CPR/AED training to individuals in the community.
  • Establish communication between:
    • PAD Medical Director
    • Personnel or employees receiving training
    • River Falls EMS PAD oversight
  • Email  to conduct a site visit at your site.
  • Goals of the site visit
    • Identify responding personnel at the location that will use PAD.
    • Determine proper placement of the AED.
    • In an AED area, the AED will ideally be placed within a 1.5 minute walking distance of area covered.
  • Suggest that the AED being considered is compatible with River Falls EMS defibrillators.

2. Pre-event Training and Program Establishment

  • Share suggested treatment protocols consistent with recommendations of the American Heart Association and River Falls EMS.
  • Train all anticipated users of the PAD program.
  • Establish methods to accomplish and document the following tasks:
    • Ensure skills maintenance. (include refresher training and mock drills)
    • Ensure device maintenance and readiness-for-use checks.
    • Ensure AED and user performance after any field use.
    • Ensure post-event psychological support is available to rescuers, co-workers, etc.
    • Review potential long term clinical outcomes of the collapsed person.

3. Post-Clinical Event Quality Improvement Monitoring: Incident Review

  • Review scene – recap of incident.
  • Review lay rescuer performance during field use and provide feedback.
  • Offer post-event psychological support to rescuer and rescuer co-workers.
  • Determine clinical outcome of person who collapsed – requires authority to access private hospital records from either physician or EMS medical director.
  • Develop plan to track community-wide outcomes and performances over time.

***In River Falls, these critical elements can be achieved by PAD programs closely affiliated with local EMS systems and resources.