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3-9 Automated External Defibrillator (AED) Protocol

Policy Type: Local

Responsible Office: Chief of Police, Virginia Commonwealth University Police Department

Initial Policy Approved: 6/8/2013

Current Revision Approved: 6/8/2013

 

General

It is the policy of the VCUPD to properly train and certify all first responders in the administration of first aid to any person in need. As first responders, the first responsibility of a police officer at the scene of a crime, accident involving injuries or medical emergency, is scene safety, then to render assistance, medical or otherwise. This responsibility must be performed immediately, even if it means that a suspect will escape or valuable clues will be destroyed. The preservation of human life is the most important consideration. However, if there are other persons on the scene who are able to render medical assistance, the police officer should arrange for them to take care of the injured parties. When sudden cardiac death/arrest occurs, early defibrillation is often critical to the victim’s survival.

The purpose of this order is to establish the proper response to sudden cardiac death/arrest using the Automated External Defibrillators (AED); to define department policy regarding the use, storage, and maintenance of the AED Machines; and to establish the procedure for deployment of the AED machines by personnel of the VCU Police Department. Although police officers are usually considered as the first responders to persons in need, this policy also includes First Aid, CPR, AED training and certification by the American Safety and Health Institute (ASHI) for civilian employees who may also be involved in situations where they are able to recognize, assess and support the most common emergencies until help arrives.

 

Accountability Statement

All employees are expected to fully comply with the guidelines and timelines set forth in this written directive. Failure to comply will result in appropriate corrective action. Responsibility rests with the division commander to ensure that any violations of policy are investigated and appropriate training, counseling and/or disciplinary action is initiated.

 

Definitions

  1. AUTOMATED EXTERNAL DEFIBRILLATOR – a medical device which combines a heart monitor and defibrillator and has been approved by the United States Food and Drug Administration, is capable of recognizing the presence or absence of ventricular fibrillation or rapid ventricular tachycardia, is capable of determining, without intervention by an operator, whether defibrillation should be performed, and automatically charges and requests delivery of an electrical impulse to an individual's heart, upon determining that defibrillation should be performed. (VA Code §32.1‐111.1)
  2. SUDDEN CARDIAC DEATH/ARREST – Sudden cardiac death (also called sudden arrest) is death resulting from an abrupt loss of heart function (cardiac arrest). The victim may or may not have diagnosed heart disease. The time and mode of death are unexpected. It occurs within minutes after symptoms appear. The most common underlying reason for patients to die suddenly from cardiac arrest is coronary heart disease (fatty buildups in the arteries that supply blood to the heart muscle).

 

Procedures

  1. Training and Certification:
    1. The Training Division provides AED and CPR training to VCUPD personnel using a curriculum approved by the State Board of Health.
    2. Training on the use of the AED and CPR is required of sworn officers upon hire during recruit training and for all officers every two years during in‐service training. Training is offered periodically for civilian employees, however, personnel who have not received the training are permitted to use the AED and will not be liable for use of the AED in good faith, pursuant to VA Code §8.01‐225.
    3. Training for use of the AED machine:
      1. The training requirements for the use of an AED shall consist of:
        1. Initial eight (8) hour block that includes CPR and practical use of the AED machine, and 
        2. Refresher four (4) hour block that includes CPR and practical use of the AED machine. 
      2. Upon completion of the class and successfully passing written tests and practical skill tests, the employee shall become certified by the ASHI in the subjects of CPR and the AED machine.
    4. All training records are maintained by the Training Division. Certification records are maintained by ASHI.
  2. Responding to a Sudden Cardiac Death/Arrest:
    1. If an employee witnesses an individual collapsing or an individual having no visible signs of life, the employee should:
      1. Immediately call 911 for Emergency Medical Service (EMS) Personnel.
      2. Check for Breathing – Breathing can be checked by observing any movement in the upper part of the individual’s abdomen just below the lowest ribs. The employee should listen to and feel for any air coming out of the mouth or nose of the individual. If the individual has stopped breathing, the employee should attempt to open the airway by gently tilting his/her head back. This maneuver may be all that is required to cause the individual to resume breathing.
      3. If the individual is not breathing, this does not mean that he/she has died. The employee will assess the individual for an open airway, breathing and pulse. If the individual is unresponsive and has a pulse, the AED machine shall NOT be attached to the person. This is to prevent the accidental defibrillation of an individual who does not have the symptoms indicated above. In addition, an AED will not be used on a person less than 8 years of age or weighing less than 55 pounds.
      4. Check for a Pulse – The heart of a dying person may continue to beat for a short time after breathing has stopped. If the victim’s heart is still beating, there will be a pulse. If the individual has no pulse and is not breathing and after arranging for medical assistance, the employee should place the AED machine on the person as soon as possible. If an AED is not available, an employee properly trained and certified in CPR/First Aid should perform CPR until EMS arrives.
        1. NOTE: PRIOR TO DEFIBRILLATION, THE EMPLOYEE MUST ENSURE THAT ALL OTHER PERSONS ARE “CLEAR” OF THE VICTIM TO PREVENT INJURY. THE SAFE USE OF AN AED IS THE RESPONSIBILITY OF THE EMPLOYEE WHO IS IN CONTROL OF THE AED. 
  3. Upon arrival of EMS personnel, the employee shall immediately begin a dialogue briefing them on the victim’s condition, if AED intervention has occurred thus far and provide any other information that may be requested.
    1. First aid should always be administered in the proper sequence of importance:
      1. Airway: Ensure that the victim has an open airway – head tilt maneuver.
      2. Breathing: If no breath is present, you may start mouth‐to‐mouth breathing.
      3. Circulation: Check for a pulse. If no pulse is present, the employee(s) should deploy the AED. If not properly trained or if an AED is unavailable, the employee certified in CPR should immediately start CPR procedures until such time that an AED and a properly trained employee are available or EMS personnel arrive.
      4. Bleeding: Check for excessive bleeding and control that bleeding by direct pressure on the wound. (Never remove a knife or other object stuck into a victim.)
      5. Treat for Shock: Keep the victim’s legs and feet elevated and keep the victim warm.
      6. Keep the victim calm and assured that medical help is on the way.
    2. After performing first aid, the employee shall perform the following next steps:
      1. If the victim is unable to speak, the employee shall make a quick check of his/her clothing or pockets for identification papers.
      2. If the victim can speak, he/she may reveal his/her identity and describe or identify the suspect. As the victim talks, the officer shall take notes to ensure documentation.
  4. Operation of an AED Machine:
    1. The AED machine will only be utilized when the following indications are observed:
      1. An individual is unresponsive;
      2. The individual is not breathing;
      3. There are no signs of circulation;
      4. The individual’s weight is greater than 55 pounds; and,
      5. The individual is 8 years of age or older.
    2. The AED machine will NOT be utilized in the following special situations:
      1. If the individual is a trauma victim;
      2. If there is a direct pathway for the flow of electricity with any type of direct contact between the patient and the employee or any other person, such as an individual lying on a steel table or a handcuffed suspect with another person, etc.; or,
      3. In rain or standing water.
        1. NOTE: Extreme caution should be used when using the AED with drowning victims
  5. Police officers or civilian personnel shall follow the instructions listed within the recorded operating message of the AED machine when it is used.
  6. If the AED detects motion during analysis, observe the following:
    1. If motion is detected, the motion detected and stop motion messages will be displayed and the motion detected, stop motion voice will prompt.
    2. Ensure that there is no contact with the patient during analysis.
    3. If motion is ceased within 20 seconds, analysis will continue automatically.
  7. Post Usage:
    1. Any time that an AED machine is attached to an individual, regardless of whether or not shock is delivered, it is considered to be an AED use.
    2. IMMEDIATELY after an AED has been utilized and after the patient has been taken care of, the officer must contact Dispatch and a supervisor.
    3. The employee shall ensure that an Administrative IBR describing the event and his/her actions is complete. If the administering employee is a civilian, he/she shall ensure that an officer completes the Administrative IBR.
    4. At any time there is a problem with an AED machine, a supervisor shall contact the Property and Evidence Unit to remove the machine from service.

 

Equipment and Maintenance

  1. All AED equipment and storage areas shall be kept clean and sanitary
    1. Employees shall use plastic bags, covered containers or compartments for storage of soiled supplies and used disposable items. Red or orange bags marked “Biohazard” shall be used for infectious waste.
    2. Bleach or a disinfectant solution shall be available for cleaning.
    3. Waterless hand‐wash is available.
  2. A first aid kit containing the following equipment and supplies will accompany each defibrillator in service:
    1. Pocket Mask or other CPR barrier device and
    2. CDC recommended protective gloves in quantities and size for all providers.
  3. A quarterly maintenance inspection shall be conducted on each AED machine in service. The Property and Evidence Unit will conduct the inspection of all AED machines. The maintenance inspection will include:
    1. Condition,
    2. Battery check, and,
    3. Function check (Machine will be turned on to verify verbal instructions and visual status).
  4. The inspection documentation shall be maintained by the Property and Evidence Unit.

 

Revision History

This policy supersedes the following archives policies:

None - New Policy