What is a PAD programme?

A Public Access Defibrillator Programme. This is the name given to a programme which places AED's (Automated External Defibrillators) in public places, with the aim of making AED's readily available to the public, teaching members of the public how to perform CPR and use the AED with the hope of saving lives in the community. PAD programmes also helps to raise awareness of Sudden Cardiac Death.

 The Irish Heart Foundation recommends that AED’s should be placed wherever people gather in larger numbers or where there may be an increased risk of Sudden Cardiac Death occurring. Areas would include hotels, golf courses, bus and rail stations, shopping centres and the like. Studies show that early intervention in the form of CPR and an AED can greatly increase the chances of survival of a Sudden Cardiac Arrest victim.

A PAD programme involves a group of people coming together to form a committee or group. This committee would then decide locations for AED’s, raise funds, get members of the community trained to use an AED and perform CPR. The programme should have medical oversight. There are countless communities all over the world who have implemented PAD programmes in their communities and many lives have been saved. Irishdefib.ie aims to bring these communities closer together, enable them to ask questions of each other and facilitate information sharing, making the benefit of their knowledge available to all.

Introduction

Before a community places a single Automated External Defibrillator in a public place, there are a great many decisions and choices to be made and a significant investment of time and money. There is also much that will need to be learned.

This section of IrishDefib.ie aims to give you an idea of the steps involved in getting a Public Access Defibrillation (PAD) programme up and running, documents are available to download where possible and there are links to relevant information where appropriate.

This is by no means an exhaustive list or even the very best option for you, we hope that with more users on the forum offering more opinions and as more programmes get up and running, a better overall programme will appear which will be of benefit to all users and all communities and more communities will achieve Irish Heart Foundation Heartsafe Community Status

 

Information and Education

There are many resources offering information on heart health and general well being, but the best place to start will always be the Irish Heart Foundation.

This is the national charity fighting stroke and heart disease; it is funded up to 90 per cent by public and corporate donations. The aim of the Heart Foundation is to ensure that every person living in Ireland will live a long, active and healthy life free from heart, stroke and blood vessel disease.

The Irish Heart Foundation has a wealth of information and we thank them for information which is referenced and repeated here, please follow the links.

Heart Health

Heart Conditions Explained

Sudden Cardiac Death (SCD)

The human heart has a built in electrical system that causes the heart to pump blood around the body in a regular pattern. If there is an interruption to this electrical pattern, enough blood cannot be pumped around the body. The victim faints and death will follow within minutes.

If this condition is treated quickly with an electric shock delivered by an automated external defibrillator (AED), normal heart rhythm can often be restored (the survival rates decreases by 10% per minute). A combination of CPR and use of an AED will give a victim a greatly increased chance of survival.

A SCD may be the first sign that the victim has had of a heart problem. In many cases, no definite cause of death can be found, even at autopsy. These deaths are thought to be caused by an arrhythmia and are labeled a Sudden Arrhythmic Death (SADS). Read more by following the links.

Sudden Cardiac Death

Cardio Pulmonary Resuscitation (CPR)

Download: Implementation of Sudden Cardiac Death Task Force Report (2006) Recommendations.

Form a Committee

What areas of your community would be beneficial to have as members? At the very least your committee needs:

A Chairman

Click here for more information on these roles

Other general committee members, for example, some committee have a local councilor as a member; consider business leaders such as the local Lions Club, Chamber of Commerce or Rotary or Club members.

Your community may already have good, knowledgeable and interested candidates for your committee such as the Order of Malta, Red Cross, Lifeboat Service or other such voluntary aid organization.

 

Legal Status

Decide a Legal Status for your Committee, you may decide not to do this, but if, going forward the legalities of this undertaking are a consideration, a "Company Limited by Guarantee" is a solid legal status.

This offers legal protection for the members for a number of reasons and is an inexpensive option. You may view and print the application form by CLICKING HERE.

This is recommended for a number of reasons:

 

Insurance

At the very least, if the committee has a legal footing, professional Indemnity Insurance is a must.

Later, when people are trained, some committees provide indemnity insurance for their trainees to take away some fears that are involved in the use of an AED. If your units are public access though, can you insure strangers or visitors who use your AED's?

 

Coverage

What is the area you desire to cover with your PAD Programme? This will require some discussion. In some areas, the electoral boundary seems like a reasonable option, but this is not always available for every community. Issues that require consideration are:

Who will be contributing to your programme?

What are the required distances between your AED’S?

What are the travelling times between AED's, on foot or otherwise.

What locations will give you a good spread of coverage in the community?

AED

What type of AED do you require? There are several types of AED available. The Irish Heart Foundation do not endorse any particular brand of AED, rightly so,

The IHF does have a consultation document on the subject though, which shows some recommended requirements for a public access defibrillator, such as ease of use, ease of upgrade etc. When you are comparing suppliers, this is a very useful document which will help you to compare the right features.

This is downloadable by CLICKING HERE and will require careful consideration.

Ensure you get quotations from a few suppliers and you may require that they demonstrate their model to you. It may be a good idea to delegate the task of choosing your AED to one or more members of the committee. Do not rush this decision.

 

Accessing the AED

How will you AED’s be accessed by responders. Again there are several options.

1 A “buddy system” whereby a telephone number is well publicised and well known in your community, in this system, if there is a cardiac event, the number is called and two responders go to the scene. This can be linked in with the 112 system over time, subject to certain criteria which we will address at a later date.

2 You could have your units placed in local businesses, who have trained responders on site. The onsite or other responder retrieves the AED when there is an emergency.

3 Responder Access. Your AED’s are placed in cabinets at various points around the community. Your trained responders know how to open them in an emergency. They may be given a key or a code for a combination lock at training.

4 Public Access. Your AED’s are placed in cabinets at various points around the community. The cabinets are accessible to the public and any passerby as the cabinet is unlocked.

Secondly, the key to the cabinet could be placed in a break glass unit attached to or near the cabinet for accessing the cabinet at any time of day or night.

Thirdly, the cabinet can be fitted with safety glass. Break the glass and take the AED. Safety glass is the same as the windscreen of a car, on impact it shatters into tiny fragments that will not cause serious cuts or lacerations.

This method holds the obvious risk of theft or misuse of the AED. Insurance for this means of access is very uncertain at the time of writing; we will address this matter again in the short term.

 

Fundraising

This could be started at any time but once you know your desired locations and the number of AED’s, cabinets and other equipment you will be in a position to look at quotes and cost your project.

Communities have been very creative when it has come to this option, this has included:

Race Nights

Table Quizzes

Fun Runs

Phones for Fibs

The opportunities here are endless.

 

Training

What is the training standard you require, there is more than one course available.

Heartsaver AED: This is an Irish Heart Foundation Certified, four hour course that teaches candidates the essential steps involved in using an AED and how to perform CPR. It is a video led, skills based course that is suitable for all. Certificates are valid for two years.

It is a good way to train a good number of people in a short time. You could then choose to up your training level when it comes to time for refreshing skills in two years time.

Cardiac First Response: It is envisaged that over the next 2 to 3 years the PHECC CFR Standard will become the convention nationally. This is a one day course which is recognized by the relevant bodies and teaches candidates the essentials of CPR, AED, Choking and the recognition and treatment of Stroke.

Instructors: You may wish to hire instructors to train your candidates in CPR and AED use. Check first to see if you already have instructors in your area that may be willing to assist.

It might be a good idea to investigate what it takes for a member of your community to become an instructor. This is a relatively straightforward process and is very rewarding for the right candidate. This will prove to be an extremely cost effective means of training larger numbers as time passes. More than one instructor in your community is certainly possible.