In the same way that CPR has become a skill that thousands of lay people have learned, the skill sets for using an AED can be easily taught. Most machines are very user friendly-some models use only simple pictures to demonstrate how to use the machine.
The most common statement by those who have used Automatic External Defibrillators (AEDs), in whatever the setting, is, "It does save lives." As AEDs become more commonplace in business and public places, we in EMS hope to see more lives saved. The life you save could be one of your own.
We welcome your interest and participation and will do everything possible to help you make an informed decision about establishing a PAD Program.
 The Case for AEDs
Cardiac Arrest
Sudden cardiac arrest (SCA) claims about 350,000 American lives each year. In most cases this event occurs due to ventricular fibrillation, an abnormal heart rhythm that causes the heart muscle to fibrillate or quiver in a chaotic motion. If left untreated, this condition leaves the heart muscle unable to pump blood and death occurs within minutes. Because sudden cardiac arrest is one of the leading causes of death in our nation, it is a major public health problem.
Statistics show that less than 5% of those who experience cardiac arrest outside of a hospital will survive. Defibrillators, however, have been shown to boost a person's chances of survival when used immediately. Data from studies of lay rescuer defibrillation programs in public locations that show the highest survival from sudden cardiac arrest occurs when the arrest is witnessed and when bystanders provide immediate CPR and defibrillation within three to five minutes of the arrest.
PAD in Action
Employees of the NUMMI Toyota plant in Fremont have first-hand experience in the benefits of a PAD Program. Over the course of two years, two assembly line workers have experienced cardiac arrest while working. In any other company, they might have died. However, at NUMMI, their co-workers were trained in the use of an AED and promptly applied the AED pads, and let the machine analyze the rhythm and shock the employee back to a life sustaining rhythm. Both employees are back at work, with no health deficits, thankful they work at a company that supports PAD. Two arrests-two saves!
Chain of Survival
Early Notification Early CPREarly DefibrillationEarly Advanced Life Support
Who is at Risk? - Sudden Cardiac Arrest (SCA) is unpredictable. Although the average victim is about 60 years old, SCA can affect anyone, regardless of their age, race, or gender. However, according to the National Center for Early Defibrillation, some conditions can put people at greater risk for SCA including:
 Age greater than 40 (men)
Post-menopausal status (women)
Inactive lifestyle
High blood pressure
High cholesterol
Diabetes
History of heart disease (either personal or in the family)
Unfortunately, SCA can affect children as well as adults. Some causes of pediatric SCA include SIDS, trauma or accident (e.g., electrocution, drowning, overdose/ poisoning), illness, and congenital heart disease. A hard blow to the chest (such as with a baseball) can also trigger cardiac arrest.
How AEDs Work
Highly sophisticated AEDs that are accurate, inexpensive and virtually maintenance-free enables their use in the home, workplace and public buildings. An AED is a device used to treat a patient with cardiac arrest whose heart is beating irregularly (fibrillating). If the heart does not return to a regular rhythm within 5-7 minutes, this fibrillation could be fatal. To stop the fibrillation, an AED is used to administer an external electric shock through the chest wall to the heart with the use of conductive adhesive pads. Built-in computers analyze the patient's heart rhythm, and interpret the rhythms that require defibrillation shocks. Audible and/or visual prompts guide the user through the process. Most AEDs require an operator to initiate the delivery of the shock in some way, such as pushing a button.
In order to have AEDs available more quickly for the persons who need them, some facilities (such as hotels, airports, and country clubs) are purchasing these devices under what is called a Public Access Defibrillation (PAD) program. However, since AEDs are prescription devices and must be labeled with the prescription statement required by law (CFR 801.109), a physician who oversees the PAD program at a facility must write a prescription for the AED in order for the facility to purchase it.
Public access refers to accessibility for trained users to use AEDs in public places. Public access does not mean that any member of the public witnessing a sudden cardiac arrest should be able to use the device. AEDs are to be used only by individuals with the proper training and certification in accordance with state and local laws.
Good Samaritan Protection
Since 1990, our county has had a successful First Responder Defibrillation Program. Now with the Good Samaritan Laws that give critical protection to the AED trainer, the prescribing physician, the AED owner, and individuals who use an AED in rendering emergency care, Alameda County EMS will be providing information for greater public access to defibrillation. Our goal will be to participate actively in strengthening the links in the chain of survival in our county by providing a resource packet for laypersons, corporations, work sites, and prescribing physicians with the information necessary to implement PAD programs.
Establishing a Program
Components of a PAD Program
A company deciding to implement AEDs into their health and safety program
A prescribing physician that oversees the program
A training organization that trains
Employees of the company in the use of an AED and CPR
Integration of the program into the local EMS system
A plan of ongoing training and AED checks
Projected Annual Costs - An estimate of projected annual program costs can include the following:
Devices (about $2500.00 per unit; divide initial cost by the projected life, usually five years)
Peripheral equipment costs (about $75 per device)
Maintenance (about $100 per device)
Insurance (variable)
Training costs (variable: includes personnel and equipment)
Program management costs (variable)
Event documentation costs (variable)
Quality assurance tools (variable)
Community-wide CPR training (variable)
There are organizations and companies that assist determining an appropriate AED model for your business and in setting up all or some of the above elements of a PAD program for free or for a fee.
How You Can Help - If you would like more information on how to establish an AED program for your business or agency or if you would like to help make the County of Alameda a safer community contact John Vonhof (PAD Program Coordinator) at (510) 618-2038.
Submit PAD Application to EMS 
Site information given to Alameda County EMS
EMS passes information to local Fire Department
Fire adds the information to the 9-1-1 / Emergency Medical Dispatch database
Prescribing Physician has a positive role in the placement and use of an AED in Alameda County. The following program points outline this role
1. Understand the Legal Requirements
A prescribing physician means a physician and surgeon, licensed in California, who issues a written order for the use of an AED. The prescribing physician may affiliate with a training program or may work directly with an agency, business, organization or individual who purchases an AED.
A PAD program must meet the requirements of the California Code of Regulations, Title 22, Section 1797.196 of the Health and Safety Code Section 3 & 4, and Section 1714.21 of the Civil Code Section 2, and local policies. The prescribing physician retains the responsibility to assure that the PAD program meets these requirements. Registration packets are available online or by mail.
2. Develop Medical Oversight
The prescribing physician is involved with the agency, business, organization or individual in developing an Internal Emergency Response System. An Internal Emergency Response System is a plan of action which utilizes responders within a facility to activate the "9-1-1" emergency system, and which provides for the access, coordination, and management of immediate medical care to seriously ill or injured individuals.Ensures compliance with regulations and requirements for training, notification, and maintenance,
Assures a mechanism for the continued competency of the authorized individuals in the AED Service Provider's employ to include periodic training and skills proficiency demonstrations.
3. Complete PAD Program Forms
Submit PAD Application to EMS
Register to become a prescribing physician 
4. Ensure that AED usage is reported to the EMS Agency
When an AED is used, the paramedics will complete the Utstein form to record relevant data tracked by Alameda County. This information is passed along to the state for tracking cardiac arrest outcomes between EMS systems.
If a cardiac arrest happens at your AED site, please work with the EMS responders to provide the necessary information.
5. Understand Title 22 AED Regulations (February 12, 2003)
6. List of approved PAD Physicians
AED Vendor, and Consultant & Training Organizations List
AED Vendor List - There are presently seven companies in the United States that manufacture AEDs. All of these companies have devices that are currently available. All AEDs on the market have been cleared by the Food and Drug Administration and thus are considered safe and effective.
AED Consultant & Training Organizations The following organizations have notified us that they provide program development and / or training in the use of AEDs. Many of them also offer on-going maintenance and access to prescribing physicians). You are encouraged to independently evaluate these organizations to determine which one offers the type of services that fits your needs.(includes links to consultants/trainers)
The Alameda County EMS Agency does not endorse any specific consultation or training organization.
PAD | AED links
American Heart Association
Sudden Cardiac Arrest Association
Initial Life Support Foundation
National AED Registry
Alameda County EMS Disclaimer and Contact Information: Disclaimer: Alameda County and its departments, divisions, sections and units, while strongly supporting the concept of PAD Programs, do not endorse any specific PAD programs, AEDs, consultants, or training organizations. Contact Information:
Alameda County EMS Agency
PAD Program Coordinator
1000 San Leandro Blvd., Suite #200
San Leandro, CA 94577
Phone: (510) 618-2038
Fax: (510) 618-2099
images from the AHA website |
