Lifesaving Resources Inc.

In October 1993, the American Heart Association appointed the Task Force on Automatic External Defibrillation. The task force was charged with conducting a conference on automatic external defibrillation, evaluating research needed for broader community use of automatic external defibrillators, and overseeing evaluation of the feasibility and desirability of their use by healthcare professionals and the lay public. In December 1994, a conference on public access defibrillation was held in Washington, DC. More than 300 persons attended, representing science, industry, the healthcare professions, law, and the federal government. During the meeting the participants reached a consensus on the general proposition of greater public access to defibrillation and the need for broad-based clinical research, public and professional education, and legislative reform. improving emergency cardiac care Following the conference, members of the task force, with input from others in the field of emergency cardiac care, wrote this statement, which was approved by the AHA Board of Directors in June 1995. Early bystander cardiopulmonary resuscitation (CPR) and rapid defibrillation are the two major contributors to survival of adult victims of sudden cardiac arrest. The AHA supports efforts to provide prompt defibrillation to victims of cardiac arrest. In public access defibrillation, the technology of defibrillation is accessible to the community Automatic external defibrillation is one of the most promising methods for achieving rapid defibrillation. In public access defibrillation, the technology of defibrillation and training in its use are accessible to the community. The AHA believes that this is the next step in strengthening the chain of survival. Public access defibrillation will involve considerable societal change and will succeed only through the strong efforts of the AHA and others with a commitment to improving emergency cardiac care. broad public support Public access defibrillation will include: Performance of defibrillation by laypersons at home and by firefighters, police, security personnel, and non-physician care providers in the community. Exploration of the use of bystander-initiated automatic external defibrillation in rural communities and congested urban areas where resuscitation strategies have had little success. The AHA can also play a major role by: Increasing public awareness that defibrillation improves the rate of survival from an often-fatal condition that each day affects 1000 Americans. Ensuring that objective, current research data are used to guide implementation of these changes in performance and teaching of CPR. Working with medical manufacturers, legislators, and governmental agencies to promote safety and efficacy, reduce cost, and update training requirements to facilitate implementation of public access defibrillation. Broader use of automatic external defibrillators should also lead to readiness tests and features that deter both misuse and misapplications. Meaningful change will occur only with the broad public support that has traditionally characterized the AHA’s efforts in the fight against heart disease and stroke.

Responding to Cardiac Arrest calls during the Coronavirus pandemic has required First Responders to modify protocols to reduce risk to responding personnel while providing lifesaving care to patients. Throughout this COVID-19 pandemic, Lifesaving Resources will continue to update best practice protocols for EMS, Fire, Law Enforcement, Lifeguards and other responding personnel. As scientists and medical teams continue to research the COVID-19 Coronavirus, new information is frequently released regarding the spread and effects of the virus. It is critical that all actions and protocols by rescue personnel are based on facts, and that these protocols are modified as needed when additional information is released. Risk of transmission Currently this is what is known about COVID-19 and the risk of transmission to First Responders (i.e. EMS, Fire, Law Enforcement, Lifeguards, etc.): SARS-CoV-2/COVID-19 can be spread by aerosolized particles. Certain procedures may either generate or expose First Responders to those aerosolized particles. Airborne precautions and proper PPE in the form of goggles, gown, gloves and an N95 mask or equivalent respirator are highly protective, even in the face of exposure to COVID-19 patients. In addition to proper PPE, the focus of social distancing and limiting the number of First Responders attending to a patient should be followed, whenever possible. Important fundamental facts surrounding the management of patient suffering out-of-hospital cardiac arrest (OHCA), including: The most important therapy provided to patients suffering from OHCA is high-performance CPR (HPCPR). HP-CPR includes compressing at the proper rate and depth, allowing for adequate recoil and minimizing interruptions. Effective management of OHCA Based on known risks of COVID-19 transmission and what is known regarding the effective management of OHCA, the following recommendations should be followed when caring for a patient with OHCA during the COVID-19 pandemic: PPE is the most protective measure First Responders can take when caring for an OHCA patient. PPE should be worn in all cases of OHCA. CPR, assisting ventilations, inserting airways, and suctioning are all aerosol-generating procedures. N95 masks (or equivalent) as well as gowns, gloves, and eye protection, are essential prior to the management of these patients. While CPR is being performed, please limit the number of First Responders to those absolutely necessary. First Responders should establish a 6-foot distance from the patient when not performing procedures. If available, consider changing chest compressors every 2 minutes to reduce individual provider exposure during CPR. If available, place a HEPA filter between the BVM and airway device. Place the filter as close to the patient as possible. Minimize any disconnections between the HEPA filter and the patient. Lifesaving Resources recommends placing a clear plastic shroud over the patient’s head and neck while performing all airway management techniques and the administration of positive-pressure ventilation. This strategy reduces the risk of ongoing exposure to First Responders.

There is no evidence that the virus that causes COVID-19 can be spread to people through the water in pools, hot tubs, spas, or water play areas. Proper operation and maintenance (including disinfection with chlorine and bromine) of these facilities should inactivate the virus in the water. Ensuring health and safety While there is ongoing community spread of COVID-19 of the virus that causes COVID-19, it is important for individuals as well as owners and operators of these facilities to take steps to ensure health and safety: Everyone should follow local and state guidance that may determine when and how recreational water facilities may operate. Individuals should continue to protect themselves and others at recreational water venues both in and out of the water – for example, by practicing social distancing and good hand hygiene. In addition to ensuring water safety and quality, owners and operators of community pools, hot tubs, spas, and water play areas should follow the interim guidance for businesses and employers for cleaning and disinfecting their community facilities.