HomeMy WebLinkAboutItem 8.1 Defibrilliation ProgramG~~.l OF Dp~~'G
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`~~~~~ STAFF REPORT C I T Y C L E R K
`c~~L1~~`~~ DUBLIN CITY COUNCIL File # ^~00^-~~
DATE: November 16, 2010
TO: Honorable Mayor and City Councilmembers
FROM: Joni Pattillo, City Manager
SUBJEC : Feasibility of Public Access Defibrillation Program
Prepared By: Demetrious N. Shaffer, Deputy Fire Chief and Bonnie Terra, Fire
Marshal
EXECUTIVE SUMMARY:
The Dublin City Council established a Fiscal Year 2009-2010 Goal to "study the feasibility of the
City establishing a process that would require business participation in the Alameda County
Public Access Defibrillation (PAD) program". Staff has researched the topic in an effort to
determine if other jurisdictions have required participation in established PAD programs, to what
extent state and local laws may impact such PAD program participation in Dublin, and the costs
(at a cursory level) associated with a program. Staff is seeking further direction from the City
Council on this item.
FINANCIAL IMPACT:
The financial impact to the City would be minimal and primarily realized in staff time necessary
to develop the program. However, the fiscal impact to the local business may be high
depending on the size of the facility and number of employees that will need to be trained. It is
estimated that the initial purchase including the Automatic External Defibrillator (AED),
cabinetry, training, and maintenance is approximately $3,500 to $4,500. Continuing education
and medical oversight will require a more in-depth analysis to determine the fiscal impact as
these costs depend on vendor prices and negotiated terms. However, Alameda County
Emergency Medical Services (EMS) identifies that costs can be reduced or offset in some
cases depending on the availability of grants.
RECOMMENDATION:
It is recommended that the City Council direct Staff to develop an outreach program with the
goal of educating new and existing businesses within Dublin of the County's PAD program and
to return to the City Council with the results of a comparative review after one year to determine
program outcomes. ~ „
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Submitted By viewed y
Deputy Fire Chief Assis nt City anager
Page 1 of 4 ITEM NO. • ~ ~
DESCRIPTION:
As part of the 2009/10 Fiscal Year Goals and Objectives, the City Council directed staff to study
the feasibility of the City establishing a process that would require business participation in the
Alameda County PAD program (Goal IV-C-3).
Background
The Alameda County PAD program was established to provide a standardized mechanism and
set of controls for the placement and use of AEDs within the county. The goal of the program is
to participate actively in strengthening the links in the chain of survival (Attachment 1).
Ultimately, Alameda County Emergency Medical Services (EMS) believes that by making AEDs
more readily available throughout the county more lives can be saved.
Data suggests that the more AEDs (with people trained to use them) located throughout a
community can increase the chance of survival for a person suffering from sudden cardiac
arrest. In fact, studies have shown that every minute that passes wherein these patients do not
receive defibrillation the chance of survival decreases by 7% to 10%.
There are approximately 2,100 calls for service within Dublin each year, of which, approximately
1,350 are medical in nature. However, a very small percentage of these incidents involve a
patient presenting with symptoms where an AED would be indicated. Since the location of a
patient that may be saved by the use of an AED is unknown, the more readily available devices
are throughout Dublin the better chance one will be available near a patient in need.
Currently, the City of Dublin has placed AEDs inside City Hall, Police Services, the Library, the
Swim Center, the Senior Center and the Shannon Community Center, and trained
approximately 75 City employees (not including Dublin Police Services). Overall there are over
20 sites within Dublin that have reported AED installation and training (Attachment 2). County
EMS has stated it is likely there are additional AEDs that have not been reported. Some sites
within Dublin that have AEDs include Carl Zeiss, Sybase, various fitness centers, Palo Alto
Medical Foundation (which has 3 units and approximately 56 people trained), and County Office
of Emergency Services (OES) and training facilities. County EMS is the agency responsible for
tracking these sites through the PAD program to ensure all requirements are met.
Requlatory Requirements
Health & Safety Code Section 104113 and Title 22, Division 9, Chapter 1.8 identifies the legal
requirements for a business that wishes to deploy AEDs. Alameda County provides the
following list of requirements that all agencies (including the City) must follow:
• Have a medical director to provide medical oversight (AEDs are regulated by the
Food and Drug Administration (FDA) and require a written prescription from a
physician)
• Have a written response plan
• Ensure employees receive initial training (and recertification every two years) in
CPR/AED (per the American Heart Association or the American Red Cross) and
the response plan
• Maintain and test the units
• Have no less than one trained employee available during normal business hours
• Notify the County of the AEDs being placed
Page 2 of 4
As identified, County EMS is the agency responsible for administration and enforcement of the
AED program within Alameda County. However, according to County EMS there is minimal staff
assigned to administer the program and there are no legally identified remedies if a business (or
other) does not meet the regulatory requirements identified above.
Given these facts, it does not appear that County EMS currently has the capacity to enforce an
additional program required by the City. As opposed to creating a new requirement for business
participation in the County's PAD program, Staff believes that partnering with the County to
increase knowledge of, and participation in, the existing program is a viable first step toward
increasing the number of PADs throughout the Dublin community. This outreach program could
be included in packets provided to new businesses when a business permit is pulled and sent
to existing businesses in coordination with the Chamber of Commerce. Businesses wishing to
participate would then work with County EMS for program implementation.
Proqram Implementation
County EMS provides the following list of steps an organization should take to implement a
PAD program:
1. Identify an AED/PAD coordinator within the company
2. Do a site assessment for AED placement (considering less than a three minute travel
time to any device with at least one per floor)
3. Find a medical director to oversee the program
4. Develop an Emergency Response Plan (free templates are available for download
through County EMS)
5. Select a training organization to provide training to employees in the use of an AED and
in CPR
6. Choose an AED including cabinetry signs and a fast response kit
7. Develop a plan of ongoing training and AED checks
8. Notify Alameda County EMS to integrate the AED location into the local EMS system
9. Inform and train employees
Additional information on the PAD program and the above implementation steps can be found
at http://www.acqov.orq/ems/ems PAD.htm
Additional Information
In December of 2008 the City of San Diego, California adopted a PAD Ordinance requiring
development of certain occupancy types and sizes to comply with the City's AED requirements.
However, this program differs from that being studied by Staff in that San Diego's Ordinance is
a complete program as opposed to a requirement to participate in the County's PAD program.
Currently, there are no cities within Alameda County that have a mandatory AED program of
either type.
After analyzing other programs that have already been implemented and considering existing
City processes, Staff has determined that implementation within the City of Dublin is feasible
but not recommended at this time. The benefits of a mandatory PAD program would be an
increased number of AEDs available for use within Dublin. However, the requirement would
represent an increased cost to new businesses looking to open in Dublin. Additionally, the
infrastructure and support (primarily within City staff and County EMS) is not currently in place
to support required PAD program implementation.
Page 3 of 4
Possible Next Steps
If the City Council directs Staff to develop a Public Access Defibrillation outreach and education
program for new and existing businesses, the following next steps will be taken:
l. Staff will develop, in coordination with County EMS, a PAD program education/outreach
campaign for new businesses.
2. Staff will work with the Chamber of Commerce to tailor an education/outreach program to
educate existing businesses on the County's PAD program.
3. Staff will develop a set of criteria to track and subsequently review at the end of a one-
year trial period in an effort to determine the effectiveness of outreach efforts.
4. Staff will report back to the City Council after a one-year trial period with program results
and possible ne~ steps.
NOTICING REQUIREMENTS/PUBLIC OUTREACH:
Noticing not required at this time.
ATTACHMENTS: 1. Informational Brochure on current Alameda County PAD
program
2. Chart including AED locations and number of personnel trained
Page 4 of 4
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The Case for AEDs
(Information Provided by Alameda County EMS)
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
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Early Notification~Early CPR~-Early Defibrillation~-Early 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:
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ATTACHMENT 1
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.+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
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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.
AED Locations in Dublin
(lnformation Provided by Alameda County EMS)
Companv Address Facilitv Tvpe # of Personnel Trained # of AEDs Unit Locations
Carl Zeiss Meditec 5160 Hacienda Dr. Business 10 1 Bld 1, across from cafeteria
Carl Zeiss Meditec 5160 Hacienda Dr. Business 12 1 En ineerin /Marketin area
Carl Zeiss Meditec 5875 Arnold Dr. Business 10 1 Bld 2, inside south entrance on ri ht side
Dublin Civic Center 100 Civic Plaza Cit 25 1 On wall next to Chamber ent door
Dublin Cor oration Yard 5600 Scarlett Court Cit 10 1 On wall outside cor oration ard structure
Dublin Libra 200 Civic Plaza Cit 3 1 In entrance lobb next to ublic tele hone
Dublin Police Services
Dublin - Shannon Comm Ctr 100 Civic Plaza
100 Civic Plaza, Ste PECS Cit
Cit 2
10 2
1 Inside main lobb securit door & in fitness center
Communit Center
Dublin Senior Center 7600 Amador Valle Blvd. Cit 4 1 Hallwa wall ast main rece tionist desk
Dublin Swim Center 8157 Villa e Parkwa Cit 21 1 Staff office wall b first aid cabinet
Curves for Women 7282 San Ramon Blvd. Health club 4 1 Front rece tionist desk
DDI 4160 Dublin Blvd, Suite 450 Business 5 1 Mid-office b co ier
Fitness 2000 7373 Villa e Parkwa Health Club 4 1 Front desk
Palo Alto Medical Foundation 4050 Dublin Blvd. Medical office 56 3 1 st, 2nd and 3rd floors
S base
Taleo Cor . One S base Drive
4140 Dublin Blvd. Business
Business 13
10 5
1 Bld A 1 st & 6th flrs, bld B 1 st & 6th flrs, MLG
Kitchen
Technolo Credit Union 7444 San Ramon Blvd. Business 2 1 Ground floor inside break room
Dublin Police Services 100 Civic Plaza Cit ACSO Personnel 2 Police Services
Sheriffs De t 5325 Broder Blvd. ALCO Sheriffs ACSO Personnel 25 Santa Rita
Sheriffs De t 4985 Broder Blvd. ALCO Sheriffs ACSO Personnel 1 OES
Sheriffs De t 4985 Broder Blvd. ALCO Sheriffs ACSO Personnel 3 OES Rescue Unit
Sheriffs De t 6289 Madi an Rd. ALCO Sheriffs ACSO Personnel 3 Re ional Trainin Center
Sheriffs De t 6289 Madi an Rd. ALCO Sheriffs ACSO Personnel 1 Ran e
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