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HomeMy WebLinkAboutItem 8.1 Defibrilliation ProgramG~~.l OF Dp~~'G 19' . . ~' -~ `82 `~~~~~ 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. ~ „ -~_.~_ ._ ~ ( G _----- 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 ~~~ ~ ~,,; 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 _ ~ - ~- ..~ ~ , _ ~ . ~ ~__ _ _ _ ~_- _ _ 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: g.l Il-1(a-IO ATTACHMENT 1 ~~ ~ .+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. 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 ~ y y n ~~ x ~ ~ z -~ y N