Defibrillators in Rugby
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We want a defibrillator !
But how should we go about this ?
Yes … we have raised the funds and want a defibrillator . We know that these are life saving pieces of equipment and more should be made available . However , they are also medical devices and are subject to special guidance . Just buying a defibrillator is not enough . We need to understand that there has to be significant governance behind defibrillators to ensure liabilities are addressed . Cost is not the issue . So how should we address this ?
( 1 ) The Defibrillator – in common use , robustness and simplicity are key . The defibrillator will most likely be used by untrained members of the public , and so the defibrillator chosen should be easy to use , robust ( to withstand knocks ), cost effective to run , reliable , and easily recommissioned after a rescue . Do not be tempted by gimmicks , or ‘ offers ’ of cheap or reconditioned equipment . There is no short cut when you are dealing with people ’ s lives . In simple terms can the device be used by someone hard of hearing , visually impaired , colour blind or does not speak English well , or just panicking ? Can the device show good visual commands as well as audio ? Can it cope with people of all sizes and shapes ?
( 2 ) Storage – The defibrillator should be easily accessible , and not behind locked doors . Ideally , if inside , a wall rack or indoor cabinet . Outside this has to be a heated cabinet , IP65 , disability compliant and ideally low voltage ( 12-24v ). A defibrillator cabinet is not just a box with the word ‘ defibrillator ’ on . It has to meet disability and discrimination laws and carry the correct and appropriate symbology to clearly identify it as a recognised medical device .
( 3 ) Governance – Governance is key to ensure all liabilities and risks are mitigated . Governance must include regular checks on the equipment in line with the manufacturers recommendations ( weekly / monthly / annual ) but also the entire provenance of the equipment and its storage . The Department of Health ( April 2014 ) recommended that any defibrillator scheme must comply with basic governance which includes :
• a correct and proper regular checking mechanism reported via a centralized system ,
• regular maintenance records ,
• initial installation records ,
• ambulance notification certification and confirmation ,
• in / out of usage reporting ,
• recommissioning ,
• data protection policies ,
• health and safety for the community policies ,
• post rescue counselling service to be available ,
• investigation requests
• policy and mechanisms of operation , and be able to report these to the authorities if required .
CHT provides the WebNos Governance system and the National Defibrillator database , for all sites , even if not supplied via CHT .
( 4 ) Training – Despite defibrillators being easy to use , training is always advised , done correctly and appropriately for the audience . This should cover not only the defibrillator usage and CPR , but also understanding the physiology of a cardiac arrest , how to recognise one , how is your defibrillator activated , and the importance of activation radii , recommissioning the defibrillator , the governance of the local scheme and what to do in the event something goes wrong . These sessions are about building confidence and removing fear .
( 5 ) Duty of care – remember . You are responsible for the safety and duty of care of members of the public . Make sure you have appropriate Public Liability insurances in place that are suitable and designed for defibrillators .
Lots to think about , but if you do need help , charities such as the Community Heartbeat Trust are working with you to help undertake these types of projects correctly and safely . www . communityheartbeat . org . uk
24 Issue 67