Maintaining a Cardiac First Response Programme
While we are developing a Cardiac First Response Programme
including defibrillation, it should be remembered that even in a well-targeted, structured programme, the defibrillator may never be needed. Furthermore, on the rare occasion that it is used, the life may not be saved, not due to shortcomings of the programme or the individual but due to an underlying medical condition. This may be a difficult situation for the ‘responder’ and the community to come to terms with. This is why it is important to include plans for debriefing after an event in any programme procedures.
Another issue that will need careful consideration by the group will
be how to manage long term motivation, especially if there are no
incidents to respond to over a long period of time. This can lead to
a situation where the community becomes de-motivated, de-skilled
and loses interest in the programme. There is a danger that when an
event then does occur, no one is willing or able to respond. To help
motivation and also for the longer term benefit of the community,
we recommend that your group adopt a broader approach to heart
health, rather than focusing solely on the management of an acute
cardiac event. A community approach to heart health promotion
will complement the focus on managing cardiac events and will help
maintain long term motivation.
You will also need to consider the ongoing costs of your programme,
particularly regarding training and re-certification.
It is important that the programme is well-managed, with clear
protocols and procedures. We would recommend that a small group
is established to manage and administer the programme. This group
should take responsibility for ensuring that the programme has well
documented procedures.
These procedures should cover areas such as:
-Group membership and recruitment
-Training
-Role of the cardiac first responder
-Code of conduct
-AED selection, site and maintenance
-Equipment - checks and restocking
-Disposal of clinical waste
-Responding to a call and vehicle use
-Communication and mode of activation
-Audit and incident reporting
-Medical direction of the programme
-Complaints/adverse events
-Debriefing after an event and post-event follow up
-Insurance and liability