AED EVENT FORM. Training notes. Background: Accessing the forms: Using the data: AED Event Form training notes V1.2

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1 AED EVENT FORM Training notes Thank you for adding The University of Warwick s AED event form to your training plan. We would appreciate your assistance in mentioning the web based collection form at the end of your training presentations within the what to do next section, when an AED has been activated and used and the patient has been handed over to the ambulance crew. Background: The Resuscitation Council (UK) has been collecting Automated External Defibrillator (AED) use data since 1999 and published initial results in 'Resuscitation '. The Council has published a further report, covering the latest analysis of almost 3500 reports. Out-of-hospital cardiac arrest is a priority for the Resuscitation Council. It has therefore, established a national out-of-hospital database with the British Heart Foundation and Association of Ambulance Medical Directors in partnership with The University of Warwick. This web based event form will capture the data where a public access AED has been used before the arrival of the ambulance crew. This data will then be added to the ambulance service information held for each case to improve the data quality and completeness of the patient s pre-hospital care. Accessing the forms: The new web based portal can be accessed by any internet abled device using the URL which will direct the operator to a web based form used for collecting the appropriate data via a series of simple questions. It is envisaged that a QR code sticker displaying the web site link will be placed onto every AED in order to direct operators via a smart phone when they scan the appropriate QR code to the same web site, and complete the form straight after the ambulance has left. Ideally the AED operator should complete the web based form as soon as possible, however some people do not have access to the internet, and so a paper based form has been created and attached to the end of these notes for use. This paper based form can then be used to transfer the data via the Community Response Manager of the supporting ambulance service, or by any nominated person who has access to the internet. Using the data: Once your information has been imported, it will be matched to the data provided by each Ambulance service to complete the data set for each case. It is therefore, important that you are as accurate as possible with the information you provide in order to improve the ability to complete the match. With all of this data, we want to be better able to understand where and why people have a cardiac arrest, and what system of care provides the best outcomes for patients in those environments and to create more understanding and recommendations for best practice to influence future changes in pre-hospital care provision.

2 AED EVENT FORM The form s Elements Date. The statistical team require the date of the cardiac arrest and not the date of importing the data via the internet. This date will be case matched to the ambulance service s data stored at The University of Warwick to complete the data for each patient. You will be provided with a drop down menu that will automatically show the current date. You can scroll backwards or forwards by clicking the < or > arrows for one month, or << or >> arrows to scroll by one year. When using the paper based form, ensure you fill in the date in the English format of DD/MM/YYYY Any cases without a correct date format will be invalid and not be matched Time of call This time is the time that you were made aware of the cardiac arrest. This may have been a call from the Ambulance Service, or a shout for help from a member of staff/public in your place of work. Please use the 24 hour clock to add your time, for example Placing of Pads Many times the AED may be brought to a patient who is unwell, but not in cardiac arrest. We are only interested in cases where the patient is not breathing; the pads were opened and placed onto the patient even if no shock was advised. Time of Pad placement There is a direct relationship between the time of cardiac arrest and time of initial shock. The shorter the time delay the greater the chance of saving the patient s life. There will inevitably be a delay between the time you get the initial call to the time the pads are placed onto the patient. Please provide your best estimate of the time the pads made contact with the patient for example If you don t know, please insert Unknown. With this ongoing information we can understand the relationship of down time and compare it with the other factors that relate to the initial cause of cardiac arrest and the quality of life from surviving patients. Location The location of the cardiac arrest has a great impact on an individual s chance of survival. We want to understand more why this is, and better recognise where AEDs are required to give the greatest chance to those patients who were not expected to have a cardiac arrest, and therefore have a greater chance of surviving. We will look at each patient s history to predict why they had an unexpected arrest, and if the location demonstrates trends that we can use to improve the future provision of care. The form provides a list of options, please choose one option that best fits the location of the event you wish to report. Street/Highway Industrial/Workplace Public Building Shopping Mall Airport Rail Station Home/Residence Assisted Living/Nursing Home GP Surgery Educational Institution Underground Bus Station Sports/Recreational Golf Course Gymnasium Sports Event

3 Postcode We require the postcode of the cardiac arrest incident which might not be the same as the postcode of the storage location of the AED when not in use. This information will help to match the incident case with the ambulance service data which will be imported later. Shock delivered? This simple question will provide the project with very valuable information about the patient s condition. We will now know the type of rhythm that the heart was in when your AED analysed the patient. This will be crucial when understanding why there is variation in survival Was it successful? We understand that the term successful can be interpreted differently by lay people responding to a patient. If you no longer need to provide chest compressions, then you can be confident the shock has been successful. You may see signs of the heart working by itself if you see the patient is: breathing by themselves at a regular rate pinking up of the skin coughing and spluttering movement of the arms and legs AED scheme types The setting of your AED device will be part of one of these types of scheme. Public Accessible Defibrillator sites PAD sites are places in the community where an AED can be taken off the wall by anyone and used on a member of the public, regardless of who owns or is trained to use the device. Community First responders (CFRs) CFRs are volunteers who have been trained and called by the ambulance service to attend a 999 call somewhere in the community. Operating Ambulance Service Wherever your location, you will be covered by one of the Ambulance Services. You will be given a drop down list of options to choose from, and if you are unsure, there is also a I don t know choice. You re Comments We have provided a comments box, for any additional information you feel appropriate. Your address By giving us your address, you are providing permission for The University of Warwick to pass on your contact details and data you have entered to the appropriate ambulance service and the British Heart Foundation. If you are a Community First Responder, then the ambulance service will already know about you, however they are keen to be able to audit how often, when and where CFRs are being utilised. If you are a Public Accessible Defibrillator site, then this information will be checked against the list held by the ambulance service and British Heart Foundation. If you re not already listed, they will then get in touch via your provided address to arrange your full details to be added. Required data Any data elements marked with an * are required data that must have some information entered to be able to submit the information on line. The option of unknown is available within these elements if required.

4 Frequently Asked Questions AED EVENT FORM Where do I get the forms from? The form is web based, and can be freely accessed from the web link There is a paper based version attached at the end of these training notes for AED operators who do not have access to the internet. The paper based form must then be inputted via the internet based form on their behalf by a nominated person such as their scheme coordinator or Community Response Manger based at the regional ambulance service. Do I have to fill this form in? No. It s voluntary, however the more information we receive, the more accurate our future research will be. Who gets the information? The University of Warwick receives all the data collected from this form. Here it will be summarised, analysed and reports distributed to approved research groups. The Resuscitation Council (UK), the British Heart Foundation and each ambulance service will be provided with a regular summary that demonstrates how often the AEDs are used within each area. The British Heart Foundation and each appropriate ambulance service will be given a list of postcode locations for PAD sites only if you have provided your contact . This will be used to add new locations to a national and regional data base to aide completeness. Will I be contacted? Only if you have provided your contact details, you may be contacted by the local ambulance service or British Heart Foundation to request your permission to add your AED location to their respective database. Where can I get more information? You can view more background information and supporting documents at the web site

5 Automated External Defibrillation Event Form This form is solely for reporting the activation and subsequent use of an Automated External Defibrillator (AED) device by the general public when you do not have internet access to the web based form at Please complete this form and submit it to either your scheme coordinator or Community Response Manager for your operating Ambulance Service. They will then complete the online form on your behalf. Date when the AED was used * (Please use a DD/MM/YYYY format.) What was the time you were called to help? * (Please use a 24hr clock format HH:MM.) Did you place the pads onto the patient s chest? * What time did you place the pads onto the patient? (Please use a 24hr clock format HH:MM.) (If you don t know, please type Unknown ) Where was the patient? * (Please choose one) Street/Highway Home/Residence Sports/Recreational Industrial/Workplace Assisted Living/Nursing Home Golf Course Public Building GP Surgery Gymnasium Shopping Mall Educational Institution Sports Event Airport Underground Rail Station Bus Station Postcode if known Was a shock delivered by the AED? * Was the shock successful in restarting the heart? * ( Successful could be signs of regular breathing, coughing, an improvement in skin colour.) Was your defibrillator used as a part of a: * Public Access Defibrillator site, i.e. an AED available on the wall or Community First Responder Scheme and you have been sent by the Ambulance Service Which Ambulance Service operates at this location? * East Midlands Ambulance Service East of England Ambulance Service Isle of Wight Primary Care Trust London Ambulance Service NI Ambulance Service HSS Trust North East Ambulance Service North West Ambulance Service Scottish Ambulance Service South Central Ambulance Service South East Coast Ambulance Service South Western Ambulance Service Welsh Ambulance Service West Midlands Ambulance Service Yorkshire Ambulance Service I don t know Your Comments Please send this form to your Scheme Coordinator AED Event or the Form training notes V1.2 Community Response Manager of your operating Ambulance Service