FAQ - Community Heartbeat

Frequently Asked Questions

Is there a need?

Sudden Cardiac Attack happens between 140,000 and 200,000 times a year in the UK, making it one of the UK’s largest killers. The potential for saving a life is dependent upon time, the faster medical help can be attained, the better the chance of survival. Clinical studies suggest you have less than 8 minutes from the event to save the life, this decreasing by 10-14% per minute. In rural areas it takes time to get medical help, so Community Public Access Defibrillators (cPAD) have a very important part to play in helping save lives in rural communities. cPAD schemes are reckoned to be about 10x more effective in saving life post hospital than CFR schemes alone. Your community needs to decide if you want one, but as SCA can happen to anyone at any time, and is not age related, better safe than sorry! Try timing yourself from your nearest Ambulance station

Is your community signed up and supportive?

Need is driven by local communities who by definition of request for the project have indicated their support. Around country these projects are driven by local groups like first aid, parish councils or Lions and round table who engage the support of the local communities, and co-ordinate fund raising and placement with the support of organisations like the Community HeartBeat Trust (CHT).

Is there a minimum number of people needed to have a scheme?

So long as there is one person supporting this, then this justifies the effort. There are already local schemes being established by householders individually in your community, and your village hall may already have a defibrillator hidden in a cupboard, or someones house. Your local doctor surgery will have one too, but it is only available when the surgery is open. This project is about utilising these resources better to save more lives.

How many people do we need to be trained?

We suggest aiming at 10 a time for each cPAD installation. Actual numbers are in reality unlimited. Annual re-qualifications on AED use are recomended. The UK RC guidlines suggest these equipment are available to non trained people as well, and certainly the programme we have designed allows for this.

Who delivers the training, to what specification and importantly is the training free of charge?

Training is provided by a local training company, or the local ambulance service. The CHT scheme is a package designed to meet the needs of ambulance run community defibrillation schemes, and can offer an HSE certified training package as part of the scheme (if required) so no additional costs need to be involved (apart from venue costs for the training). If a community opts to take extra training beyond that offered, then the local training organisation is always at liberty to charge for that extra service in agreement with their local community project. The training package is nationally set and meets HSE and Royal College of Surgeons, as well as the defibrillator manufacturer’s standards. CHT will ensure the trainers to meet their exacting standards before allowing them to undertake the CHT course. Training allows you to move around the country, and be certified anywhere to undertake a cPAD use, or first aid. This is unlike a short training course from your local supplier, which may not be HSE accredited. CHT reciomends that training is provided free.

We have a local BHF Heartstart course. Can this suffice for training?

Heartstart is a good awareness training for CPR and heart attacks and we encourage you to undertake this where available. It is not designed for AED training specifically, nor specifically for cPAD schemes. It is good to integrate this programme, however, as part of your local community awareness. The CHT course covers how to recognise an SCA, what to do, how to act, how to undertake CPR and use the Defibrillator and also has a full Emergency First Aid programme. This makes it a full and complete course that gives the attendees a long term useful skill set.

Do we have to be Community Responders?

No. CFR schemes are independent of this, but clearly trained responders can also use the cPAD equipment in an emergency. If you wish to establish a CFR scheme, this a matter for the local ambulance service and not the Community HeartBeat Trust. It is hoped that by having a cPAD scheme locally then this will encourage local communities to join first aid and CFR schemes. Many cPAD schemes are being established by CFR groups or ambulance services.

What are the procedures for using the defibrillator?

UK Resuscitation Council (UKRC) are the definitive guide to using cPAD equipment. CHT will only support recognised UKRC protocols.

What governance processes are in place?

UKRC no longer require members of the public to be trained to use AEDs. This is because it is so easy to use one and very safe. However HeartBeat feels good high quality training is required to get maximum benefit and has a standardised project to allow maximum benefits to be obtained by a local community group. Our Trustees scrutinise all CHT activity and link into local ambulance trusts in a co-operative manner. Training is certified and scrutinised to make sure it conforms to UKRC guidelines, and additional training to HSE standards. Equipment is governed by the manufacturer who takes responsibility for maintenance and functional operation of the AED. This replicates, and exceeds, existing PAD schemes. All PAD locations and codes are notified to the local ambulance Trust, who record on their CAD systems. A copy of the notification form can be supplied. All PAD boxes give instructions to call 999. Daily and weekly checks are done on the cPAD equipment by the local scheme co-ordinator (who will be recognised by the ambulabnce trust), and in some cases by the local ambulance trust themselves too, to ensure fully operational equipment. CHT is not responsible for the maintainance of the cPAD installations, only to assist in their provision.

What long term sustainability is there in place?

The defibrillator manufacturer will support the service for 7 years, this being the life of the defibrillator and guarantees on the equipment. CHT have also negotiated a replacement service for supplies with the manufacturers.

Who will be the responsible person to carry out regular serviceability checks on the machine replace batteries, pads etc and replace items following the use of the machine, downloading of information etc.?

CHT have agreed with the manufacturers to fully support all consumables for the seven year period, including post use replacement of consumables, where a service agreement is in place. This will be enacted by the local scheme. Local regular checking is undertaken by the supporting group through a checklist supplied, or by the local ambulance service. This is the same system as used for similar cPAD schemes, and the British Heart Foundation (BHF) national PAD schemes. The CHT scheme is unique in that it offers a local group support free where a service agreement is in place.

Are local communities required to purchase the defibrillators and support materials, or are they going to be donated to the communities by either a supplier/manufacturer or as a donation from a supportive member of the public?

The funding source is actually irrelevant as it has no bearing upon the service offerd by the CHT. The Community HeartBeat Trust is a charity. Local groups can donate monies to CHT, or other charities, in return they will donate a defibrillator. Alternatively they can seek sponsorship or local fundraising. Again just like other schemes nationally. CHT aims to be able to provide grants for the establishment of cPAD schemes.

If the defibrillators and equipment are to be purchased by communities they should have a choice of a range of defibrillators and not be taken down the road of just one option or manufacturer?

CHT supports the use of specific AED equipment where possible for very good reasons, which can be provided. These include easy of training, support, ease of use, price, and these are the same equipment as used in the national defibrillation project funded by the government and the national lottery, and the same equipment you see on stations, shopping centres and sports centres. We also work with the local ambulance servvice to make sure it is equipment they are happy with. Standardisation means you are trained to use one wherever you are and are not faced with new challenges when an emergency arises. All makes of defibrillator are available if desired. If a community chooses to use another manufacturer, or has one already, then this will alter the costs involved to that community. There are of course, no restrictions on a local community choosing any manufacturer or AED, but this defeats the objects of standardisation, and may lead to delays in servicing a cardiac arrest. To date all communities interested have stated a preference for the Cardiac Science equipment, but the decision is by your local community.

What is the specification of the cabinet?

The high visability yellow CHT cabinet is a secure, vandal resistant IP65 certified and contains a thermostatically controlled heater, lighting and indicator lamps. It is manufactured to all relevant BS standards. Two versions are available, a standard steel box and a special design for mountain and coastal reguions. HeartBeat is not responsible for which electricity supplier is chosen by a local community, but will require it to be fitted by a certified electrician. Cost of running is estimated to be about £10-£30 per year. Normally shops, pubs and village halls house the units and supply the electricity. Permission of the owner of the building will be required.

Why is the box yellow?

There is no international or UK requirements for AED boxes to be a specific colour. CHT worked with the ambulance service and members of the public, as well as seeking the advice of the DH, UK RC and ERC, to ensure the boxes provided are highly visible and therfore easy to find in poor light conditions. It was felt by the reviewers that 'medical green' and other dark colours made the boxes harder to find, and as this is about time to patient, then the easier it is to find a cPAD box ther quicker the AED to the patient. The choice of 'Traffic Yellow' is as a result of this consultation process, and the same colour as used by local councils and highways for easy recognition. Most ambulances are also yellow now for the same reason. In reality if you wish another colour, we can provide at a cost, but most ambulance organisations and PCTs spoken to endorse the yellow colour.

Do we need planning permission?

Not normally. Planning permission is not normally required as this is emergency medical equipment. CHT is in the process of contacting local authorities in the country to make sure that they are in agreement with this position and will be able to advise local communities as to the position locally. CHT is not responsible for gaining local planning consent if required. This is the responsibility of the local group. To date all local authorities contacted hasve agreed planning permission will not be needed but listed building consent may be if applicable to the location. If in doubt ask your local authority for advice and build the cost into your fundraising.

If the local ambulance service directed a person to a cPAD site and when they arrived the box had no defibrillator in the cabinet or when it was attempted to be used for some reason it failed to work, if as a community we had not reasonably tried to ensure that there are processes in place to reduce the risk of this happening would we be at serious risk of prosecution?

Unlikely. It is rare for thefts to occur. All due process is taken to reduce the risk to the equipment malfunctioning or not being available. The cPAD box is vandal resistant, and checked weekly by the local scheme co-ordinator/ambulance trust. There are procedures in place for consumables replacement. This is a scheme that exceeds that currently in place in shopping centres and stations, where the same issues could arise. The manufacturer will warrant the AED equipment, as in the current BHF scheme. The Community HeartBeat Trust scheme is supported by the BHF and almost all Ambulance Trusts.

Do I need indemnity insurance for using one?

No. The patient is to all intensive purposes 'dead' when you arrive. Using CPR with a PAD will hopefully bring them back to life. No one will complain about that! However, calling 999 and taking instructions from the ambulance service will automatically cover you anyway. Remember that you must call 999! A very good guide to this area is published on the website of the UKRC.

How much should my village budget?

Approximately £1 per day per cPAD location.