THE DISTANCE COVERED BY A DEFIBRILLATOR


The increase in numbers of community defibrillators has led to an expectation they will be activated to a 999 call in every case. This is not true. Community defibrillators will only be activated as long as certain conditions are present, and 999 ambulance operators are instructed to ask relevant questions to ascertain if a defibrillator is needed. In addition, the presence of ‘Activation radii’ or a ‘lone rescuer’, will determine if a defibrillator is needed or can be accessed. Add to this the increasing numbers of reports of the “emergency operator” not knowing the location of code, suggests that the public are not being made aware of the right processes or constraints associated with their community defibrillator.

A 999/112 call must always be undertaken whilst at the patient. The reason for this is the 999 operators will pick up automatically the location of the call, either directly from the land line or via GPS if a modern mobile. Thus, they already know the address, or very likely the location. Do not go to the cabinet, then call 999. Some ‘defibrillator’ cabinets have inaccurate or incomplete instructions that can be misunderstood by the public when stressed, who assume the BT emergency operator can give access codes. Always ask for Ambulance.

  • Once the 999 call is received by the ambulance operators, they are tasked with asking 2 questions - is the patient breathing? Is thepatient conscious? They use AI now to determine the type and severity of emergency and automatically dispatch an ambulance to theaddress/location without the need for further questions at this stage. The 'on screen script’ will not allow a process outside of thedefined script. In 999/1000 cases this is fine. Sometimes their screen shows no location. They will then ask you if a defibrillator isnearby. Note some 999 operators may say the defib is not visible to them. This is because it is flagged as ‘out of use’ or ‘not available’at this point in time. This does not mean it is not registered.
  • They will then tell the caller how to undertake CPR - this is a requirement within 60s of the call - and if it is determined a defibrillatoris required, where the nearest active one is and how to get access (which may not be the one you are aware of). This shortens response times, and also stops unnecessary use of defibrillators.
  • What they cannot do, without some searching, is to take a second 999 call from the defibrillator cabinet location and allocate it to anexisting 999 call from a different (original) location. Thus, delays occur where a second 999 ambulance operator is trying to find the first 999 call, and seeing if a defibrillator had already been allocated, or if it was required. As an added complication, if the defibrillator is not needed, or not available, the location and code information does not appear on the 999 operator's screen, and so they cannot relay this to the caller. 111 calls do not have access to the defibrillator information as these are not ambulance call centres, but commercially provided services for non-urgent cases. If patient is unconscious call 999 not 111.
  • Sometimes the 999 call does not go to the local ambulance service, particularly in border areas or very busy periods, but instead goes to the next available call handler from an adjacent ambulance service, or even the police, then this service would not know of the location of the defibrillator, or the code to get access if locked. They may ask if a defibrillator is nearby (ie within 400m, not 2 miles!).
  • If you are on your own with the patient, you will not be sent to fetch the defibrillator, but stay doing CPR until help arrives. Your community may wish to consider a VETS scheme of volunteers (contact CHT for information). Also if an ambulance is close enough to the incident and can get there faster than you would be able to get to the defibrillator and back, you will also not be sent to the defibrillator. This does not mean the defibrillator is not available or not registered, just not appropriate to the situation.
  • • Finally, there is a thing called Out of Activation Radius. This means that calls are allocated to resources, in this case a defibrillator. Sometimes the emergency is further away from the defibrillator than the local ‘activation radius’. In this case the operator will not know of a defibrillator nearby, and will not activate. Typical activation radii are 200m to 500m, dependent upon ambulance service and geography.

 

AMBULANCE SERVICE AREA

RADIUS (METRES)

SCOTLAND 500
NORTH WEST 500
NORTH EAST 500
YORKSHIRE 600
EAST MIDLANDS 500
WEST MIDLANDS 200
WALES 500
SOUTH WEST 200
SOUTH CENTRAL 500
SOUTH EAST COAST 400
LONDON 200
EAST OF ENGLAND 1600

Ambulance services are also covered by Ambulance Quality Indicators. This is the mechanism for monitoring performance. 

To comply with the 2017 AQI guidance set by the NHS, the ambulance service cannot record a community defibrillator as counting to the 8-minute Category 1 call target unless the defibrillator is on scene, and the operator has confirmed that the person present is willing to use this if required. 

CAT1 calls are heart problems. Under the AQI2017, they can also count the CAT2 calls (stroke, other life-threatening) as meeting an 8-minute response if similarly the defibrillator is on scene and the person attending confirms by positive agreement they are willing to use if required. These AQI may change in the future. 

By attending both CAT1 and CAT2 calls, this may result in your community defibrillator being deployed quite frequently.

Use the radius mapping tool below to check how much of your community will be covered by your defibrillator. Navigate to your address using the search bar and on the right click the pencil icon, followed by the disc, then simply input your local radius from the table and click on your central location point to display.

 

 

 

Back To Ambulance Services     

Disclaimer

Please make sure you have read and understood this disclaimer - It will be assumed that you have read prior to CHT receiving any request. CHT are not responsible for your fund raising, nor your cPAD operations, but may assist in both. CHTs only aim is to support the installation of a cPAD scheme in the most cost effective way possible adhering to Best Practice, and help save lives in your community. This website, and any downloaded information, is for information only on how to go about obtaining and installing a cPAD, and other relevant information. All copyrights and trademarks are recognised. All support for the cPAD will be undertaken by the village committee responsible and via standard manufacturers warranties. Any training organisation will only be responsible for the initial awareness training and not for the functioning or maintenance of the AED. Please do not send any monies to CHT until you have registered your scheme with us, and have agreement from the local ambulance service for the establishment of a cPAD scheme. All schemes must be registered with the local ambulance service (CHT will also undertake this or you can do via this site, but this does not remove responsibility for you to notify the local ambulance service of your AED location). 999/112 (ambulance) must always be called prior to using a cPAD equipment. VAT may be applicable if your organisation is not an eligible body as defined by HMRC. All current or historical claims for VAT will be met by the local community. All schemes will be asked to sign an agreement taking responsibility for their own fund raising and donations to CHT, and then the operation and maintenance of the cPAD equipment. All CHT provided schemes will need to manage their maintenance through the WebNoS online system as a condition of CHT support. It is your responsibility to maintain the equipment in working order and to make sure the local ambulance service is aware of this. WebNoS makes this possible and also acts as an audit trail for management of the equipment. Sites provided by CHT and not using WebNoS may be disengaged from the ambulance service CAD systems. Any web site showing defibrillator locations is for information only, and should not be used in preference to dialling 999. CHT works in close cooperation with the UK ambulance services. Always dial 999 in an emergency

Registered Charity Number - 1132824