Out of Hospital Cardiac Arrest

There are several factors that can influence a patient's survival from out-of-hospital cardiac arrest. One of the most significant of these factors is the time from the patient's collapse to the time of defibrillation.

Defibrillation

Many cardiac arrests involve a disturbance of the heart's electrical system. The most common of these disturbances is ventricular fibrillation (V-Fib). Defibrillation involves delivery of an electric shock to the patient's chest. The shock travels through the chest to stop V-Fib so that the heart can recommence its normal rhythm. An automated external defibrillator (AED) is a machine that analyzes a patient's heart rhythm. If the AED recognizes V-Fib, the AED will tell the provider to press a button that will deliver a shock to the patient. The AED will not allow a shock to be delivered unless it recognizes V-Fib.

Time Frame

A patient's chance of survival from cardiac arrest due to V-Fib is decreased by approximately 10% with each minute that passes. It is therefore crucial that defibrillation is provided within the first few minutes after a patient's collapse. Cardiopulmonary resuscitation (CPR) can delay the damage to the heart after cardiac arrest, allowing for a slightly longer time for effective defibrillation. CPR alone, however, cannot restore the heart's normal electrical function. It is imperative to both perform CPR and defibrillate the heart within the first few minutes after a cardiac arrest to give the patient the best chance of survival.

Public Access Defibrillation Provider and the "Good Samaritan Law"

Article 30 of the New York State Public Health Law (Section 3000-B) allows for persons trained in the use of an automated external defibrillator (AED) to operate AEDs for emergency treatment. Furthermore, the trained person who uses the AED "voluntarily and without expectation of monetary compensation" is not liable for damages.

Article 30 of the New York State Public Health Law
Section 3000-B. Automated Defibrillators: Public Access Providers

1. Definitions. As used in this section, unless the context clearly requires otherwise, the following terms shall have the following meanings:

A) "Automated external defibrillator" means a medical device, approved by the United States Food and Drug Administration, that: (I) is capable of recognizing the presence or absence, in a patient, of ventricular fibrillation and rapid ventricular tachycardia; (II) is capable of determining, without intervention by an operator, whether defibrillation should be performed on the patient; (III) upon determining that defibrillation should be performed, automatically charges and requests delivery of an electrical impulse to the patient's heart; and (IV) then, upon action by an operator, delivers an appropriate electrical impulse to the patient's heart to perform defibrillation.

B) "Emergency Health Care Provider" means: (I) a physician with knowledge and experience in the delivery of emergency cardiac care; or (II) a hospital licensed under article twenty-eight of this chapter that provides emergency cardiac care.

C) "Public access defibrillation provider" means a person, firm, organization or other entity possessing or operating an automated external defibrillator pursuant to a collaborative agreement under this section.

D) "Nationally-recognized organization" means a national organization approved by the department for the purpose of training people in use of an automated external defibrillator.

2. Collaborative agreement. A person, firm, organization or other entity may purchase, acquire, possess and operate an automated external defibrillator pursuant to a collaborative agreement with an emergency health care provider. The collaborative agreement shall include a written agreement that incorporates written practice protocols, and policies and procedures that shall assure compliance with this section. The public access defibrillation provider shall file a copy of the collaborative agreement with the department and with the appropriate regional council prior to operating the automated external defibrillator.

3. Possession and operation of automated external defibrillator. Possession and operation of an automated external defibrillator by a public access defibrillation provider shall comply with the following:

A) No person may operate an automated external defibrillator unless the person has successfully completed a training course in the operation of an automated external defibrillator approved by a nationally-recognized organization or the state emergency medical services council, and the completion of the course was recent enough to still be effective under the standards of the approving organization. However, this section shall not prohibit operation of an automated external defibrillator, (I) by a health care practitioner licensed or certified under title VIII of the education law or a person certified under this article acting within his or her lawful scope of practice or (II) by a person acting pursuant to a lawful prescription.

B) The public access defibrillation provider shall cause the automated external defibrillator to be maintained and tested according to applicable standards of the manufacturer and any appropriate government agency.

C) The public access defibrillation provider shall notify the regional council of the existence, location and type of any automated external defibrillator it possess.

D) Every use of an automated external defibrillator on a patient shall be immediately reported to the appropriate local emergency medical services system, emergency communications center or emergency vehicle dispatch center as appropriate and promptly reported to the emergency health care provider.

E) The Emergency Health Care Provider shall participate in the regional quality improvement program pursuant to subdivision one of section three thousand four-A of this article.

4. Application of other laws. A) Operation of an automated external defibrillator pursuant to this section shall be considered first aid or emergency treatment for the purpose of any statute relating to liability. B) Operation of an automated external defibrillator pursuant to this section shall not constitute the unlawful practice of a profession under title VIII of the education law.

5. (I) A person who, or entity, partnership, corporation, firm or society that, purchases or makes available resuscitation equipment that facilitates first aid, as required by or pursuant to law or local law, or (II) the emergency health care provider with a collaborative agreement under section three thousand-B of this article with respect to an automated external defibrillator, shall not be liable for damages arising either from the use of that equipment by a person who voluntarily and without expectation of monetary compensation renders first aid or emergency treatment at the scene of an accident or medical emergency, or from the use of defectively manufactured equipment; provided that this subdivision shall not limit the person's or entity's, partnership's, corporation's, firm's, (or) society's or the emergency health care provider's liability for his, her or its own negligence, gross negligence or intentional misconduct.

Credit for purchase of an automated external defibrillator (as of 02/2006-New York State)

The credit for purchase of an automated external defibrillator is available to taxpayers who purchase a qualified automated external defibrillator(s) in tax years beginning on and after January 1, 2001. The credit is equal to the lesser of the purchase cost of the unit, or $500. There is no limit on the number of units purchased during the tax year for which the credit may be taken. However, the credit cannot exceed $500 for each unit purchased.

An automated external defibrillator, as defined under section 3000-b of the Public Health Law, is a medical device approved by the United States Food and Drug Administration, that:

• Is capable of recognizing the presence or absence, in a patient, of ventricular fibrillation and rapid ventricular tachycardia;
• Is capable of determining, without intervention by an operator, whether defibrillation should be performed on the patient;
• Upon determining that defibrillation should be performed, automatically charges and requests delivery of an electrical impulse to the patient's heart; and
• Then, upon action by an operator, delivers an appropriate electrical impulse to the patient's heart to perform defibrillation.
• The credit is not refundable, and you may not carry any unused credit forward to future years.

To claim this credit, complete Form IT-250, Claim for Credit for Purchase of an Automated External Defibrillator, and attach it to your Form IT-201 or IT-203.