As more camps purchase an automated external defibrillator (AED), the ability to establish and effectively manage a program that supports the use and maintenance of this life-saving device is critical. The initial thrill of getting the AED must be supported by an ongoing plan that keeps the device functional, maintains staff training, and updates camp administration with applicable state and/or local regulations.

Sources of information include resources provided by the company that manufactured the camp's AED and advisory groups responsible for AED standards and program operation (e.g., American Heart Association, America Red Cross). But nothing can replace a given camp's well-organized management system, a system that encompasses appropriate resources and is overseen by a camp professional. What are the components of this system? What might a camp consider when reviewing its AED program?

Personnel

A physician is typically needed to provide medical oversight, a task that includes selecting an appropriate AED for the camp and evaluating the AED's deployment following an incident. More importantly, however, a camp AED program coordinator is needed to manage the day-to-day aspects of an AED program. Has your camp appointed someone to this task? The responsibilities of that coordinator should include elements such as:

• Establishing and facilitating an advisory group that provides input to decisions that impact the camp's AED program.
• Establishing and documenting the policies that govern the placement, maintenance, and use of AED equipment.
• Establishing the documenting practices associated with selecting and training camp personnel on the AED.
• Overseeing the implementation and review of these policies and practices. 

Designating a person to coordinate a camp's AED program goes a long way toward assuring the viability of an AED response when it's needed. But also consider the need for a professional who can provide critical incident debriefing following an AED incident. This role is often neglected until something happens and the need to debrief staff and others surfaces. Preplan for this eventuality. The professional selected for this service can often be utilized for incidents beyond those associated with AED use.

Reviewing AED Placement and Maintenance

Most AED programs include an annual review of topics associated with the location of an AED and its maintenance. Changes to camp activities and renovation of facilities may impact location, while mechanical wear directs the need to periodically check the device itself. Specific tasks, typically listed in check-off format, ease the review process and include:

• Assessing a portable AED to determine that:
  • Its location minimizes — if not eliminates — the potential for tampering with the device.
  • Its placement facilitates quick deployment from a location that is accessible 24 hours a day.
• Assessing wall-mounted AEDs to determine that:
  • Its location is in a facility with a high number of people (e.g., camp dining hall) and/or in a facility that houses high-stress activities (e.g., athletic field, waterfront).
  • Its location is central to reasonably anticipated events that might trigger need for an AED (also consider location of the camp's health center).
  • It's mounted on a publically accessible wall, near a phone, and in a way that minimizes the potential for tampering as well as provides protection from weather.
  • Its location is identified by easyto- read signs that follow state/ local labeling requirements.
• Maintaining a written record of equipment inspection and testing:
  • AED unit inspected and tested following the manufacturer's guidelines.
  • AED battery checked/replaced per manufacturer guidelines.
  • Electrode pads inspected/replaced per manufacture guidelines.
  • Support equipment stored with the AED such as disposable gloves, facemasks, extra pads, safety razor, absorbent towels, scissors, incident report form plus pen.
  • Nonfunctioning and/or malfunctioning equipment is removed for repair.

Maintaining Appropriate Written Records

The AED's program coordinator is typically charged with responsibility for maintaining records of equipment testing and training personnel. Some of this can be accomplished via a checklist that includes the review date; other records may be narrative in nature (e.g., copy of letters, minutes of discussions). Topics to document include:

• Annual list of camp personnel who have been trained to use the equipment, the date of that training, and the name/credential of the trainer.
• Verification that the training program meets local and state requirements.
• Listing the topics covered in the training, such as recognizing signs of cardiac arrest, activating EMS, performing CPR, determining if AED use is needed/appropriate, using the AED, and the safety protocols associated with deploying the device.
• Description of in-services for personnel that demonstrates their skill proficiency and response to AED incident simulations. These typically include elements such as:
  • Activating external EMS services.
  • Appropriately assessing scene safety and client need for CPR/AED.
  • Accurately following CPR/AED protocols when providing this level of care.
  • Accurately and objectively completing the AED incident form in a timely manner.
• Determining if changes/updates are needed to the incident form, what those are, and noting when the change/update was completed.
• Review of incident forms associated with CPR/AED to make sure information such as the following is captured:
  • Date/time of incident and its location.
  • Witness information (name, address, phone, e-mail) is complete and accurate.
  • Time that responder(s) arrived; time that external EMS arrived.
  • Client information: name, age, sex, contact info, condition when responder(s) arrived.
  • Time that CPR/AED use was initiated.
  • Incident outcome. 

Post-Incident Follow-Up

Another aspect of an AED program is a description of the camp's incident review following use of the device. The program's coordinator can certainly facilitate this discussion, but the appropriate camp administrators and the camp's legal counsel should also be part of the process. The camp's overseeing physician may also be needed.

The review focus starts by making sure each incident report is accurately and completely filled out. Typically the emergency response process is then evaluated. Was it complete? Appropriate to the situation? Did it follow protocols? What might be done to improve the camp's emergency response?

In addition, critical incident debriefing should be provided to responding personnel and considered for others impacted by the event. Do not minimize this important step. Know who can facilitate the debriefing process, how quickly that individual can get to camp, and have a global understanding of the process itself. Critical incident debriefing will certainly be needed by responding camp staff; indeed, one might require these personnel to attend at least the initial meeting. But others may also need to be debriefed. For example, did a camper group witness the incident and now need this kind of support? Was the individual who needed the AED a key member of a particular staff group that is also stressed over the incident?

Post-incident follow-up also includes making sure the AED is ready for future use, replacing supplies, and returning the device to its designated location.

Take Action Now!

If reading these summative comments made you feel secure with your camp's AED program, then you can probably serve as an example to others. Offer to help. On the other hand, if you found yourself noting needed improvement, take the time now to act on that observation. Several resources are available, especially on reputable websites like www.AmericanHeart.org and the one maintained by your AED's manufacturer. Utilize them, because someone will need your AED someday.

Be ready; be prepared.

Linda Ebner Erceg, RN, MS, PHN, is the associate director of Health & Risk Management for Concordia Language Villages and executive director of the Association of Camp Nurses in Bemidji, Minnesota.

Originally published in the 2014 November/December Camping Magazine.