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version The U. S. Food and Drug Administration (FDA) has given market clearance so AEDs can be made available with a physician's prescription. To ensure a safe and effective PAD program, it's essential to provide additional physician oversight. The role and time commitment of the physician varies depending on the size and characteristics of the program. The physician's main duties are to:
Having a physician oversee a PAD program brings authority and expertise to
the program team. The physician's role will be heaviest at the beginning of
the program. Once it's set up, someone else designated as the PAD program coordinator
may actually do most of the day-to-day word associated with operations (similar
to standing orders), but active physician oversight enhances the program.
Successful AED programs involve a physician as an advocate and teacher. As an
advocate, the physician should provide the energy and dedication needed to help
get the program started, and then provide ongoing guidance and oversight. He
or she can also serve as a visible spokesperson for the program.
As a teacher, the physician approves the initial AED training. The level of
involvement in hands-on-training often depends on the size of the program, the
availability of other appropriate instructors and the physician's management
style. In some programs the physician may be directly involved in training sessions.
In others he or she may simply provide guidance to the program coordinator.
Coordinating the PAD program with the local EMS system is an important aspect
of the physician's role. Ensuring that the EMS system is notified of a facility's
PAD program and providing follow-up data on any use of the AED are elements
of this responsibility. In states where a registration or application process
is required for PAD programs, the physician would complete that process. See
Element 3: Integrating With the Emergency Medical Services (EMS) System
which follows for additional details.
The physician providing medical oversight is also a guardian of quality. A protocol
for the facility that specifies details such as the location of AEDs and how
bystanders alert rescuers should be developed by the physician. Follow-up after
an AED is used is also the physician's responsibility. Each time an AED is used,
a review should be conducted. The main purpose of this review is to give rescuers
positive feedback and practical suggestions for improving when necessary. Talking
to rescuers about their feelings after the experience is also important. In
addition, the review process also allows for problems in the program to be quickly
spotted and fixed.
In many large corporations, plants or public facilities, a physician already
on staff or associated with the site in some other way may be the logical choice
to oversee the PAD program. If such a person is not available, contact the local
EMS for suggestions. In many areas the EMS Medical Director has agreed to function
in this capacity. Other possible sources for identifying a physician to provide
oversight are emergency physicians, cardiologists, occupational health physicians
and AHA ACLS Regional Faculty physicians. In some cases physician entrepreneurs
may offer their services for a fee. In others, AED manufacturers may have names
of physicians who will fill this role. In these latter two situations it's important
to be sure that the physician is located in the city where the PAD program is
implemented.
The most important criterion for selecting a physician to provide oversight
are:
Key roles and duties of the overseeing physician are:
Key roles and duties of the PAD program site are:
