SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GENERAL INSTRUCTION MANUAL ISSUING ORG.
SAUDI ARAMCO SAMSO ORGANIZATION
SUBJECT
Basic life Support (BLS) Heartsaver Automated External Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
I.
GI NUMBER
Approved 150.002
ISSUE DATE 09/15/2008 APPROVAL MMR
REPLACES 03/09/2005 PAGE NO.
1 of 21
CONTENT: This document describes the Saudi Heart Association (SHA) and Saudi Aramco requirements for training in Basic Life Support (BLS) Heartsaver Automated External Defibrillator (AED), Standard First Aid (SFA), Instructor Training Program (ITP), and acquisition of First Aid Kits/AED machines. 1. Definitions: 1.1 SFA/BLS Heartsaver AED Training: is provided by Instructors of the Health Promotion Unit (HPU), Preventive Medicine Services Division (PMSD), Saudi Aramco Medical Services Organization (SAMSO). 1.2 SFA/BLS Heartsaver AED Instructor Training Program (ITP): is provided by certified SFA/BLS/AED Instructors from the Health Promotion Unit, in order to train trainers designated by a requesting organization to conduct SFA/BLS Heartsaver AED classes on job site only for employees who fall under its department/division. 1.3 SFA/BLS/AED Instructor Trainer: is a Health Promotion Instructor who is certified to train others to become SFA/BLS/AED Instructors. 1.4 Non-SAMSO Instructor: is an Instructor trained in SFA/BLS Hearsaver AED by a certified SFA/BLS/AED Instructor Trainer from the Health Promotion Unit. He/she will send monthly statistics of completed classes to the SFA/BLS/AED Group Leader, Health Promotion Unit. 1.5 First Aid Kits: are supplies required to administer First Aid to the sick or injured; available through B2B Purchasing System. 1.6 Health Promotion Standards and Guidelines: are based on the Saudi Heart Association (SHA), American Heart Association (AHA) and American Red Cross (ARC) requirements. 1.7 Overall AED Program Coordinator: is a qualified individual in the Health Promotion Unit, Preventive Medicine Services Division, who will be responsible for implementing and administering the AED program in Saudi Aramco. 1.8 AED Site Coordinator: is a qualified individual at the authorized facility who will supervise the implementation of the AED program in that facility. 1.9 SAMSO AED Committee: Chaired by the Overall AED Program Coordinator and includes members from Occupational Medicine Services (OMS), Emergency Medical Services (EMS), Medical Designated Facilities Department (MDFD), SAMSO and the Cardio-pulmonary Resuscitation (CPR) Center. The committee is responsible for ensuring that the AED installation and operation requirements have been met. These requirements fall under three categories: (i) Pre-installation Requirements: a) Evaluate the site assessment form. (ii) Post-installation Requirements: b) provide assistance in the installation, if requested.
* CHANGE
** ADDITION
NEW INSTRUCTION
COMPLETE REVISION
SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GENERAL INSTRUCTION MANUAL ISSUING ORG.
SAUDI ARAMCO SAMSO ORGANIZATION
SUBJECT
Basic life Support (BLS) Heartsaver Automated External Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
GI NUMBER
Approved 150.002
ISSUE DATE 09/15/2008 APPROVAL MMR
REPLACES 03/09/2005 PAGE NO.
2 of 21
1.10 AED Facility Sponsoring Committee: includes the AED Site Coordinator and other personnel in the facility where the AED machine is to be installed. The committee coordinates with the SAMSO AED Committee with regards to the AED installation and operation requirements. II.
PURPOSE: 1. To ensure that a standardized high quality training in SFA/BLS/AED is practiced consistently throughout the company in accordance with the Health Promotion Unit’s standards and guidelines. 2. To ensure that at least one employee per shift at each site is qualified to administer SFA/BLS Heartsaver AED to the sick or injured victim. 3. To ensure that adequate AED machines are available at all company work sites. 4. To ensure that end-users are aware of the AED installation and operation requirements.
III.
GENERAL POLICES: 1. AED machine shall be placed in strategic locations at all company work sites based on completion of the AED Site Assessment Form (Attachment) by Facility Sponsoring Committee. A work location is considered a strategic location if: o The location is more than 3km far from the nearest Emergency Medical Service (EMS). o The estimated response time from the location to the nearest Emergency Medical Service (EMS) is more than 5 minutes. o The approximate average age of workforce at the location is over 45. 2. First Aid Kit shall be available at all work sites, in accordance with Saudi Arab Government Decision No.404, dated 17 Jamada 11, 1394 (7 July 1974). 3. All employees are eligible to be certified to administer SFA/BLS Heartsaver AED procedure through a recognized training program. 4. Health Promotion Unit shall provide direction and support to BLS Heartsaver AED Instructors to include a training module on AED use with pediatric electrodes for children from 1 to 8 years of age in BLS Heartsaver AED courses at the community. 5. SFA/BLS Heartsaver AED training and certification are the responsibility of the Health Promotion Unit for non SAMSO employees and dependants throughout the company. 6. If the requesting department/division has more than 200 employees to be trained annually, Health Promotion Unit will train candidates from the respective area to
* CHANGE
** ADDITION
NEW INSTRUCTION
COMPLETE REVISION
SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GENERAL INSTRUCTION MANUAL ISSUING ORG.
SAUDI ARAMCO SAMSO ORGANIZATION
SUBJECT
Basic life Support (BLS) Heartsaver Automated External Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
GI NUMBER
Approved 150.002
ISSUE DATE 09/15/2008 APPROVAL MMR
REPLACES 03/09/2005 PAGE NO.
3 of 21
serve as Instructors, who will then provide SFA/BLS Heartsaver AED Training to their department/division employees only. 7. Departments/Divisions are to ensure formation of a functional AED Facility Sponsoring Committee. IV.
SFA/BLS/AED TRAINING POLICIES: 1.
Class Format: Course Title
Duration
Adult BLS Hearsaver AED Standard First Aid Adult BLS Hearsaver AED Re-certification 2.
Validity of Certificate
6 hours
Max. Class Size Participants 6 candidates
6 hours
8 candidates
3 years
4 hours
6 candidates
2 Years
2 years
Scheduling: 2.1
Applying: ¾ Employees are booked by their training coordinators through SAP Human Resources only. ¾ Health Promotion Unit sends an automated confirmation of the booking to the employee, his/her Training Coordinator and Supervisor. The confirmation will be sent directly to the requester if he/she is a dependant.
2.2
Eligibility: ¾ All Saudi Aramco employees are eligible to receive BLS Hearsaver AED and SFA Training. The training coordinator for contract personnel is required to enroll the contractor through Saudi Aramco Contractor Training Division.
2.3
Time Frame: ¾ Classes are taught in one day, but may be split into two consecutive mornings for special reasons of convenience, such as Ramadan schedule.
2.4
Scheduling Candidates in Arabic vs. English Classes: ¾ Health Promotion may urge bilingual candidates to select Arabic classes.
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NEW INSTRUCTION
COMPLETE REVISION
SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GENERAL INSTRUCTION MANUAL
GI NUMBER
ISSUING ORG.
SAUDI ARAMCO SAMSO ORGANIZATION
SUBJECT
Basic life Support (BLS) Heartsaver Automated External Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
2.5
Approved 150.002
ISSUE DATE 09/15/2008 APPROVAL MMR
REPLACES 03/09/2005 PAGE NO.
4 of 21
Infant and Child CPR Course ¾ The course is available to employees and dependents upon special request.
3. Requirements to Successful Completion of SFA/BLS Heartsaver AED Training Courses: 3.1
Attendance: Participants must attend all (6) hours for all training courses
3.2
Practical evaluation: Participants must perform all skills satisfactorily.
3.3
Written test: Participants must pass a written test.
4. Class Location: Health Promotion Unit offers these courses on its premises in Dhahran, Ras Tanura, Abqaiq, Al-Hasa, Udhailiyah, Jeddah and Yanbu. 5.
Language Skills: 5.1 5.2
Candidates for Arabic classes must be proficient in reading and writing Arabic. Candidates for English classes must be proficient in reading and writing English and must have completed ITC English level 7B as minimum requirements.
Instructors must not use two languages in the same class to accommodate language difficulties as it is distracting to all parties in the class V. SFA/BLS Heartsaver AED Instructor Training Program (ITP) 1.
Class Format: Course Title BLS Heartsaver AED Instructor SFA Instructor
Prerequisites No prerequisite required 8 days 3 candidates BLS Heartsaver AED + 3 months Note: Health Promotion Unit reserves the right to call the Instructor for an evaluation and recertification, if needed. 1st day
* CHANGE
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Minimum Duration 8 days
Provider Class
Maximum class Size 3 candidates
5th day
NEW INSTRUCTION
1st Instructor Teaching
COMPLETE REVISION
SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GENERAL INSTRUCTION MANUAL
GI NUMBER
ISSUING ORG.
SAUDI ARAMCO SAMSO ORGANIZATION
SUBJECT
Basic life Support (BLS) Heartsaver Automated External Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
2nd day 3rd day 4th day
Solo One Solo Two Solo Three
Approved 150.002
6th day 7th day 8th day
ISSUE DATE 09/15/2008 APPROVAL MMR
REPLACES 03/09/2005 PAGE NO.
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2nd Instructor Teaching 3rd Instructor Teaching Graduation
2. Scheduling: 2.1. Applying: (i) Application must be signed by a department head or above. (ii) The requesting organization must commit itself to adhere to SFA/BLS Heartsaver AED standards and guidelines. 2.2. Eligibility: In order to qualify for the ITP: (i) The size of population to be trained by the requesting department/division must exceed the manpower capacity of Health Promotion Unit to carry out the training (200 or more students per year) (ii) The Instructor will have a workload of at least two full SFA or BLS Heartsaver AED classes per week. (iii) After completing the SFA/BLS Heartsaver AED Course, Instructors must teach their department/division employees only. Instructors are not eligible to teach employees from other departments/divisions unless prior permission from the Health Promotion Unit is obtained. Note: Ordinarily, if the requesting organization already has a certified Instructor, he/she must be carrying a load of at least (4) full SFA/BLS Hearsver AED classes per week before applying for training of an additional Instructor. A request for an additional Instructor, when the existing one teaches fewer than four classes a week, will be evaluated on a one to one basis. 2.3. Requirements for successful completion: (i) A satisfactory performance evaluation and a passing score on a final test are required for successful completion of any of the aforementioned courses. 2.4. Class location: (i) Health Promotion Unit offers these courses on its premises in Dhahran. 2.5. Language: * CHANGE
** ADDITION
NEW INSTRUCTION
COMPLETE REVISION
SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GENERAL INSTRUCTION MANUAL ISSUING ORG.
SAUDI ARAMCO SAMSO ORGANIZATION
SUBJECT
Basic life Support (BLS) Heartsaver Automated External Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
GI NUMBER
Approved 150.002
ISSUE DATE 09/15/2008 APPROVAL MMR
REPLACES 03/09/2005 PAGE NO.
6 of 21
(i) Priority is given to candidates who will teach Arabic classes. 2.6 Reporting & Recordkeeping: (i)
VI.
Each Instructor shall: a. Send monthly statistics of completed classes to the SFA/BLS/AED Group Leader, Health Promotion Unit. b. Enter all completed courses into the SAP System. c. Issue certificates.
RESPONSIBILITIES: 1.
Supervisors of Requesting Organization: 1.1
Ensure that at least one employee per shift in each site has a current SFA/BLS/AED certificate by scheduling initial training through the Health Promotion Unit.
1.2 Order the appropriate SFA/BLS/AED materials through SAP Purchase Requisition. 1.3 Ensure that the Facility Sponsoring Committee is functional. 1.4 Order training materials as recommended by the Health Promotion Unit. 1.5 Order the appropriate First Aid Kit items through SAP/B2B system, specifying one of the following kits: (i) 10-unit size First Aid Kit. (ii) 36-unit size First Aid Kit. 2.
Supervisor, Health Promotion Unit: 2.1 Assumes overall responsibility to respond to the industrial and community need for SFA/BLS/AED Instructor training company-wide through adequate manpower and materials. 2.2 Assumes responsibility to issue SFA/BLS Heartsaver AED Instructor certificates throughout the company. 2.3 Assumes overall responsibility to keep statistics and records of certified SFA/BLS Hearsaver AED Instructor Training Program participants throughout the company.
* CHANGE
** ADDITION
NEW INSTRUCTION
COMPLETE REVISION
SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GENERAL INSTRUCTION MANUAL ISSUING ORG.
SAUDI ARAMCO SAMSO ORGANIZATION
SUBJECT
Basic life Support (BLS) Heartsaver Automated External Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
GI NUMBER
Approved 150.002
ISSUE DATE 09/15/2008 APPROVAL MMR
REPLACES 03/09/2005 PAGE NO.
7 of 21
2.4 Assigns Instructors to teach SFA/BLS Hearsaver AED Instructors Training courses in Dhahran or Districts, in Arabic or in English, as appropriate. 2.5 Conducts ongoing evaluation of Health Promotion Unit Instructor to ensure that employees receive the highest possible quality of teaching. 2.6 Provides Non-SAMSO departments/divisions with Audiovisual Software. 2.7 Provides Non-SAMSO departments/divisions with information on how to order SFA/BLS/AED materials, and how to conduct an AED site assessment. 2.8 Assumes overall responsibility of keeping the program up to date. This includes: (i) Ensuring that the literatures and audiovisual materials are available in both Arabic and English languages at all time. (ii) Updating certified Instructors with the most recent information. 3. AED Program Sponsoring Physician: 3.1 The Company’s sponsoring physician shall be an Occupational Medicine Specialist. 3.2 The sponsoring physician shall review incidents where AED has been operated. 3.3 The sponsoring physician shall be responsible for providing medical direction for the deployment of the AED’s in Saudi Aramco Facilities. 3.4 Immediately notify the Company’s AED Program Coordinator of any changes in the status of the Company Sponsoring Physician. 4.
Overall AED Program Coordinator: 4.1 Shall be a qualified individual in the Health Promotion Unit, Preventive Medicine Services Division, SAMSO. 4.2. Shall meet the following qualifications: (i) Be certified or licensed as a BLS/AED provider. (ii) Have successfully completed an AED training course, incorporating BLS training. (ii) Be responsible for administering the AED program at Saudi Aramco. 4.3 Shall provide information and orientation on the operation of the AED machine to Company Management upon request.
* CHANGE
** ADDITION
NEW INSTRUCTION
COMPLETE REVISION
SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GENERAL INSTRUCTION MANUAL ISSUING ORG.
SAUDI ARAMCO SAMSO ORGANIZATION
SUBJECT
Basic life Support (BLS) Heartsaver Automated External Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
GI NUMBER
Approved 150.002
ISSUE DATE 09/15/2008 APPROVAL MMR
REPLACES 03/09/2005 PAGE NO.
8 of 21
4.4 Conduct AED Site Assessment Training Sessions as needed. 4.5 Shall keep a record of the location of the AED machines installed in Saudi Aramco facilities. 4.6 Shall be responsible for providing advice on placement of AED machines in locations which meet the requirements of SAMSO. 4.7 Shall serve as Chairman of the SAMSO AED Committee. 5.
Authorized AED Program Operator 5.1 Must be 18 years old or over. 5.2 Must be initially trained as a qualified BLS/AED provider and maintain training certifications in accordance with the Health Promotion Unit standards and guidelines. 5.3 Operators who utilize an AED in Saudi Aramco facilities must notify the AED Program Coordinator and SAMSO’s or MDF’s EMS as applicable, as soon as possible after using the AED.
6.
AED Program Site Coordinators: Each authorized facility is required to have an AED Program Site Coordinator, who shall: 6.1 Ensure that the location of the AED machine is shown on the building emergency map. 6.2 Ensure that the AED daily inspection is performed by a properly trained individual in accordance with manufacturer procedures. 6.3 Ensure that completed Inspection Log Forms are kept quarterly for internal record. 6.4 Ensure all electronic rescue data is downloaded from the AED within 24 hours of any incident where the AED was used on an arrest victim in company facilities, and that all required reports are completed and forwarded to SAMSO’s or MDF’s EMS, as applicable. 6.5 Submit data or other information concerning the company AED Program which may be periodically requested by SAMSO.
* CHANGE
** ADDITION
NEW INSTRUCTION
COMPLETE REVISION
SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GENERAL INSTRUCTION MANUAL ISSUING ORG.
SAUDI ARAMCO SAMSO ORGANIZATION
SUBJECT
Basic life Support (BLS) Heartsaver Automated External Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
GI NUMBER
Approved 150.002
ISSUE DATE 09/15/2008 APPROVAL MMR
REPLACES 03/09/2005 PAGE NO.
9 of 21
6.6 Perform an AED drill and site assessment, as needed, in coordination with the SAMSO AED Committee. VII
AED REPORTING & RECORD KEEPING The Preventive Medicine Services Division will maintain the documentation of all necessary AED machine inspections, authorized users, etc., and will be the company’s point of contact with all company facilities kingdom-wide. The EMS of SAMSO or the MDF will be notified immediately whenever an AED is deployed during an emergency, and whenever an AED is utilized on an actual arrest victim during an incident. The information contained on the Saudi Aramco Facility AED Report Form for Cardiac Arrests will be submitted to the concerned EMS within 24 hours of the incident. For quality control purposes, the following records shall be maintained: 1. Saudi Aramco Facility AED Report Form for Cardiac Arrests: The AED Program Site Coordinator will complete the form in Appendix A “Saudi Aramco Facility AED Report Form for Cardiac Arrests” upon all uses of the AED on an actual arrest victim, and will forward it to the concerned EMS. A copy of this report will be maintained in the concerned EMS Offices. 2. AED Daily Inspection Log Form: Each AED Program Site Coordinator is responsible for ensuring that the AED daily inspection is performed by a properly trained individual in accordance with manufacturer procedures. Completed Inspection Log Forms should by kept by the AED Program Site Coordinator.
VIII
AED INCIDENT REVIEW
1.
The SAMSO AED Committee shall: 1.1 Review each incident in which an AED was operated or where there was a response with an AED, to determine the appropriateness of the operation of the AED or the AED response. For each incident in which the AED Committee determines that the use of the AED was inappropriate, a conference among the individual operating the AED, the AED Program Coordinator and the sponsoring committee shall be held. 1.2 Receive a report summarizing the conclusions of the review and conference.
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** ADDITION
NEW INSTRUCTION
COMPLETE REVISION
SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GENERAL INSTRUCTION MANUAL ISSUING ORG.
SAUDI ARAMCO SAMSO ORGANIZATION
SUBJECT
Basic life Support (BLS) Heartsaver Automated External Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
GI NUMBER
Approved 150.002
ISSUE DATE 09/15/2008 APPROVAL MMR
REPLACES 03/09/2005 PAGE NO.
10 of 21
1.3 Report each incident as required by the regulations. 1.4 Provide remedial action as necessary to resolve any issues of compliance with the regulations. 2.
The AED Facility Sponsoring Committee shall maintain: 2.1 Original AED Program Certificates 2.2 AED machines and related supplies in accordance with the standards established by the AED manufacturer as follows: i. ii. iii. iv. v. vi. vii. viii. ix. x. xi.
sets of defibrillator chest pads (1 set attached to device and 2 spare sets); disposable pocket facemasks 1 disposable bag resuscitator pairs disposal gloves safety razors (for shaving patient’s chest, if necessary to obtain proper defibrillator pad contact; 1 absorbent towel/trauma pad 4x4 inch gauze pads 1 waste bag for contaminated wastes 1 pair scissors 1 bottle waterless antibacterial hand gel/hand sanitizer Saudi Aramco Facility AED Report Forms for Cardiac Arrest
2.3. All AED storage areas, machines and supplies in a clean and sanitary condition. 2.4
Each AED in a closed, intact case with no visible signs of damage which would interfere with its use.
2.5 Written records of the required information (see the record keeping section of this G.I. Section VI Reporting & Record Keeping). Automated External Defibrillator Quality Review Procedures AED Operated ↓
* CHANGE
** ADDITION
NEW INSTRUCTION
COMPLETE REVISION
SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GENERAL INSTRUCTION MANUAL
GI NUMBER
Approved 150.002
ISSUING ORG.
SAUDI ARAMCO SAMSO ORGANIZATION
SUBJECT
Basic life Support (BLS) Heartsaver Automated External Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
ISSUE DATE 09/15/2008 APPROVAL MMR
REPLACES 03/09/2005 PAGE NO.
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Review incident With AED Program Sponsoring Physician ↓ The AED Operation was Appropriate
•
•
Yes
↓ No
Device Failed
↓
↓
↓
Keep original report by AED Program Site Coordinator Send Copies to the concerned EMS
•
Keep original • report by AED Program Site • Coordinator • Send Copies to the concerned EMS ↓ Conference With • The AED Operator • Overall AED Program Coordinator • AED Program Sponsoring Physician ↓ Send a Summary/Report to the concerned EMS
Keep original report by AED Program Site Coordinator Send Copies to the concerned EMS
REFERENCES: Saudi/American Heart Associations / Emergency Cardiovascular Care (ECC) Guidelines 2005. Preventive Medicine Services Division/Health Promotion Unit Guidelines.
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** ADDITION
NEW INSTRUCTION
COMPLETE REVISION
SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GENERAL INSTRUCTION MANUAL ISSUING ORG.
SAUDI ARAMCO SAMSO ORGANIZATION
SUBJECT
Basic life Support (BLS) Heartsaver Automated External Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
Recommended :
Concurred:
Approved:
* CHANGE
GI NUMBER
Approved 150.002
ISSUE DATE 09/15/2008 APPROVAL MMR
REPLACES 03/09/2005 PAGE NO.
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____________________________________ Chief Preventive Medicine Services Division
_________________
_____________________________________ General Manager Healthcare Development Organization
_________________
_____________________________________ Vice President Medical Services Organization
_________________
** ADDITION
NEW INSTRUCTION
Date
Date
Date
COMPLETE REVISION
SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GENERAL INSTRUCTION MANUAL ISSUING ORG.
SAUDI ARAMCO SAMSO ORGANIZATION
SUBJECT
Basic life Support (BLS) Heartsaver Automated External Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
GI NUMBER
Approved 150.002
ISSUE DATE 09/15/2008 APPROVAL MMR
REPLACES 03/09/2005 PAGE NO.
13 of 21
APPENDIX A SAUDI ARAMCO FACILITY AED REPORT FORM FOR CARDIAC ARRESTS
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** ADDITION
NEW INSTRUCTION
COMPLETE REVISION
SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GENERAL INSTRUCTION MANUAL
GI NUMBER
Approved 150.002
ISSUING ORG.
SAUDI ARAMCO SAMSO ORGANIZATION
SUBJECT
Basic life Support (BLS) Heartsaver Automated External Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
ISSUE DATE 09/15/2008 APPROVAL MMR
REPLACES 03/09/2005 PAGE NO.
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CONFIDENTIAL SAUDI ARAMCO FACILITY AED REPORT FORM FOR CARDIAC ARRESTS To be completed immediately after a cardiac arrest occurs at your facility or the facility where an AED is put on a patient. Form should be filled out by the main caregiver at the scene and the Facility AED Operator and returned to SAMSO’s or MDF’s EMS, as applicable, within 48 hours. Please Return Completed Form with your AED Summary Report to: 1. Facility Name: ____________________________________________________________________ 2. Incident Location: _________________________________________________________________ 3. Date of Incident: ______/______/_____ Mo Day Yr 4. Estimated Time of Incident: ___:____ am/pm Hr Min
4.a. Estimated Time that 110 Call was placed: ___:____ Hr Min
am/pm
5. Name of Patient: ___________________________________________________________________ First Middle Last 6. Patient Gender
Male [ ]
Female [
8. Did the patient collapse (become unresponsive)?
]
Yes [ ]
7. Estimated age of Patient: __________________ yrs No [
]
8a. If Yes, what were the events immediately prior to the collapse (check all that apply): Difficulty Breathing [ ] Electrical Shock [ ]
Chest Pain [ ] Injury [ ]
8b. Was someone present to see the person collapse? If yes, was that person a trained AED Employee?
Yes [ ] Yes [ ]
No Signs or Symptoms [ ] Unknown [ ]
Drowning [ ]
No [ ] No [ ]
8c. After the collapse at the time of patient assessment and just prior to the Facility AED pads being applied: Was the person breathing? Yes [ ] No [ ] Did the person have a pulse? Yes [ ] No [ ] 9. Was BLS given prior to 110 EMS arrivals?
Yes [ ] Go to #9a
No [ ] Go to # 10a
9a. Estimated time BLS Started: ___:___ am/pm Hr Min 9b. Was BLS started prior to the arrival of a trained AED employee? Yes [ ] No [ 9c. Who Started BLS? Bystander [ ] Trained AED Employee [ ] 10. Was Facility AED brought to the patient’s side prior to 110 EMS arrivals?
]
Yes [ ]
No [
]
10a. If No, briefly describe why and skip to question 17: _____________________________________ 10b. If Yes, estimated time (based on your watch) Facility AED at patient’s side: ___:____am/pm Hr Min
TURN OVER AND COMPLETE BOTH SIDES
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** ADDITION
NEW INSTRUCTION
COMPLETE REVISION
SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GENERAL INSTRUCTION MANUAL
GI NUMBER
Approved 150.002
ISSUING ORG.
SAUDI ARAMCO SAMSO ORGANIZATION
SUBJECT
Basic life Support (BLS) Heartsaver Automated External Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
ISSUE DATE 09/15/2008 APPROVAL MMR
REPLACES 03/09/2005 PAGE NO.
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CONFIDENTIAL 11. Were the Facility AED pads put on the patient? Yes [ ] No [ ] 11a. If yes, was the person who put the AED pads on the patient: A trained AED Facility Employee [ ] An untrained AED Facility Employee [
]
A bystander [ ]
12. Was the Facility AED turned on? Yes [ ] No [ ] 12a. If Yes, estimated time (based on your watch) Facility AED turned on? : ___:___am/pm Hr Min 13. Did the facility AED ever shock the patient? Yes [ ] No [ ] 13a. If Yes, estimated time (based on your watch) of 1st shock by facility AED? : ___:___am/pm Hr Min 13b. If shocks were given, how many shocks were delivered prior to the EMS ambulance arrival? 14. Name of person operating the Facility AED: ___________________________________________________________________________________ First Middle Last 14a. Is this person a trained AED employee? Yes [ ] No [ ] 14b. Highest level of medical training of person administering the Facility AED: Public AED trained [ ] First responder AED trained [ ] EMT-B [ ] CRT EMT-P [ ] Nurse/Physician [ ] Other healthcare provider [ ] No known training [ ] 15. Was there any mechanical difficulty or failure associated with the use of the Facility AED? Yes [ ] No [ ] 15a. If yes, briefly explain: ____________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________
16. Were there any unexpected events or injuries that occurred during the use of the Facility AED? Yes [ ] No [ ] 16a. If yes, briefly explain: ___________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________ 17. Indicate the patient’s status at the time of the EMS arrival: 17a. Pulse restored 17b. Breathing restored 17c. Responsiveness restored
Yes [ ] Yes [ ] Yes [ ]
No [ ] No [ ] No [ ]
Don’t Know [ Don’t Know [ Don’t Know [
] ] ]
If Yes, time pulse restored ________________ If Yes, time breathing restored_____________ If Yes, time patient responsive ____________
18. Was the patient transported to the hospital? Yes [ ] No [ ] 18a. If Yes, how was the patient transported? EMS Ambulance [ ] Private Vehicle [ ] Other________________________________ Report Completed by: __________________________________________________________________________________________________________ Please Print Name Date ______________________________________________________________________________________________________ Signature Date _________________________ ______________________________________________________ Title Office Phone Make Model of the Facility AED that was used? ______________________________ _____________________________________________________ Manufacture Model RETURN TO SAMSO’s EMS OR MDF’s EMS AS APPLICABLE WITHIN 48 HOURS FOLLOWING INCIDENT: PLEASE FORWARD QUESTIONS TO YOUR FACILITY AED COORDINATOR Facility Name: _________________________________
c.c:
Occupational Medicine Section, PMSD
* CHANGE
** ADDITION
NEW INSTRUCTION
COMPLETE REVISION
SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GENERAL INSTRUCTION MANUAL ISSUING ORG.
SAUDI ARAMCO SAMSO ORGANIZATION
SUBJECT
Basic life Support (BLS) Heartsaver Automated External Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
GI NUMBER
Approved 150.002
ISSUE DATE 09/15/2008 APPROVAL MMR
REPLACES 03/09/2005 PAGE NO.
16 of 21
APPENDIX B SAUDI ARAMCO AED DAILY INSPECTION LOG FORM
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COMPLETE REVISION
SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GENERAL INSTRUCTION MANUAL ISSUING ORG.
SAUDI ARAMCO SAMSO ORGANIZATION
SUBJECT
Basic life Support (BLS) Heartsaver Automated External Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
GI NUMBER
Approved 150.002
ISSUE DATE 09/15/2008 APPROVAL MMR
REPLACES 03/09/2005 PAGE NO.
17 of 21
SAUDI ARAMCO AED DAILY AND MONTHLY SAFETY INSPECTION RECORD ______________ (Month/Year)
AED Machine Serial #:________________ AED Location: ___________________
DAILY CHECK Day
MM/DD/YY
Inspector’s Initials
Case Intact? Yes
No
Status Indicator Green Yes No
Pads Expired Yes
No
All Supplies in Case? Yes
No
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
* CHANGE
** ADDITION
NEW INSTRUCTION
COMPLETE REVISION
SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GENERAL INSTRUCTION MANUAL ISSUING ORG.
SAUDI ARAMCO SAMSO ORGANIZATION
SUBJECT
Basic life Support (BLS) Heartsaver Automated External Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
GI NUMBER
Approved 150.002
ISSUE DATE 09/15/2008 APPROVAL MMR
REPLACES 03/09/2005 PAGE NO.
18 of 21
ctd… SAUDI ARAMCO AED DAILY AND MONTHLY SAFETY INSPECTION RECORD ______________ (Month/Year)
AED Machine Serial #:________________ AED Location: ___________________
MONTHLY CHECK INSTRUCTIONS 1. Open AED lid 2. Wait for the AED to indicate status: Observe the change of the Status Indicator to Red. After approximately 5 seconds, verify that the Status Indicator returns to Green. 3. Check the expiration date on the electrodes. 4. Listen for the voice prompts. 5. Close the lid and confirm that Status Indicator remains Green.
YES
MONTHLY CHECK COMPLETED BY:_____________________ BADGE #: ____________ DATE: ___________
* CHANGE
** ADDITION
NEW INSTRUCTION
COMPLETE REVISION
NO
SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GENERAL INSTRUCTION MANUAL ISSUING ORG.
SAUDI ARAMCO SAMSO ORGANIZATION
SUBJECT
Basic life Support (BLS) Heartsaver Automated External Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
GI NUMBER
Approved 150.002
ISSUE DATE 09/15/2008 APPROVAL MMR
REPLACES 03/09/2005 PAGE NO.
19 of 21
INSTRUCTIONS FOR COMPLETING AED DAILY AND MONTHLY INSPECTION RECORD DATE:
The AED machine should be inspected daily. Enter the date the AED machine was inspected.
INSPECTORS INITIALS:
Enter the inspector’s legible initials. Only trained individuals may perform the daily inspection.
CASE INTACT?
Yes or No. Check to see if the storage case (either soft, flexible or intact: wallmounted) is present, serviceable and undamaged. If all ok, enter “yes”, if not, enter “no”. To report deficiency, immediately complete the Saudi Aramco Return Form # attached and contact the local vendor.
STATUS INDICATOR:
Yes or No. Check to see if the status indicator in the handle is “green”. If the indicator is “red”, the unit is NOT ready for a rescue and should be immediately pulled from service. Complete Saudi Aramco Return Form # SA 9667 (insert link when is up on e-forms) and contact the local vendor immediately for repair.
PADS EXPIRED?
Yes or No. Check to see if expiration date of the pads (electrodes) has exceeded. Sixty (60) days prior to the expiration date. Plan ahead to order the replacement pads from local vendor.
ALL SUPPLIES IN CARRYING CASE:
Yes or No. If everything is present enter “yes”, if everything is not present, enter “no”. Immediately order the missing supplies from the local vendor.
MONTHLY CHECKS:
Follow the instructions on the Saudi Aramco AED Daily and Monthly Safety Inspection Record.
CONTACT Local Vendor E-mail:
[email protected] Office Tel: 02 667-8811 Ext 226 Office Fax: 02 669-1188 Mobile: 0506 311 179
* CHANGE
** ADDITION
NEW INSTRUCTION
COMPLETE REVISION
SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GENERAL INSTRUCTION MANUAL ISSUING ORG.
SAUDI ARAMCO SAMSO ORGANIZATION
SUBJECT
Basic life Support (BLS) Heartsaver Automated External Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
GI NUMBER
Approved 150.002
ISSUE DATE 09/15/2008 APPROVAL MMR
REPLACES 03/09/2005 PAGE NO.
20 of 21
Saudi Aramco AED Site Assessment Form This Form is to help Saudi Aramco Departments determine whether an on-site AED program is advisable. Use one Form per facility Organization Name:
Facility Location:
Building:
Region:
(AED Site Coordinator)
1.
SITE GEOGRAPHY
1.1
How many buildings are on your site:
___________
1.2
Number of floors:
___________
1.3
List all areas that may not be easily accessible by responders including closed or locked or restricted areas:
2.
a)_________________________
c)_________________________
b) _________________________
d) _________________________
POPULATION CHARACTERISTICS
2.1
Number of Saudi Aramco employees: _________
2.2
Number of Contractor employees: _________
2.3
Approximate average age of workforce: 20-30
2.4
Approximate % of employees over 45 years: __________
* CHANGE
** ADDITION
30-40
NEW INSTRUCTION
40-50
< 50
COMPLETE REVISION
SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GENERAL INSTRUCTION MANUAL ISSUING ORG.
SAUDI ARAMCO SAMSO ORGANIZATION
SUBJECT
Basic life Support (BLS) Heartsaver Automated External Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
GI NUMBER
Approved 150.002
ISSUE DATE 09/15/2008 APPROVAL MMR
REPLACES 03/09/2005 PAGE NO.
21 of 21
Saudi Aramco AED Site Assessment Form (Page 1 of 2)
3. 3.1
EMS CAPABILITIES Where is the primary EMS unit located? Within 3 KM
3.2
within 10 KM
>15 KM
What is the estimated response time from your location to the nearest EMS? 0-3 Min
4. 4.1
within 5 KM
3-5 Min
5-10 Min
10-15 Min
20 + Min
TRAINING COURSES Is BLS/AED training conducted by one of your employees at your department/division? Yes If “Yes”
No How often _____________________ By whom_______________________ # trained________________________
AED Site Coordinator Signature: __________________________________ Date: __________________________________________________________
* CHANGE
** ADDITION
NEW INSTRUCTION
COMPLETE REVISION
