1、Designation: F 1255 90 (Reapproved 2002)Standard Practice forPerformance of Prehospital Automated Defibrillation1This standard is issued under the fixed designation F 1255; the number immediately following the designation indicates the year oforiginal adoption or, in the case of revision, the year o
2、f last revision. A number in parentheses indicates the year of last reapproval. Asuperscript epsilon (e) indicates an editorial change since the last revision or reapproval.1. Scope1.1 This practice covers guidelines for the performance ofautomated defibrillation.1.2 This practice is one in a set of
3、 performance guidelinesfor prehospital defibrillation.1.3 This practice is specifically not meant to deal withequipment specifications, quality assurance, or training.1.4 This practice is limited to external defibrillators used inthe prehospital setting.1.5 This standard does not purport to address
4、all of thesafety concerns, if any, associated with its use. It is theresponsibility of the user of this standard to establish appro-priate safety and health practices and determine the applica-bility of regulatory limitations prior to use.2. Referenced Documents2.1 ASTM Standards:F 1149 Practice for
5、 the Qualifications, Responsibilities, andAuthority of Individuals and Institutions Providing Medi-cal Direction of Emergency Medical Services2F 1177 Terminology Relating to Emergency Medical Ser-vices22.2 American Heart Association Document:National Standards and Guidelines for CardiopulmonaryResus
6、citation (CPR) and Emergency Cardiac Care (ECC),American Heart Association (Current Edition)33. Terminology3.1 Definitions of Terms Specific to This Standard:3.1.1 automated defibrillatoran automatic or semi-automatic device, or both, capable of rhythm analysis anddefibrillation after electronically
7、 detecting the presence ofventricular fibrillation and ventricular tachycardia.3.1.2 basic life support/cardiopulmonary resuscitation(BLS/CPR)a set of skills that includes airway management,chest compressions, and others defined by the American HeartAssociation.3.1.3 defibrillationthe discharge of a
8、n electrical currentthrough the heart for the purpose of restoring a perfusingcardiac rhythm. For the purpose of this practice, defibrillationmay include cardioversion.3.1.4 operatoras outlined in this practice, a person whohas successfully completed a course of training and may treatprehospital car
9、diac arrest with an automatic or semi-automaticdefibrillator. Legal functioning as an operator will be basedupon licensure or certification requirements, or both, as estab-lished by the authority or authorities having jurisdiction.3.1.5 protocolsSee Terminology F 1177.3.1.6 service medical directort
10、he physician who ismedico-legally responsible for the patient care provided by theoperator (Practice F 1149).3.1.7 standing ordersSee Terminology F 1177.4. Significance and Use4.1 This practice establishes minimum guidelines for pre-hospital automated defibrillation.4.2 This practice does not preclu
11、de the use of automateddefibrillators as prescribed by a licensed physician.4.3 All persons who are identified as prehospital automateddefibrillation operators shall meet the requirements of thispractice.4.4 Using this practice, emergency medical service institu-tions, organizations, and certificati
12、on/licensing agencies shouldbe able to develop standards for the certification/licensing andpractice of the prehospital automated defibrillation operator.5. Guidelines for Prehospital Automated Defibrillation5.1 The operator shall be familiar with all operations of theautomated defibrillator.5.2 The
13、 operator shall be capable of performing prehospitaldefibrillation in accordance with standing orders, protocolsdeveloped, approval by the service medical director or othermedical authority or authorities having jurisdiction, or acombination thereof.5.3 The operator shall be capable of recognizing a
14、 patientwho is unresponsive, apneic and pulseless.5.4 The operator shall be capable of preparing the auto-mated defibrillator for operational use.5.5 The operator shall be capable of applying and activatingthe automated defibrillator according to the manufacturersrecommendations and standing orders/
15、protocols.1This practice is under the jurisdiction of ASTM Committee F30 on EmergencyMedical Services and is the direct responsibility of Subcommittee F30.02 onPersonnel, Training, and Education.Current edition approved March 5, 1990. Published April 1990.2Annual Book of ASTM Standards, Vol 13.02.3A
16、vailable from the American Heart Association, 7372 Greenville Ave., Dallas,TX 75231.1Copyright ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959, United States.5.6 The operator shall ensure that no one is in contact withthe patient or the automated defibrillato
17、r, and that no onepresent in the vicinity of the patient is exposed to any dangerof accidental shock during charging and defibrillation.5.7 The operator shall be capable of accomplishing the taskslisted in 5.3-5.5 and 5.6 within 90 s following patient contact.5.8 The operator shall be capable of rec
18、ognizing thatdefibrillation energy was delivered.5.9 The operator shall be capable of recognizing the successor lack of success of defibrillation and treat the patientaccordingly.5.10 The operator shall be capable of performing BLS/CPRas indicated.5.11 The operator shall be capable of recognizing an
19、dresponding, in accordance with the standing orders or proto-cols, or both, to patients who return to or remain in anunresponsive, apneic and pulseless condition.5.12 The operator shall be capable of preparing the auto-mated defibrillator for the next use.5.13 The operator or the service, or both, u
20、tilizing theautomated defibrillator shall be capable of providing, at aminimum, the following information for quality assurancepurposes:5.13.1 Patient data, including age; sex; whether the arrestwas witnessed or unwitnessed; pulselessness; and initial car-diac rhythm as identified by the automated d
21、efibrillator.5.13.2 EMS system data, including time of:5.13.2.1 Collapse/arrest,5.13.2.2 Call for help,5.13.2.3 Dispatch (include advanced life support, whereavailable),5.13.2.4 Initiation of BLS/CPR,5.13.2.5 Arrival of automated defibrillator at patients side,5.13.2.6 Initial defibrillation,5.13.2.
22、7 Departure to hospital, and5.13.2.8 Arrival at hospital.5.13.3 EMS System Data, in those systems that includethese elements, including time of:5.13.3.1 Activation of on-line medical control, and5.13.3.2 Arrival of advanced life support.5.13.4 Treatment, including documentation of treatment foreach
23、rhythm encountered.5.13.5 Cardiac arrest patient outcome, including the rhythmafter each defibrillation attempt; the return of pulse or sponta-neous respiration, or both; and the level of consciousness.5.14 The operator or the service, or both, utilizing theautomated defibrillator shall ensure it is
24、 maintained in accor-dance with manufacturers recommendations.5.15 The operator shall be capable of recognizing any of thepossible failure modes of the device and shall document anysuch failures to the service medical director.6. Operator Proficiency Requirements6.1 The operator shall demonstrate co
25、ntinued proficiency inautomated defibrillation in accordance with standing orders/protocol.6.2 Proficiency shall include performance skills demonstrat-ing the ability to use the automated defibrillator correctly in asimulated environment.6.3 There shall be documented evidence of initial andcontinuin
26、g education sufficient to establish and maintain pro-ficiency in use of the automated defibrillator as approved by theservice medical director.7. Keywords7.1 automated defibrillation; defibrillation; emergencymedical services; prehospital automated defibrillation; prehos-pital defibrillationASTM Int
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28、y their own responsibility.This standard is subject to revision at any time by the responsible technical committee and must be reviewed every five years andif not revised, either reapproved or withdrawn. Your comments are invited either for revision of this standard or for additional standardsand sh
29、ould be addressed to ASTM International Headquarters. Your comments will receive careful consideration at a meeting of theresponsible technical committee, which you may attend. If you feel that your comments have not received a fair hearing you shouldmake your views known to the ASTM Committee on St
30、andards, at the address shown below.This standard is copyrighted by ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959,United States. Individual reprints (single or multiple copies) of this standard may be obtained by contacting ASTM at the aboveaddress or at 610-832-9585 (phone), 610-832-9555 (fax), or serviceastm.org (e-mail); or through the ASTM website(www.astm.org).F 1255 90 (2002)2
