Canadian Armed Forces Military Personnel Instruction 02/05 – Automated External Defibrillator Usage

1. Identification

Date of Issue: 2005-03-29

Date of Modification: 2024-12-01

Application: This Canadian Armed Forces Military Personnel Instruction (CAFMPI) applies to officers and non-commissioned members (NCMs) of the Canadian Armed Forces (CAF).

Approval Authority: Chief of Military Personnel (CMP)

Enquiries: Administrative Response Centre (ARC)

2. Definitions

AED (DEA)

Is a medical device – either the automatic or semi-automatic type of defibrillator – used to transmit an electrical current to a patient’s myocardium (heart muscle) following cardiac arrest. It is inclusive of the defibrillator, case, batteries and disposable pads.

AED Instructor (Instructeur en matière de DEA)

Is an individual trained to instruct AED clinical utilization:

• In accordance with Heart and Stroke Foundation of Canada guidelines or other guidelines as deemed appropriate by the Surgeon General; and
• By a training agency recognized by Health Canada as an approved federal government first aid related training provider and recorded in the list of approved organizations under Part XVI of the Canada Occupational Safety and Health Regulations.

AED Provider (Dispensateur de soins en matière de DEA)

Is an individual trained in AED clinical utilization:

• In accordance with Heart and Stroke Foundation of Canada guidelines or other guidelines as deemed appropriate by the Surgeon General; and
• By a training agency recognized by Health Canada as an approved federal government first aid related training provider and recorded in the list of approved organizations under Part XVI of the Canada Occupational Safety and Health Regulations.

AED Training Equipment (Équipement de formation relative au DEA)

Is equipment that includes an AED cardiac rhythm simulator and may include other electronic equipment directly associated with the AED device. It does not include training mannequins.

Cardiac Arrest (Arrêt cardiaque)

Is a life-threatening event and the number one cause of mortality for those individuals over the age of thirty-five. The most effective medical intervention for non-traumatic cardiac arrest is defibrillation.

3. Abbreviations

4. Policy Direction

Policy Statement

4.1 The CAF is committed to:

1. promoting and safeguarding the cardiac health of CAF members and other entitled persons;
2. providing appropriate interventions and treatment to CAF members and other entitled persons who experience cardiac arrest; and
3. providing appropriate interventions and treatment to non-entitled persons who experience cardiac arrest while on CAF bases and establishments.

AED Information Management System

4.2 An AED information management system will be established and maintained by D H Svcs Del. It will include:

1. Data on every AED clinical use; and
2. Data related to training and competency maintenance for AED providers.

AED Locations – Compulsory

4.3 An AED device will be located in the following areas:

1. Emergent care departments of all CF H Svcs Cs;
2. All CAF Dental Clinics unless reasonable access to an AED device within a CF H Svcs C exists on a 24/7 basis;
3. All CAF civilian pattern ambulances used for medical response or to provide support to activities;
4. Standard military pattern ambulances used to provide in-garrison medical support to activities;
5. All CAF airfield crash ambulances; and
6. All DND and CAF fire department emergency medical response vehicles.

Note – An AED device may not be required in the above locations where a manual defibrillation device is present, and providers are trained with clinical skills maintained in ACLS and the operation of a manual defibrillation device. An AED device will be available when ACLS providers trained and maintained in the operation of manual defibrillation are not available. An AED device may be a single unit or a unit combining both manual and automatic defibrillation capability.

AED Locations – Optional

4.4 An AED device may be located in any area deemed appropriate by the local commander in consultation with the local medical authority. AED devices should be reasonably available in a manner consistent with Canadian practice. Any such procurement, maintenance and life cycle costs will be the responsibility of the local commander.

Procurement and Maintenance of AED Equipment

4.5 Procurement, maintenance and life cycling of AED equipment identified within the “compulsory” category is the responsibility of CF H Svcs Gp HQ. Procurement, maintenance and life cycling of AED equipment identified within the “optional” category is the responsibility of local commanders. AED equipment procured for DND/CAF use must meet the specifications developed and promulgated by CF H Svcs Gp HQ. CF H Svcs Gp HQ staff can provide guidance to local commanders and L Med Dirs regarding the most appropriate AED to purchase, as well as maintenance and life cycle strategies.

Guidelines

4.6 The AED medical intervention will be used to treat cardiac arrest in accordance with Heart and Stroke Foundation of Canada Guidelines.

5. Requirements

Lifestyle

5.1 All CAF members are encouraged to adopt a healthy cardiac lifestyle.

Medical Director

5.2 The Med Dir is the Surgeon General, or designate/delegate. The Med Dir will:

1. approve training and MCSP standards for AED Instructors;
2. approve sound AED policies;
3. fulfill the role of Med Dir or designate a Med Dir; and
4. appoint L Med Dirs.

Local Medical Director

5.3 L Med Dirs will be appointed at the direction and discretion of the Med Dir. L Med Dirs will:

1. provide medical supervision of local programs;
2. ensure certification and maintenance of clinical skills of local AED providers;
3. ensure certification, maintenance of clinical skills and monitoring of local AED instructors;
4. chart review in accordance with applicable QI programs;
5. ensure appropriate use of the AED device; and
6. be available for consultation on AED program matters.

AED – Restricted Use Medical Device

5.4 The use of the AED is restricted to qualified persons or persons under the direct supervision of a qualified person in many Canadian provinces. The AED Clinical Utilization Policy requires that all AED users must be under the direction of a Med Dir.

6. AED Training

General

6.1 The AED can be operated effectively with minimal operator training. CAF Regular Force and Primary Reserve health services clinicians, Search and Rescue Technicians, public service clinicians employed by DND, civilian clinicians contracted by DND, CAF and DND Fire Fighters, and Regular Force and Primary Reserve Military Police may train to and maintain clinical skills in AED clinical utilization in accordance with Heart and Stroke Foundation of Canada Guidelines, or other guidelines as deemed appropriate by the Surgeon General.

Additional AED Providers

6.2 Additional AED providers may be trained at the discretion of any CAF MO in consultation with the Med Dir, or L Med Dir, as appropriate.

Coordination and Conduct of AED Training

6.3 AED training may be conducted through any agency deemed appropriate by the L Med Dir and recognized as an approved federal government first aid related training provider by Health Canada as recorded in the list of approved organizations under Part XVI of the Canada Occupational Safety and Health Regulations (Annex A). It may be conducted either as integral to other training or as a stand-alone training course.

AED Instructors

6.4 AED Instructors must meet the following criteria:

1. Be an AED provider;
2. Have current AED training and maintain clinical skills to a standard and in a method as established by the Med Dir;
3. Have training and experience in adult education or other training recognized by and acceptable to DND and the Med Dir;
4. Maintain CPR Instructor level certification provided by a training provider that is recognized and approved by Health Canada for the federal government and in accordance with Heart and Stroke Foundation of Canada Guidelines or other guidelines as deemed appropriate by the Surgeon General; and
5. As a minimum, maintain training standards as follows:
   1. Teach at least one AED course per year,
   2. Be monitored and re-certified every three years or as deemed appropriate by the Med Dir, and
   3. Attend continuing education as deemed appropriate by the Med Dir.

7. Responsibilities

Responsibilities Table

7.1 The following table identifies the responsibilities associated with the instruction.

8. References

Acts, Regulations, Central Agency Policies and Policy DAOD

• QR&O Chapter 34, Medical Services
• Canada Occupational Safety and Health Regulations, Part XVI

Other References

• Heart and Stroke Foundation of Canada AED clinical guidelines
• MSI CF3000-018, Good Samaritan Assistance
• National Occupational Competency Profile, Paramedic Association of Canada
• Service Level Agreement Concerning the Provision of Medical First Response, Prehospital Medical Emergency Care, Emergency Medical Services System CAF Provost Marshal / CAF Fire Marshal / DGHS dated 22-01-2004 (and as amended from time to time)