1. Jules Scadden, P.S, CQI/Data Coordinator-Sac County Ambulance National Association of EMTs (NAEMT) jkscadden@gmail.com

2.  EMS historically provided first defibrillation  Studies- improved outcomes with rapid defibrillation (1) (2)  EMS-Call-to-arrive often 4-5 min or longer  PAD decreased time-defibrillation (1)  By-stander CPR with early defibrillation + coordination with local EMS improved survival rates

3.  Lack of interoperability between devices  Electrodes/Defib pads  Adult vs Peds modes requires pad changes  Software Updates/Guideline changes  Cost prohibitive to many EMS services and small businesses  Lack of EMS-PAD program collaboration

4.  AED used at local high school during a community event. CPR was interrupted twice to change defib pads with arrival of local BLS ambulance and ALS ambulance  Volunteer FR AED fails on third shock—battery dead—unit had never been used/checked during monthly meetings indicated batteries were fine

5.  Universal Electrodes and wiring systems  Institute universal “Adult” vs “Peds” shock button  Remote protocol/algorithms/software updates  Cost of AEDs must not be prohibitive  Collaboration of AED placement/PAD programs with local EMS

6.  Universal pads/electrodes and wiring systems as well as an “adult” vs “Pediatric” shock button can improve patient outcomes by eliminating interrupted CPR  Remote system updates will ensure updates are installed in a timely manner, decreasing “out-of-service” time and potential machine failure  Significant cost increase with technology increases would place an increased burden on EMS services and potentially make PAD programs prohibitive.  Collaboration with local EMS services will enhance a PAD program and improve patient outcomes