Community Public Access Defibrillator (cPAD) Guidance

1.1 Rationale 

Stockton-on-Tees Borough Council is regularly contacted by residents, organisations and by elected members regarding the installation of, and support for Community Public Access Defibrillators (cPAD) across the borough. This policy has been developed by the Public Health team and Highways, Estates team to inform the consistent corporate approach of Stockton-on-Tees Borough Council responding to and resolving these queries. Effective use of cPAD devices is supported by cardiopulmonary resuscitation (CPR) knowledge and training. This document also explains how CPR training is supported by the council.    

1.2 Cardiac arrest, cardiopulmonary resuscitation (CPR) and defibrillators 

Cardiac arrest is a life-threatening condition that occurs when the heart suddenly stops beating effectively, leading to the disruption of blood flow to the vital organs. It is a medical emergency that requires immediate intervention to prevent severe brain damage or death. In the event of a cardiac arrest, CPR and defibrillators play a crucial role in saving lives.  

CPR is a lifesaving technique that involves manually compressing the chest and providing rescue breaths to a person experiencing cardiac arrest. By performing CPR, this helps to maintain blood circulation and deliver oxygen to the brain and other organs until professional medical help arrives. In the case of cardiac arrest, performing CPR as soon as possible significantly increases the chances of survival and reduces the risk of long-term complications. 

Defibrillators are devices used to restore a normal heart rhythm during cardiac arrest. These devices deliver an electrical shock to the heart, known as defibrillation, which helps reset the heart's electrical activity and potentially restore it's normal function. The use of a defibrillator within the first few minutes of a cardiac arrest can increase the survival rate by up to 70%. This emphasises the importance of defibrillators in public spaces, and training residents of Stockton-on-Tees in CPR.  

1.3 cPAD provision and guidance 

Defibrillators are devices used to restore a normal heart rhythm during cardiac arrest. A cPAD is a defibrillator that is located in a community setting and available for members of the public to access, 24 hours a day. Devices are accessed through use of a key code which is provided by the 999 operators. 

They are safe to use and will not allow a shock to be given unless the heart's rhythm requires it. 

cPADs are funded and looked after by 'Guardians'. Guardians are volunteers who are responsible for the purchase and maintenance of the cPAD. They undertake regular checks and register the status of the cPAD on a live list of available defibrillators owned by the North East Ambulance Service (NEAS). This list is called 'The Circuit' and is accessed by the 999 operator when they receive an emergency call to determine the nearest available defibrillator. 

Across Stockton-on-Tees there are approximately 141 cPADs. In addition there are an additional 82 devices that located in premises that have restricted access, for example, schools and workplaces. There is currently no national guidance on the level of provision of defibrillators for a given area, however it has been suggested that any location that has 1000 adults over the age of 35 years present during normal business hours can expect one incident of Out of Hospital Cardiac Arrest (OHCA) every 5 years and should have a cPAD available. The North East Ambulance Service (NEAS) suggest that cPADs are installed at a minimum distance of 500m from an existing 24, 7 cPAD location, and no more than 1km. The rationale for this is that in a life-threatening emergency, the caller would be alerted to the nearest cPAD within 500m of their location. 

North East Ambulance Service (NEAS) provide guidance to community groups interested in purchasing and installing a cPAD. A defibrillator with an external cabinet costs approximately £1800. It is the responsibility of the organisation, individual or group who wish to purchase the defibrillator to cover any set-up costs and ongoing costs associated with the installation and maintenance of the cPAD, and registration of the cPAD with The Circuit. The community group must also identify a 'Guardian' who is responsible for checking and reporting the device status on 'The Circuit'. The Guardian should routinely check the cPAD every 2 weeks. In the event of the defibrillator having been used in an emergency the guardian is contacted to ensure that pads are replaced and the defibrillator checked. While this is being done the defibrillator will not be listed as available to use. 

The 'guardian and community group' are also responsible for providing electricity to keep the defibrillator at operating temperature during the winter, periodical maintenance costs including the cost of replacement batteries and pads, and resolving any other issues with the cPAD that arise. Replacement cost vary greatly between different models and if the defibrillator has been used but usually are only required once every 3 to 5 years. Funding is available to help with these costs, detailed in Section 3.