I

104TH CONGRESS

2D SESSION H. R. 3022

To amend the Public Health Service Act to establish a program regarding

training in lifesaving first aid, including training in the use of automated

external defibrillators to assist individuals experiencing cardiac arrest.

IN THE HOUSE OF REPRESENTATIVES

MARCH 6, 1996

Mr. STUDDS (for himself, Mr. MCDERMOTT, Mr. ENGEL, Mr. WAXMAN, Mr.

BEILENSON, Mr. FROST, Mr. EVANS, Mrs. COLLINS of Illinois, Mr. RANGEL, Mr. DELLUMS, Mr. GUTIERREZ, Mr. MORAN, and Mr. LIPINSKI) introduced the following bill; which was referred to the Committee on Commerce

A BILL

To amend the Public Health Service Act to establish a program regarding training in lifesaving first aid, including

training in the use of automated external defibrillators

to assist individuals experiencing cardiac arrest.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Cardiac Arrest Sur5 vival Act’’.

6 SEC. 2. FINDINGS.

7 The Congress finds as follows:
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1 (1) A significant increase in the number of indi2 viduals trained in lifesaving first aid would save

3 many lives, particularly an increase in the number of

4 individuals trained in responding to cardiac arrest.

5 (2) Each year approximately 350,000 individ6 uals die from cardiac arrest resulting from cardio7 vascular diseases.

8 (3) Cardiac arrest can arise in other cir9 cumstances, including drownings, cases of drug sen10 sitivity or drug toxicity, and cases of electrical shock.

11 (4) More than 65 percent of deaths from car12 diac arrest occur before the victims reach hospitals.

13 (5) Although cardiopulmonary resuscitation

14 (commonly known as CPR) is an important tech15 nique in responding to cardiac arrest, the technique

16 alone cannot terminate ventricular fibrillation in the

17 heart.

18 (6) Ventricular fibrillation often can be termi19 nated through use of an electrical device known as

20 a defibrillator, and one that is automated and is de21 signed for external application is well-suited to re22 sponding to instances of cardiac arrest in cir23 cumstances in which the victim is not at a hospital.

24 (7) In the typical nonhospital circumstances,

25 the most effective response to cardiac arrest is to
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1 recognize the warning signs for an imminent attack

2 and request emergency medical services through the

3 telephone number 911; to use the technique of

4 cardiopulmonary resuscitation; and to apply an auto5 matic external defibrillator.

6 SEC. 3. ESTABLISHMENT OF PROGRAM REGARDING TRAIN7 ING IN LIFESAVING FIRST AID.

8 Title XII of the Public Health Service Act (42 U.S.C.

9 300d et seq.) is amended by adding at the end the follow10 ing part:

11 ‘‘PART G—LIFESAVING FIRST AID

12 ‘‘SEC. 1271. PROGRAM REGARDING TRAINING.

13 ‘‘(a) IN GENERAL.—The Secretary shall carry out a

14 program for the following purposes:

15 ‘‘(1) To develop and operate demonstration

16 projects to provide training in the provision of life17 saving first aid.

18 ‘‘(2) To develop and disseminate recommenda19 tions regarding the provision of such training.

20 ‘‘(3) To collect data in accordance with section

21 1273.

22 ‘‘(4) To conduct evaluations in accordance with

23 such section.

24 ‘‘(b) TRAINING CRITERIA.—
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1 ‘‘(1) IN GENERAL.—In carrying out subsection

2 (a), the Secretary shall develop criteria for training

3 individuals in the provision of lifesaving first aid, in4 cluding the following:

5 ‘‘(A) Criteria regarding the use of particu6 lar techniques according to the age of the vic7 tim, including criteria specific to infants and

8 children.

9 ‘‘(B) Criteria designed to train members of

10 the general public to serve as first responders.

11 ‘‘(C) Criteria designed to train health pro12 fessionals to serve as such responders.

13 ‘‘(2) USE OF AGE-RELATED CRITERIA.—The

14 criteria developed under paragraph (1)(A) shall be

15 utilized by the Secretary in the operation of dem16 onstration projects under subsection (a), in making

17 recommendations under such subsection, and in con18 ducting evaluations in accordance with section 1273.

19 ‘‘(c) RECOMMENDATIONS FOR STATE POLICIES.—

20 ‘‘(1) IN GENERAL.—In carrying out subsection

21 (a), the Secretary shall provide to the States the rec22 ommendations of the Secretary for State policies re23 garding the provision of lifesaving first aid, includ24 ing recommendations regarding State laws.
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1 ‘‘(2) CERTAIN CONSIDERATIONS.—In providing

2 recommendations to the States under paragraph (1),

3 the Secretary shall consider the following:

4 ‘‘(A) With respect to the licensure of

5 health professionals, whether training in lifesav6 ing first aid should be a precondition to the re7 ceipt of a license in each of the professions.

8 ‘‘(B) With respect to obtaining access to

9 emergency medical services through the tele10 phone number 911—

11 ‘‘(i) whether individuals who take the

12 telephone calls should be required to un13 dergo training in instructing callers to per14 form particular forms of lifesaving first

15 aid, including cardiopulmonary resuscita16 tion; and

17 ‘‘(ii) whether there are other skills

18 that should be required for such individ19 uals.

20 ‘‘(C) Whether individuals in any field other

21 than health care should be required to undergo

22 training in lifesaving first aid as a condition of

23 employment in the field; and if so, whether such

24 fields include employment as any of the follow25 ing: Law-enforcement officers; fire fighting per-
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1 sonnel; teachers in preschool programs, elemen2 tary or secondary schools, or institutions of

3 higher education; coaches and other instructors

4 or supervisors in sports or other extracurricular

5 activities; providers of day-care services; school6 bus drivers; and lifeguards.

7 ‘‘(D) Whether there should be require8 ments to ensure that the general public under9 goes training in lifesaving first aid; and if so,

10 whether effective requirements toward such goal

11 would include—

12 ‘‘(i) requiring such training as a con13 dition for granting a license to operate

14 motor vehicles; and

15 ‘‘(ii) requiring such training as a con16 dition for graduation from secondary

17 schools and institutions of higher edu18 cation.

19 ‘‘(d) RECOMMENDATIONS REGARDING FEDERAL

20 POLICIES.—In carrying out subsection (a), the Secretary

21 may develop recommendations for Federal policies regard22 ing the provision of lifesaving first aid, including rec23 ommendations regarding Federal laws.

24 ‘‘(e) CONSULTATIONS.—In carrying out this part, the

25 Secretary shall consult with public and private entities
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1 with expertise in providing training in lifesaving first, in2 cluding training on particular techniques according to the

3 age of the victim.

4 ‘‘(f) GRANTS AND CONTRACTS.—In carrying out this

5 part, the Secretary may make grants to and enter into

6 cooperative agreements with public and nonprofit private

7 entities, and may enter into contracts with public and pri8 vate entities.

9 ‘‘SEC. 1272. AUTOMATED EXTERNAL DEFIBRILLATION AS

10 RESPONSE TO CARDIAC ARREST.

11 ‘‘(a) IN GENERAL.—In carrying out section 1271, the

12 Secretary shall comply with the following:

13 ‘‘(1) Demonstration projects and recommenda14 tions under subsection (a) of such section shall in15 clude projects and recommendations regarding the

16 use of automated external defibrillators.

17 ‘‘(2) Training criteria under subsection (b) of

18 such subsection shall include criteria regarding such

19 use.

20 ‘‘(3) Recommendations and considerations

21 under subsection (c) of such section shall include

22 recommendations and considerations regarding such

23 use.

24 ‘‘(b) ADDITIONAL CONSIDERATIONS REGARDING

25 STATE POLICIES.—In providing recommendations to the
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1 States pursuant to subsection (a)(3), the Secretary shall,

2 in addition to the considerations required pursuant to such

3 subsection, consider the following:

4 ‘‘(1) With respect to office buildings, stadiums,

5 musical arenas, and other sites at which large num6 bers of members of the public gather, whether it

7 should be required that an automatic external

8 defibrillator be located on the premises; and if so,

9 whether it should be required that there be on the

10 premises an individual trained in the use of the de11 vice.

12 ‘‘(2) With respect to patient-transport vehicles

13 that are equipped to provide basic life support,

14 whether it should be required that the vehicles have

15 an automatic external defibrillator (or, as applicable,

16 whether the class of vehicles subject to such require17 ment should be expanded).

18 ‘‘(3) With respect to individuals who are not

19 health professionals, whether it is the policy of the

20 States to prohibit such individuals from using auto21 matic external defibrillators; and if so, whether and

22 to what extent the policies should be modified.

23 ‘‘(4) With respect to health professionals who

24 have not undergone training in the use of automatic

25 external defibrillators, whether it is the policy of the
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1 States to prohibit or restrict such professionals from

2 using such devices; and if so, whether and to what

3 extent the policies should be modified.

4 ‘‘(5) With respect to tort laws commonly known

5 as good Samaritan laws, whether such laws should

6 be modified to provide that individuals and organiza7 tions cannot be found liable for the use of automatic

8 external defibrillators.

9 ‘‘(6) Whether other tort laws should be so

10 modified.

11 ‘‘(7) With respect to the use of external

12 defibrillators in circumstances other than in hos13 pitals, whether there are circumstances in which a

14 manual device should be used rather than an auto15 mated device.

16 ‘‘(8) With respect to the use of external

17 defibrillators in hospitals, whether there are cir18 cumstances in which a manual device should be used

19 rather than an automated device.

20 ‘‘(c) RECOMMENDATIONS REGARDING FEDERAL

21 POLICIES.—

22 ‘‘(1) IN GENERAL.—In carrying out section

23 1271(d), the Secretary shall develop recommenda24 tions for Federal policies regarding the use of auto-
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1 mated external defibrillators, including recommenda2 tions regarding Federal laws.

3 ‘‘(2) CERTAIN CONSIDERATIONS.—In develop4 ing recommendations under paragraph (1), the Sec5 retary shall consider the following:

6 ‘‘(A) With respect to Federal office build7 ings, military facilities, and other Federal sites

8 at which substantial numbers of Federal em9 ployees or members of the public gather, wheth10 er it should be required that an automatic ex11 ternal defibrillator be located on the premises;

12 and if so, whether it should be required that

13 there be on the premises an individual trained

14 in the use of the device.

15 ‘‘(B) With respect to tort liabilities of

16 manufacturers of automatic external

17 defibrillators that arise from the use of such de18 vices, whether the Federal Government, in

19 order to ensure the continued economic feasibil20 ity of manufacturing the devices, should provide

21 for the modification of tort laws to establish

22 reasonable limitations on the amount of com23 pensation that may be awarded.
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1 ‘‘SEC. 1273. COLLECTION OF DATA; EVALUATIONS.

2 ‘‘(a) COLLECTION OF DATA.—In carrying out section

3 1271(a), the Secretary shall collect data toward determin4 ing the following with respect to the United States:

5 ‘‘(1) The incidence of cardiac arrest and other

6 conditions with respect to which the provision of life7 saving first aid may be appropriate.

8 ‘‘(2) The injuries, illnesses, or other cir9 cumstances giving rise to such arrest or other condi10 tions in the incident involved.

11 ‘‘(3) The extent to which the age of the victim

12 was relevant to the occurrence of the incident.

13 ‘‘(4) The rate of survival in the incidents.

14 ‘‘(5) The incidents in which lifesaving first aid

15 was provided, the rate of survival in such incidents,

16 and the extent to which the first responders involved

17 had received training in the provision of such aid.

18 ‘‘(b) EVALUATIONS.—In carrying out section

19 1271(a), the Secretary shall conduct evaluations of pro20 grams that provide training in lifesaving first aid, includ21 ing demonstration projects under paragraph (1) of such

22 section. Such evaluations shall include consideration of

23 whether the programs provided training in particular tech24 niques according to the age of the victim.
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1 ‘‘SEC. 1274. BIENNIAL REPORT TO CONGRESS.

2 Not later than February 1, 1997, and every second

3 year thereafter, the Secretary shall submit to the Congress

4 a report on the activities carried out under this part. The

5 report shall provide—

6 ‘‘(1) a description of the demonstration projects

7 carried out under section 1271(a);

8 ‘‘(2) the recommendations developed pursuant

9 to such section; and

10 ‘‘(3) a summary of the evaluations conducted

11 under section 1273(b).

12 ‘‘SEC. 1275. DEFINITIONS

13 ‘‘For purposes of this part:

14 ‘‘(1) The term ‘automated external defibrillator’

15 means a fully automated or semiautomated external

16 defibrillator that, as a result of the use of computers

17 to detect and analyze cardiac rhythms and apply

18 electrical current accordingly, requires substantially

19 less training to operate than a manual external

20 defibrillator.

21 ‘‘(2) The term ‘external defibrillator’ means a

22 device that, through external contact with the chest

23 wall, provides an electric current to the heart muscle

24 for the purpose of terminating ventricular fibrilla25 tion.
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1 ‘‘(3) The term ‘first responder’ means an indi2 vidual who provides, or attempts to provide, lifesav3 ing first aid.

4 ‘‘(4) The term ‘lifesaving first aid’ includes the

5 performance of cardiopulmonary resuscitation, the

6 application of an automated or manual external

7 defibrillator, and the provision of relief for the ob8 struction of a breathing passage by a foreign object.

9 With respect to matters referred to in the preceding

10 sentence, such term includes the use of particular

11 techniques according to the age of the victim.

12 ‘‘SEC. 1276. AUTHORIZATION OF APPROPRIATIONS.

13 ‘‘For the purpose of carrying out this part, there are

14 authorized to be appropriated such sums as may be nec15 essary for each of the fiscal years 1996 through 2000.’’.

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