II

105TH CONGRESS

2D SESSION S. 2196

To amend the Public Health Service Act to provide for the establishment

at the National Heart, Lung, and Blood Institute of a program regarding

lifesaving interventions for individuals who experience cardiac arrest,

and for other purposes.

IN THE SENATE OF THE UNITED STATES

JUNE 19, 1998

Mr. GORTON (for himself, Mrs. MURRAY, Mr. GRAMS, and Mr. BINGAMAN)

introduced the following bill; which was read twice and referred to the

Committee on Labor and Human Resources

A BILL

To amend the Public Health Service Act to provide for

the establishment at the National Heart, Lung, and

Blood Institute of a program regarding lifesaving interventions for individuals who experience cardiac arrest,

and for other purposes.

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 Congress makes the following findings:
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1 (1) Each year more than 350,000 adults suffer

2 cardiac arrest, usually away from a hospital. More

3 than 95 percent of them will die, in many cases, be4 cause lifesaving defibrillators arrive on the scene too

5 late, if at all.

6 (2) These cardiac arrest deaths occur primarily

7 from occult underlying heart disease and from

8 drownings, allergic or sensitivity reactions, or elec9 trical shocks.

10 (3) Survival from cardiac arrest requires suc11 cessful early implementation of a chain of events,

12 the chain of survival which begins when the person

13 sustains a cardiac arrest and continues until the

14 person arrives at the hospital.

15 (4) A successful chain of survival requires the

16 first person on the scene to take rapid and simple

17 initial steps to care for the patient and to assure the

18 patient promptly enters the emergency medical serv19 ices system.

20 (5) The first persons on the scene when an ar21 rest occurs are typically lay persons who are friends

22 or family of the victim, fire services, public safety

23 personnel, basic life support emergency medical serv24 ices providers, teachers, coaches, and supervisors of

25 sports or other extracurricular activities, providers of
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1 day care, school bus drivers, lifeguards, attendants

2 at public gatherings, coworkers, and other leaders

3 within the community.

4 (6) A coordinated Federal response is necessary

5 to ensure that appropriate and timely lifesaving

6 interventions are provided to persons sustaining non7 traumatic cardiac arrest. The Federal response

8 should include, but not be limited to—

9 (A) significantly expanded research con10 cerning the efficacy of various methods of pro11 viding immediate out-of-hospital lifesaving

12 interventions to the nontraumatic cardiac arrest

13 patient;

14 (B) the development of research-based, na15 tionally uniform, easily learned and well re16 tained model core educational content concern17 ing the use of such lifesaving interventions by

18 health care professionals, allied health person19 nel, emergency medical services personnel, pub20 lic safety personnel, and other persons who are

21 likely to arrive immediately at the scene of a

22 sudden cardiac arrest;

23 (C) an identification of the legal, political,

24 financial, and other barriers to implementing

25 these lifesaving interventions; and
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1 (D) the development of model State legis2 lation to reduce identified barriers and to en3 hance each State’s response to this significant

4 problem.

5 SEC. 3. NATIONAL INSTITUTES OF HEALTH MODEL PRO6 GRAM ON THE FIRST LINKS IN THE CHAIN OF

7 SURVIVAL.

8 Section 421 of the Public Health Service Act (42

9 U.S.C. 285b–3) is amended by adding at the end the fol10 lowing subsection:

11 ‘‘(c) Programs under subsection (a)(1)(E) (relating

12 to emergency medical services and preventive, diagnostic,

13 therapeutic, and rehabilitative approaches) shall include

14 programs for the following:

15 ‘‘(1) The development and dissemination, in co16 ordination with the emergency services guidelines

17 promulgated under section 402(a) of title 23, United

18 States Code, by the Associate Administrator for

19 Traffic Safety Programs, Department of Transpor20 tation, of a core content for a model State training

21 program applicable to cardiac arrest for inclusion in

22 appropriate current emergency medical services edu23 cational curricula and training programs that ad24 dress lifesaving interventions, including

25 cardiopulmonary resuscitation and defibrillation. In
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1 developing the core content for such program, the

2 Director of the Institute may rely upon the content

3 of similar curricula and training programs developed

4 by national nonprofit entities. The core content of

5 such program—

6 ‘‘(A) may be used by health care profes7 sionals, allied health personnel, emergency med8 ical services personnel, public safety personnel,

9 and any other persons who are likely to arrive

10 immediately at the scene of a sudden cardiac

11 arrest (in this subsection referred to as ‘cardiac

12 arrest care providers’) to provide lifesaving

13 interventions, including cardiopulmonary resus14 citation and defibrillation;

15 ‘‘(B) shall include age-specific criteria for

16 the use of particular techniques, which shall in17 clude infants and children; and

18 ‘‘(C) shall be reevaluated as additional

19 interventions are shown to be effective.

20 ‘‘(2) The operation of a limited demonstration

21 project to provide training in such core content for

22 cardiac arrest care providers to validate the effec23 tiveness of the training program.

24 ‘‘(3) The definition and identification of cardiac

25 arrest care providers, by personal relationship, expo-
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1 sure to arrest or trauma, occupation (including

2 health professionals), or otherwise, who could pro3 vide benefit to victims of out-of-hospital arrest by

4 comprehension of such core content.

5 ‘‘(4) The establishment of criteria for comple6 tion and comprehension of such core content, includ7 ing consideration of inclusion in health and safety

8 educational curricula.

9 ‘‘(5) The identification and development of

10 equipment and supplies that should be accessible to

11 cardiac arrest care providers to permit lifesaving

12 interventions by preplacement of such equipment in

13 appropriate locations insofar as such activities are

14 consistent with the development of the core content

15 and utilize information derived from such studies by

16 the National Institutes of Health on investigation in

17 cardiac resuscitation.

18 ‘‘(6) The development in accordance with this

19 paragraph of model State legislation (or Federal leg20 islation applicable to Federal territories, facilities,

21 and employees). In developing the model legislation,

22 the Director of the Institute shall cooperate with the

23 Attorney General, and may consult with nonprofit

24 private organizations that are involved in the draft-
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1 ing of model State legislation. The model legislation

2 shall be developed in accordance with the following:

3 ‘‘(A) The purpose of the model legislation

4 shall be to ensure—

5 ‘‘(i) access to emergency medical serv6 ices through consideration of a require7 ment for public placement of lifesaving

8 equipment; and

9 ‘‘(ii) good samaritan immunity for

10 cardiac arrest care providers; those in11 volved with the instruction of the training

12 programs; and owners and managers of

13 property where equipment is placed.

14 ‘‘(B) In the development of the model leg15 islation, there shall be consideration of require16 ments for training in the core content and use

17 of lifesaving equipment for State licensure or

18 credentialing of health professionals or other oc19 cupations or employment of other individuals

20 who may be defined as cardiac arrest care pro21 viders under paragraph (3).

22 ‘‘(7) The coordination of a national database

23 for reporting and collecting information relating to

24 the incidence of cardiac arrest, the circumstances

25 surrounding such arrests, the rate of survival, the
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1 effect of age, and whether interventions, including

2 cardiac arrest care provider interventions, or other

3 aspects of the chain of survival, improve the rate of

4 survival. The development of such database shall be

5 coordinated with other existing databases on emer6 gency care that have been developed under the au7 thority of the National Highway Traffic Safety Ad8 ministration and the Centers for Disease Control

9 and Prevention.’’.

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