I
105TH CONGRESS
2D SESSION
H. R. 4121
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 HOUSE OF REPRESENTATIVES
JUNE 23, 1998
Mr. STEARNS (for himself, Mr. GEKAS, Mr. SERRANO, Mr. WAXMAN, Mr.
FROST, Mrs. MINK of Hawaii, Mr. FILNER, Mr. HILLIARD, Mr. MCCOL-
LUM, Mrs. KENNELLY of Connecticut, Mr. CLEMENT, Mr. SHAYS, Mr.
FALEOMAVAEGA, Mr. HASTINGS of Florida, Ms. CARSON, Mr. WOLF, Mr.
WALSH, Mr. BOEHLERT, Mrs. LINDA SMITH of Washington, Mr. COOK,
and Mr. DELAHUNT) introduced the following bill; which was referred to
the Committee on Commerce
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 inter-
ventions for individuals who experience cardiac arrest,
and for other purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Cardiac Arrest Sur-
vival Act’’.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) Each year more than 350,000 adults suffer
cardiac arrest, usually away from a hospital. More
than 95 percent of them will die, in many cases, be-
cause lifesaving defibrillators arrive on the scene too
late, if at all.
(2) These cardiac arrest deaths occur primarily
from occult underlying heart disease and from
drownings, allergic or sensitivity reactions, or elec-
trical shocks.
(3) Survival from cardiac arrest requires suc-
cessful early implementation of a chain of events,
the chain of survival which begins when the person
sustains a cardiac arrest and continues until the
person arrives at the hospital.
(4) A successful chain of survival requires the
first person on the scene to take rapid and simple
initial steps to care for the patient and to assure the
patient promptly enters the emergency medical serv-
ices system.
(5) The first persons on the scene when an ar-
rest occurs are typically lay persons who are friends
or family of the victim, fire services, public safety
personnel, basic life support emergency medical serv-
ices providers, teachers, coaches, and supervisors of
sports or other extracurricular activities, providers of
day care, school bus drivers, lifeguards, attendants
at public gatherings, coworkers, and other leaders
within the community.
(6) A coordinated Federal response is necessary
to ensure that appropriate and timely lifesaving
interventions are provided to persons sustaining non-
traumatic cardiac arrest. The Federal response
should include, but not be limited to—
(A) significantly expanded research con-
cerning the efficacy of various methods of pro-
viding 
immediate 
out-of-hospital 
lifesaving
interventions to the nontraumatic cardiac arrest
patient;
(B) the development of research-based, na-
tionally uniform, easily learned and well re-
tained model core educational content concern-
ing the use of such lifesaving interventions by
health care professionals, allied health person-
nel, emergency medical services personnel, pub-
lic safety personnel, and other persons who are
likely to arrive immediately at the scene of a
sudden cardiac arrest;
(C) an identification of the legal, political,
financial, and other barriers to implementing
these lifesaving interventions; and
(D) the development of model State legis-
lation to reduce identified barriers and to en-
hance each State’s response to this significant
problem.
SEC. 3. NATIONAL INSTITUTES OF HEALTH MODEL PRO-
GRAM ON THE FIRST LINKS IN THE CHAIN OF
SURVIVAL.
Section 421 of the Public Health Service Act (42
U.S.C. 285b–3) is amended by adding at the end the fol-
lowing subsection:
‘‘(c) Programs under subsection (a)(1)(E) (relating
to emergency medical services and preventive, diagnostic,
therapeutic, and rehabilitative approaches) shall include
programs for the following:
‘‘(1) The development and dissemination, in co-
ordination with the emergency services guidelines
promulgated under section 402(a) of title 23, United
States Code, by the Associate Administrator for
Traffic Safety Programs, Department of Transpor-
tation, of a core content for a model State training
program applicable to cardiac arrest for inclusion in
appropriate current emergency medical services edu-
cational curricula and training programs that ad-
dress 
lifesaving 
interventions, 
including
cardiopulmonary resuscitation and defibrillation. In
developing the core content for such program, the
Director of the Institute may rely upon the content
of similar curricula and training programs developed
by national nonprofit entities. The core content of
such program—
‘‘(A) may be used by health care profes-
sionals, allied health personnel, emergency med-
ical services personnel, public safety personnel,
and any other persons who are likely to arrive
immediately at the scene of a sudden cardiac
arrest (in this subsection referred to as ‘cardiac
arrest care providers’) to provide lifesaving
interventions, including cardiopulmonary resus-
citation and defibrillation;
‘‘(B) shall include age-specific criteria for
the use of particular techniques, which shall in-
clude infants and children; and
‘‘(C) shall be reevaluated as additional
interventions are shown to be effective.
‘‘(2) The operation of a limited demonstration
project to provide training in such core content for
cardiac arrest care providers to validate the effec-
tiveness of the training program.
‘‘(3) The definition and identification of cardiac
arrest care providers, by personal relationship, expo-
sure to arrest or trauma, occupation (including
health professionals), or otherwise, who could pro-
vide benefit to victims of out-of-hospital arrest by
comprehension of such core content.
‘‘(4) The establishment of criteria for comple-
tion and comprehension of such core content, includ-
ing consideration of inclusion in health and safety
educational curricula.
‘‘(5) The identification of equipment and sup-
plies that should be accessible to cardiac arrest care
providers to permit lifesaving interventions by
preplacement of such equipment in appropriate loca-
tions insofar as such activities are consistent with
the development of the core content and utilize in-
formation derived from such studies by the National
Institutes of Health on investigation in cardiac re-
suscitation.
‘‘(6) The development in accordance with this
paragraph of model State legislation (or Federal leg-
islation applicable to Federal territories, facilities,
and employees). In developing the model legislation,
the Director of the Institute shall cooperate with the
Attorney General, and may consult with nonprofit
private organizations that are involved in the draft-
ing of model State legislation. The model legislation
should take into consideration the following:
‘‘(A) The purpose of the model legislation
shall be to ensure—
‘‘(i) access to emergency medical serv-
ices through consideration of a require-
ment for public placement of lifesaving
equipment; and
‘‘(ii) good samaritan immunity for
cardiac arrest care providers; those in-
volved with the instruction of the training
programs; and owners and managers of
property where equipment is placed.
‘‘(B) In the development of the model leg-
islation, there shall be consideration of require-
ments for training in the core content and use
of lifesaving equipment for State licensure or
credentialing of health professionals or other oc-
cupations or employment of other individuals