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. RAN-
GEL, Mr. DELLUMS, Mr. GUTIERREZ, Mr. MORAN, and Mr. LIPINSKI) in-
troduced the following bill; which was referred to the Committee on Com-
merce
A BILL
To amend the Public Health Service Act to establish a pro-
gram regarding training in lifesaving first aid, including
training in the use of automated external defibrillators
to assist individuals experiencing cardiac arrest.
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.
The Congress finds as follows:
(1) A significant increase in the number of indi-
viduals trained in lifesaving first aid would save
many lives, particularly an increase in the number of
individuals trained in responding to cardiac arrest.
(2) Each year approximately 350,000 individ-
uals die from cardiac arrest resulting from cardio-
vascular diseases.
(3) Cardiac arrest can arise in other cir-
cumstances, including drownings, cases of drug sen-
sitivity or drug toxicity, and cases of electrical shock.
(4) More than 65 percent of deaths from car-
diac arrest occur before the victims reach hospitals.
(5) Although cardiopulmonary resuscitation
(commonly known as CPR) is an important tech-
nique in responding to cardiac arrest, the technique
alone cannot terminate ventricular fibrillation in the
heart.
(6) Ventricular fibrillation often can be termi-
nated through use of an electrical device known as
a defibrillator, and one that is automated and is de-
signed for external application is well-suited to re-
sponding to instances of cardiac arrest in cir-
cumstances in which the victim is not at a hospital.
(7) In the typical nonhospital circumstances,
the most effective response to cardiac arrest is to
recognize the warning signs for an imminent attack
and request emergency medical services through the
telephone number 911; to use the technique of
cardiopulmonary resuscitation; and to apply an auto-
matic external defibrillator.
SEC. 3. ESTABLISHMENT OF PROGRAM REGARDING TRAIN-
ING IN LIFESAVING FIRST AID.
Title XII of the Public Health Service Act (42 U.S.C.
300d et seq.) is amended by adding at the end the follow-
ing part:
‘‘PART G—LIFESAVING FIRST AID
‘‘SEC. 1271. PROGRAM REGARDING TRAINING.
‘‘(a) IN GENERAL.—The Secretary shall carry out a
program for the following purposes:
‘‘(1) To develop and operate demonstration
projects to provide training in the provision of life-
saving first aid.
‘‘(2) To develop and disseminate recommenda-
tions regarding the provision of such training.
‘‘(3) To collect data in accordance with section
1273.
‘‘(4) To conduct evaluations in accordance with
such section.
‘‘(b) TRAINING CRITERIA.—
‘‘(1) IN GENERAL.—In carrying out subsection
(a), the Secretary shall develop criteria for training
individuals in the provision of lifesaving first aid, in-
cluding the following:
‘‘(A) Criteria regarding the use of particu-
lar techniques according to the age of the vic-
tim, including criteria specific to infants and
children.
‘‘(B) Criteria designed to train members of
the general public to serve as first responders.
‘‘(C) Criteria designed to train health pro-
fessionals to serve as such responders.
‘‘(2) USE
OF
AGE-RELATED
CRITERIA.—The
criteria developed under paragraph (1)(A) shall be
utilized by the Secretary in the operation of dem-
onstration projects under subsection (a), in making
recommendations under such subsection, and in con-
ducting evaluations in accordance with section 1273.
‘‘(c) RECOMMENDATIONS FOR STATE POLICIES.—
‘‘(1) IN GENERAL.—In carrying out subsection
(a), the Secretary shall provide to the States the rec-
ommendations of the Secretary for State policies re-
garding the provision of lifesaving first aid, includ-
ing recommendations regarding State laws.
‘‘(2) CERTAIN CONSIDERATIONS.—In providing
recommendations to the States under paragraph (1),
the Secretary shall consider the following:
‘‘(A) With respect to the licensure of
health professionals, whether training in lifesav-
ing first aid should be a precondition to the re-
ceipt of a license in each of the professions.
‘‘(B) With respect to obtaining access to
emergency medical services through the tele-
phone number 911—
‘‘(i) whether individuals who take the
telephone calls should be required to un-
dergo training in instructing callers to per-
form particular forms of lifesaving first
aid, including cardiopulmonary resuscita-
tion; and
‘‘(ii) whether there are other skills
that should be required for such individ-
uals.
‘‘(C) Whether individuals in any field other
than health care should be required to undergo
training in lifesaving first aid as a condition of
employment in the field; and if so, whether such
fields include employment as any of the follow-
ing: Law-enforcement officers; fire fighting per-
sonnel; teachers in preschool programs, elemen-
tary or secondary schools, or institutions of
higher education; coaches and other instructors
or supervisors in sports or other extracurricular
activities; providers of day-care services; school-
bus drivers; and lifeguards.
‘‘(D) Whether there should be require-
ments to ensure that the general public under-
goes training in lifesaving first aid; and if so,
whether effective requirements toward such goal
would include—
‘‘(i) requiring such training as a con-
dition for granting a license to operate
motor vehicles; and
‘‘(ii) requiring such training as a con-
dition for graduation from secondary
schools and institutions of higher edu-
cation.
‘‘(d) RECOMMENDATIONS
REGARDING
FEDERAL
POLICIES.—In carrying out subsection (a), the Secretary
may develop recommendations for Federal policies regard-
ing the provision of lifesaving first aid, including rec-
ommendations regarding Federal laws.
‘‘(e) CONSULTATIONS.—In carrying out this part, the
Secretary shall consult with public and private entities
with expertise in providing training in lifesaving first, in-
cluding training on particular techniques according to the
age of the victim.
‘‘(f) GRANTS AND CONTRACTS.—In carrying out this
part, the Secretary may make grants to and enter into
cooperative agreements with public and nonprofit private
entities, and may enter into contracts with public and pri-
vate entities.
‘‘SEC. 1272. AUTOMATED EXTERNAL DEFIBRILLATION AS
RESPONSE TO CARDIAC ARREST.
‘‘(a) IN GENERAL.—In carrying out section 1271, the
Secretary shall comply with the following:
‘‘(1) Demonstration projects and recommenda-
tions under subsection (a) of such section shall in-
clude projects and recommendations regarding the
use of automated external defibrillators.
‘‘(2) Training criteria under subsection (b) of
such subsection shall include criteria regarding such
use.
‘‘(3) 
Recommendations 
and 
considerations
under subsection (c) of such section shall include
recommendations and considerations regarding such
use.
‘‘(b) ADDITIONAL
CONSIDERATIONS
REGARDING
STATE POLICIES.—In providing recommendations to the
States pursuant to subsection (a)(3), the Secretary shall,
in addition to the considerations required pursuant to such
subsection, consider the following:
‘‘(1) With respect to office buildings, stadiums,
musical arenas, and other sites at which large num-
bers of members of the public gather, whether it
should be required that an automatic external
defibrillator be located on the premises; and if so,
whether it should be required that there be on the
premises an individual trained in the use of the de-
vice.
‘‘(2) With respect to patient-transport vehicles
that are equipped to provide basic life support,
whether it should be required that the vehicles have
an automatic external defibrillator (or, as applicable,
whether the class of vehicles subject to such require-
ment should be expanded).
‘‘(3) With respect to individuals who are not
health professionals, whether it is the policy of the
States to prohibit such individuals from using auto-
matic external defibrillators; and if so, whether and
to what extent the policies should be modified.
‘‘(4) With respect to health professionals who
have not undergone training in the use of automatic
external defibrillators, whether it is the policy of the
States to prohibit or restrict such professionals from
using such devices; and if so, whether and to what
extent the policies should be modified.
‘‘(5) With respect to tort laws commonly known
as good Samaritan laws, whether such laws should
be modified to provide that individuals and organiza-
tions cannot be found liable for the use of automatic
external defibrillators.
‘‘(6) Whether other tort laws should be so
modified.
‘‘(7) With respect to the use of external
defibrillators in circumstances other than in hos-
pitals, whether there are circumstances in which a
manual device should be used rather than an auto-
mated device.
‘‘(8) With respect to the use of external
defibrillators in hospitals, whether there are cir-
cumstances in which a manual device should be used
rather than an automated device.
‘‘(c) RECOMMENDATIONS
REGARDING
FEDERAL
POLICIES.—
‘‘(1) IN
GENERAL.—In carrying out section
1271(d), the Secretary shall develop recommenda-
tions for Federal policies regarding the use of auto-
mated external defibrillators, including recommenda-
tions regarding Federal laws.
‘‘(2) CERTAIN
CONSIDERATIONS.—In develop-
ing recommendations under paragraph (1), the Sec-
retary shall consider the following:
‘‘(A) With respect to Federal office build-
ings, military facilities, and other Federal sites
at which substantial numbers of Federal em-
ployees or members of the public gather, wheth-
er it should be required that an automatic ex-
ternal defibrillator be located on the premises;
and if so, whether it should be required that
there be on the premises an individual trained
in the use of the device.
‘‘(B) With respect to tort liabilities of
manufacturers 
of 
automatic 
external
defibrillators that arise from the use of such de-
vices, whether the Federal Government, in
order to ensure the continued economic feasibil-
ity of manufacturing the devices, should provide
for the modification of tort laws to establish
reasonable limitations on the amount of com-
pensation that may be awarded.
‘‘SEC. 1273. COLLECTION OF DATA; EVALUATIONS.
‘‘(a) COLLECTION OF DATA.—In carrying out section
1271(a), the Secretary shall collect data toward determin-
ing the following with respect to the United States:
‘‘(1) The incidence of cardiac arrest and other
conditions with respect to which the provision of life-
saving first aid may be appropriate.
‘‘(2) The injuries, illnesses, or other cir-
cumstances giving rise to such arrest or other condi-
tions in the incident involved.
‘‘(3) The extent to which the age of the victim
was relevant to the occurrence of the incident.
‘‘(4) The rate of survival in the incidents.
‘‘(5) The incidents in which lifesaving first aid
was provided, the rate of survival in such incidents,
and the extent to which the first responders involved
had received training in the provision of such aid.
‘‘(b) 
EVALUATIONS.—In 
carrying 
out 
section
1271(a), the Secretary shall conduct evaluations of pro-
grams that provide training in lifesaving first aid, includ-
ing demonstration projects under paragraph (1) of such
section. Such evaluations shall include consideration of
whether the programs provided training in particular tech-
niques according to the age of the victim.
‘‘SEC. 1274. BIENNIAL REPORT TO CONGRESS.
Not later than February 1, 1997, and every second
year thereafter, the Secretary shall submit to the Congress
a report on the activities carried out under this part. The
report shall provide—
‘‘(1) a description of the demonstration projects
carried out under section 1271(a);
‘‘(2) the recommendations developed pursuant
to such section; and
‘‘(3) a summary of the evaluations conducted
under section 1273(b).
‘‘SEC. 1275. DEFINITIONS
‘‘For purposes of this part:
‘‘(1) The term ‘automated external defibrillator’
means a fully automated or semiautomated external
defibrillator that, as a result of the use of computers
to detect and analyze cardiac rhythms and apply
electrical current accordingly, requires substantially
less training to operate than a manual external
defibrillator.
‘‘(2) The term ‘external defibrillator’ means a
device that, through external contact with the chest
wall, provides an electric current to the heart muscle
for the purpose of terminating ventricular fibrilla-
tion.
‘‘(3) The term ‘first responder’ means an indi-
vidual who provides, or attempts to provide, lifesav-
ing first aid.
‘‘(4) The term ‘lifesaving first aid’ includes the
performance of cardiopulmonary resuscitation, the
application of an automated or manual external
defibrillator, and the provision of relief for the ob-
struction of a breathing passage by a foreign object.
With respect to matters referred to in the preceding
sentence, such term includes the use of particular
techniques according to the age of the victim.
‘‘SEC. 1276. AUTHORIZATION OF APPROPRIATIONS.
‘‘For the purpose of carrying out this part, there are
authorized to be appropriated such sums as may be nec-
essary for each of the fiscal years 1996 through 2000.’’.
Æ