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8/10/2019 Aramco Gen
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SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GI NUMBER Approved150.002
GENERAL INSTRUCTION MANUAL
ISSUING ORG. SAUDI ARAMCO SAMSO ORGANIZATIONISSUE DATE
09/15/2008
REPLACES
03/09/2005
SUBJECT
Basic life Support (BLS) Heartsaver Automated External
Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
APPROVALMMR
PAGE NO.
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I. CONTENT:
This document describes the Saudi Heart Association (SHA) and Saudi Aramco requirements for
training in Basic Life Support (BLS) Heartsaver Automated External Defibrillator (AED), StandardFirst Aid (SFA), Instructor Training Program (ITP), and acquisition of First Aid Kits/AED machines.
1. Definitions:
1.1SFA/BLS Heartsaver AED Training: is provided by Instructors of the Health
Promotion Unit (HPU), Preventive Medicine Services Division (PMSD), SaudiAramco Medical Services Organization (SAMSO).
1.2SFA/BLS Heartsaver AED Instructor Training Program (ITP): is provided
by certified SFA/BLS/AED Instructors from the Health Promotion Unit, in orderto train trainers designated by a requesting organization to conduct SFA/BLSHeartsaver AED classes on job site only for employees who fall under its
department/division.
1.3SFA/BLS/AED Instructor Trainer: is a Health Promotion Instructor who is certifiedto train others to become SFA/BLS/AED Instructors.
1.4Non-SAMSO Instructor: is an Instructor trained in SFA/BLS Hearsaver AED by a
certified SFA/BLS/AED Instructor Trainer from the Health Promotion Unit. He/she willsend monthly statistics of completed classes to the SFA/BLS/AED Group Leader,
Health Promotion Unit.
1.5First Aid Kits:are supplies required to administer First Aid to the sick or
injured; available through B2B Purchasing System.1.6Health Promotion Standards and Guidelines:are based on the Saudi Heart
Association (SHA), American Heart Association (AHA) and American Red
Cross (ARC) requirements.1.7Overall AED Program Coordinator:is a qualified individual in the Health
Promotion Unit, Preventive Medicine Services Division, who will be responsible
for implementing and administering the AED program in Saudi Aramco.1.8AED Site Coordinator:is a qualified individual at the authorized facility who
will supervise the implementation of the AED program in that facility.
1.9SAMSO AED Committee:Chaired by the Overall AED Program Coordinatorand includes members from Occupational Medicine Services (OMS), Emergency
Medical Services (EMS), Medical Designated Facilities Department (MDFD),SAMSO and the Cardio-pulmonary Resuscitation (CPR) Center. The committee
is responsible for ensuring that the AED installation and operation requirementshave been met. These requirements fall under three categories:
(i) Pre-installation Requirements: a) Evaluate the site assessment form.(ii) Post-installation Requirements: b) provide assistance in the installation,
if requested.
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SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GI NUMBER Approved150.002
GENERAL INSTRUCTION MANUAL
ISSUING ORG. SAUDI ARAMCO SAMSO ORGANIZATIONISSUE DATE
09/15/2008
REPLACES
03/09/2005
SUBJECT
Basic life Support (BLS) Heartsaver Automated External
Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
APPROVALMMR
PAGE NO.
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1.10 AED Facility Sponsoring Committee:includes the AED Site Coordinator and other
personnel in the facility where the AED machine is to be installed. The committeecoordinates with the SAMSO AED Committee with regards to the AED installation and
operation requirements.
II. PURPOSE:
1. To ensure that a standardized high quality training in SFA/BLS/AED is practicedconsistently throughout the company in accordance with the Health Promotion Units
standards and guidelines.2. To ensure that at least one employee per shift at each site is qualified to administer
SFA/BLS Heartsaver AED to the sick or injured victim.
3. To ensure that adequate AED machines are available at all company work sites.4. To ensure that end-users are aware of the AED installation and operation requirements.
III. GENERAL POLICES:
1. AED machine shall be placed in strategic locations at all company work sitesbased on completion of the AED Site Assessment Form (Attachment) by Facility
Sponsoring Committee. A work location is considered a strategic location if:o The location is more than 3km far from the nearest Emergency Medical
Service (EMS).
o The estimated response time from the location to the nearest Emergency
Medical Service (EMS) is more than 5 minutes.o The approximate average age of workforce at the location is over 45.
2. First Aid Kit shall be available at all work sites, in accordance with Saudi ArabGovernment Decision No.404, dated 17 Jamada 11, 1394 (7 July 1974).
3. All employees are eligible to be certified to administer SFA/BLS HeartsaverAED procedure through a recognized training program.
4. Health Promotion Unit shall provide direction and support to BLS HeartsaverAED Instructors to include a training module on AED use with pediatric
electrodes for children from 1 to 8 years of age in BLS Heartsaver AED coursesat the community.
5. SFA/BLS Heartsaver AED training and certification are the responsibility of theHealth Promotion Unit for non SAMSO employees and dependants throughout
the company.
6. If the requesting department/division has more than 200 employees to be trainedannually, Health Promotion Unit will train candidates from the respective area to
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SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GI NUMBER Approved150.002
GENERAL INSTRUCTION MANUAL
ISSUING ORG. SAUDI ARAMCO SAMSO ORGANIZATIONISSUE DATE
09/15/2008
REPLACES
03/09/2005
SUBJECT
Basic life Support (BLS) Heartsaver Automated External
Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
APPROVALMMR
PAGE NO.
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* CHANGE ** ADDITION NEW INSTRUCTION COMPLETE REVISION
serve as Instructors, who will then provide SFA/BLS Heartsaver AED Training
to their department/division employees only.
7. Departments/Divisions are to ensure formation of a functional AED FacilitySponsoring Committee.
IV. SFA/BLS/AED TRAINING POLICIES:
1. Class Format:
Course Title Duration Max. Class Size
Participants
Validity of Certificate
Adult BLS HearsaverAED
6 hours 6 candidates 2 years
Standard First Aid 6 hours 8 candidates 3 years
Adult BLS Hearsaver
AED Re-certification
4 hours 6 candidates 2 Years
2. Scheduling:
2.1 Applying:
Employees are booked by their training coordinators through SAP HumanResources only.
Health Promotion Unit sends an automated confirmation of the booking to theemployee, his/her Training Coordinator and Supervisor. The confirmation will
be sent directly to the requester if he/she is a dependant.
2.2 Eligibility:
All Saudi Aramco employees are eligible to receive BLS Hearsaver AED andSFA Training. The training coordinator for contract personnel is required to
enroll the contractor through Saudi Aramco Contractor Training Division.
2.3 Time Frame:
Classes are taught in one day, but may be split into two consecutive morningsfor special reasons of convenience, such as Ramadan schedule.
2.4 Scheduling Candidates in Arabic vs. English Classes:
Health Promotion may urge bilingual candidates to select Arabic classes.
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SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GI NUMBER Approved150.002
GENERAL INSTRUCTION MANUAL
ISSUING ORG. SAUDI ARAMCO SAMSO ORGANIZATIONISSUE DATE
09/15/2008
REPLACES
03/09/2005
SUBJECT
Basic life Support (BLS) Heartsaver Automated External
Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
APPROVALMMR
PAGE NO.
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2.5 Infant and Child CPR Course
The course is available to employees and dependents upon special request.
3. Requirements to Successful Completion of SFA/BLS Heartsaver AED Training
Courses:
3.1 Attendance: Participants must attend all (6) hours for all training courses
3.2 Practical evaluation: Participants must perform all skills satisfactorily.
3.3 Written test: Participants must pass a written test.
4. Class Location:
Health Promotion Unit offers these courses on its premises in Dhahran, Ras Tanura,
Abqaiq, Al-Hasa, Udhailiyah, Jeddah and Yanbu.
5. Language Skills:
5.1 Candidates for Arabic classes must be proficient in reading and writing Arabic.
5.2 Candidates for English classes must be proficient in reading and writing English andmust have completed ITC English level 7Bas minimum requirements.
Instructors must not use two languages in the same class to accommodate language difficultiesas it is distracting to all parties in the class
V. SFA/BLS Heartsaver AED Instructor Training Program (ITP)
1. Class Format:
Course Title Minimum Duration Maximum class Size Prerequisites
BLS Heartsaver AEDInstructor
8 days 3 candidates No prerequisiterequired
SFA Instructor 8 days 3 candidates BLS HeartsaverAED + 3 months
Note: Health Promotion Unit reserves the right to call the Instructor for an evaluation andrecertification, if needed.
1stday Provider Class 5
tday 1
stInstructor Teaching
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SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GI NUMBER Approved150.002
GENERAL INSTRUCTION MANUAL
ISSUING ORG. SAUDI ARAMCO SAMSO ORGANIZATIONISSUE DATE
09/15/2008
REPLACES
03/09/2005
SUBJECT
Basic life Support (BLS) Heartsaver Automated External
Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
APPROVALMMR
PAGE NO.
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2n
day Solo One 6t
day 2n
Instructor Teaching
3r day Solo Two 7t day 3r Instructor Teaching4
tday Solo Three 8
tday Graduation
2. Scheduling:
2.1. Applying:
(i) Application must be signed by a department head or above.(ii) The requesting organization must commit itself to adhere to SFA/BLS
Heartsaver AED standards and guidelines.
2.2. Eligibility:
In order to qualify for the ITP:
(i) The size of population to be trained by the requestingdepartment/division must exceed the manpower capacity of Health
Promotion Unit to carry out the training (200 or more students peryear)
(ii) The Instructor will have a workload of at least two full SFA or BLS
Heartsaver AED classes per week.
(iii) After completing the SFA/BLS Heartsaver AED Course, Instructorsmust teach their department/division employees only. Instructors are
not eligible to teach employees from other departments/divisionsunless prior permission from the Health Promotion Unit is obtained.
Note:Ordinarily, if the requesting organization already has a certified Instructor, he/she must be
carrying a load of at least (4) full SFA/BLS Hearsver AED classes per week before applying fortraining of an additional Instructor. A request for an additional Instructor, when the existing one teaches
fewer than four classes a week, will be evaluated on a one to one basis.
2.3. Requirements for successful completion:
(i) A satisfactory performance evaluation and a passing score on a final test arerequired for successful completion of any of the aforementioned courses.
2.4. Class location:
(i) Health Promotion Unit offers these courses on its premises in Dhahran.
2.5. Language:
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SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GI NUMBER Approved150.002
GENERAL INSTRUCTION MANUAL
ISSUING ORG. SAUDI ARAMCO SAMSO ORGANIZATIONISSUE DATE
09/15/2008
REPLACES
03/09/2005
SUBJECT
Basic life Support (BLS) Heartsaver Automated External
Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
APPROVALMMR
PAGE NO.
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(i) Priority is given to candidates who will teach Arabic classes.
2.6 Reporting & Recordkeeping:
(i) Each Instructor shall:
a. Send monthly statistics of completed classes to theSFA/BLS/AED Group Leader, Health Promotion Unit.
b. Enter all completed courses into the SAP System.
c. Issue certificates.
VI. RESPONSIBILITIES:
1. Supervisors of Requesting Organization:
1.1 Ensure that at least one employee per shift in each site has a current SFA/BLS/AED
certificate by scheduling initial training through the Health Promotion Unit.
1.2 Order the appropriate SFA/BLS/AED materials through SAP Purchase Requisition.
1.3 Ensure that the Facility Sponsoring Committee is functional.
1.4 Order training materials as recommended by the Health Promotion Unit.
1.5 Order the appropriate First Aid Kit items through SAP/B2B system,
specifying one of the following kits:
(i) 10-unit size First Aid Kit.
(ii) 36-unit size First Aid Kit.
2. Supervisor, Health Promotion Unit:
2.1 Assumes overall responsibility to respond to the industrial and community need forSFA/BLS/AED Instructor training company-wide through adequate manpower and
materials.
2.2 Assumes responsibility to issue SFA/BLS Heartsaver AED Instructor certificatesthroughout the company.
2.3 Assumes overall responsibility to keep statistics and records of certified SFA/BLSHearsaver AED Instructor Training Program participants throughout the company.
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SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GI NUMBER Approved150.002
GENERAL INSTRUCTION MANUAL
ISSUING ORG. SAUDI ARAMCO SAMSO ORGANIZATIONISSUE DATE
09/15/2008
REPLACES
03/09/2005
SUBJECT
Basic life Support (BLS) Heartsaver Automated External
Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
APPROVALMMR
PAGE NO.
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* CHANGE ** ADDITION NEW INSTRUCTION COMPLETE REVISION
2.4 Assigns Instructors to teach SFA/BLS Hearsaver AED Instructors Training courses in
Dhahran or Districts, in Arabic or in English, as appropriate.
2.5 Conducts ongoing evaluation of Health Promotion Unit Instructor to ensure thatemployees receive the highest possible quality of teaching.
2.6 Provides Non-SAMSO departments/divisions with Audiovisual Software.2.7 Provides Non-SAMSO departments/divisions with information on how to order
SFA/BLS/AED materials, and how to conduct an AED site assessment.
2.8 Assumes overall responsibility of keeping the program up to date. Thisincludes:
(i) Ensuring that the literatures and audiovisual materials are available in both Arabicand English languages at all time.
(ii) Updating certified Instructors with the most recent information.
3. AED Program Sponsoring Physician:
3.1 The Companys sponsoring physician shall be an Occupational MedicineSpecialist.
3.2 The sponsoring physician shall review incidents where AED has been
operated.
3.3 The sponsoring physician shall be responsible for providing medical direction for the
deployment of the AEDs in Saudi Aramco Facilities.
3.4 Immediately notify the Companys AED Program Coordinator of any changes in the status
of the Company Sponsoring Physician.
4. Overall AED Program Coordinator:
4.1 Shall be a qualified individual in the Health Promotion Unit,
Preventive Medicine Services Division, SAMSO.
4.2. Shall meet the following qualifications:(i) Be certified or licensed as a BLS/AED provider.
(ii) Have successfully completed an AED training course, incorporating BLStraining.
(ii) Be responsible for administering the AED program at Saudi Aramco.
4.3 Shall provide information and orientation on the operation of the AEDmachine to Company Management upon request.
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SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GI NUMBER Approved150.002
GENERAL INSTRUCTION MANUAL
ISSUING ORG. SAUDI ARAMCO SAMSO ORGANIZATIONISSUE DATE
09/15/2008
REPLACES
03/09/2005
SUBJECT
Basic life Support (BLS) Heartsaver Automated External
Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
APPROVALMMR
PAGE NO.
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* CHANGE ** ADDITION NEW INSTRUCTION COMPLETE REVISION
4.4 Conduct AED Site Assessment Training Sessions as needed.
4.5 Shall keep a record of the location of the AED machines installed in Saudi Aramcofacilities.
4.6 Shall be responsible for providing advice on placement of AED machines inlocations which meet the requirements of SAMSO.
4.7 Shall serve as Chairman of the SAMSO AED Committee.
5. Authorized AED Program Operator
5.1 Must be 18 years old or over.
5.2 Must be initially trained as a qualified BLS/AED provider and maintain training
certifications in accordance with the Health Promotion Unit standards and guidelines.
5.3 Operators who utilize an AED in Saudi Aramco facilities must notify the AED
Program Coordinator and SAMSOs or MDFs EMS as applicable, as soon aspossible after using the AED.
6. AED Program Site Coordinators:
Each authorized facility is required to have an AED Program Site Coordinator, who shall:
6.1 Ensure that the location of the AED machine is shown on the building emergencymap.
6.2 Ensure that the AED daily inspection is performed by a properly trainedindividual in accordance with manufacturer procedures.
6.3 Ensure that completed Inspection Log Forms are kept quarterly for internalrecord.
6.4 Ensure all electronic rescue data is downloaded from the AED within 24 hours
of any incident where the AED was used on an arrest victim in companyfacilities, and that all required reports are completed and forwarded to
SAMSOs or MDFs EMS, as applicable.
6.5 Submit data or other information concerning the company AED Program
which may be periodically requested by SAMSO.
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SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GI NUMBER Approved150.002
GENERAL INSTRUCTION MANUAL
ISSUING ORG. SAUDI ARAMCO SAMSO ORGANIZATIONISSUE DATE
09/15/2008
REPLACES
03/09/2005
SUBJECT
Basic life Support (BLS) Heartsaver Automated External
Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
APPROVALMMR
PAGE NO.
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* CHANGE ** ADDITION NEW INSTRUCTION COMPLETE REVISION
6.6 Perform an AED drill and site assessment, as needed, in coordination with the
SAMSO AED Committee.
VII AED REPORTING & RECORD KEEPING
The Preventive Medicine Services Division will maintain the documentation of all necessary AED
machine inspections, authorized users, etc., and will be the companys point of contact with allcompany facilities kingdom-wide.
The EMS of SAMSO or the MDF will be notified immediately whenever an AED is deployed during
an emergency, and whenever an AED is utilized on an actual arrest victim during an incident. Theinformation contained on the Saudi Aramco Facility AED Report Form for Cardiac Arrestswill be
submitted to the concerned EMS within 24 hours of the incident.
For quality control purposes, the following records shall be maintained:
1. Saudi Aramco Facility AED Report Form for Cardiac Arrests:
The AED Program Site Coordinator will complete the form in Appendix A Saudi Aramco
Facility AED Report Form for Cardiac Arrests upon all uses of the AED on an actual arrest
victim, and will forward it to the concerned EMS. A copy of this report will be maintained inthe concerned EMS Offices.
2. AED Daily Inspection Log Form:
Each AED Program Site Coordinator is responsible for ensuring that the AED daily inspection
is performed by a properly trained individual in accordance with manufacturer procedures.
Completed Inspection Log Forms should by kept by the AED Program Site Coordinator.
VIII AED INCIDENT REVIEW
1. The SAMSO AED Committee shall:
1.1Review each incident in which an AED was operated or where
there was a response with an AED, to determine theappropriateness of the operation of the AED or the AED response.
For each incident in which the AED Committee determines thatthe use of the AED was inappropriate, a conference among the
individual operating the AED, the AED Program Coordinator and
the sponsoring committee shall be held.
1.2Receive a report summarizing the conclusions of the review andconference.
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SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GI NUMBER Approved150.002
GENERAL INSTRUCTION MANUAL
ISSUING ORG. SAUDI ARAMCO SAMSO ORGANIZATIONISSUE DATE
09/15/2008
REPLACES
03/09/2005
SUBJECT
Basic life Support (BLS) Heartsaver Automated External
Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
APPROVALMMR
PAGE NO.
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* CHANGE ** ADDITION NEW INSTRUCTION COMPLETE REVISION
1.3Report each incident as required by the regulations.
1.4Provide remedial action as necessary to resolve any issues ofcompliance with the regulations.
2. The AED Facility Sponsoring Committee shall maintain:
2.1 Original AED Program Certificates
2.2 AED machines and related supplies in accordance with the standards established by theAED manufacturer as follows:
i. sets of defibrillator chest pads (1 set attached to device and 2 sparesets);
ii. disposable pocket facemasksiii. 1 disposable bag resuscitatoriv. pairs disposal glovesv. safety razors (for shaving patients chest, if necessary to obtain proper
defibrillator pad contact;
vi. 1 absorbent towel/trauma padvii. 4x4 inch gauze pads
viii. 1 waste bag for contaminated wastesix. 1 pair scissors
x. 1 bottle waterless antibacterial hand gel/hand sanitizerxi. Saudi Aramco Facility AED Report Forms for Cardiac Arrest
2.3. All AED storage areas, machines and supplies in a clean and sanitary condition.
2.4 Each AED in a closed, intact case with no visible signs of damage which would interfere
with its use.
2.5 Written records of the required information (see the record keeping section of this G.I. -
Section VI Reporting & Record Keeping).
Automated External Defibrillator
Quality Review Procedures
AED Operated
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SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GI NUMBER Approved150.002
GENERAL INSTRUCTION MANUAL
ISSUING ORG. SAUDI ARAMCO SAMSO ORGANIZATIONISSUE DATE
09/15/2008
REPLACES
03/09/2005
SUBJECT
Basic life Support (BLS) Heartsaver Automated External
Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
APPROVALMMR
PAGE NO.
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* CHANGE ** ADDITION NEW INSTRUCTION COMPLETE REVISION
Review incidentWith AED Program Sponsoring
Physician
The AED Operation was
Appropriate
Yes No Device Failed
Keep originalreport by AED
Program Site
Coordinator
Send Copies to theconcerned EMS
Keep originalreport by AED
Program Site
Coordinator
Send Copies to theconcerned EMS
Keep original report by AEDProgram Site Coordinator
Send Copies to theconcerned EMS
Conference With
The AED Operator
Overall AED ProgramCoordinator
AED Program SponsoringPhysician
Send a Summary/Report to theconcerned EMS
REFERENCES:
Saudi/American Heart Associations / Emergency Cardiovascular Care (ECC) Guidelines 2005.
Preventive Medicine Services Division/Health Promotion Unit Guidelines.
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SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GI NUMBER Approved150.002
GENERAL INSTRUCTION MANUAL
ISSUING ORG. SAUDI ARAMCO SAMSO ORGANIZATIONISSUE DATE
09/15/2008
REPLACES
03/09/2005
SUBJECT
Basic life Support (BLS) Heartsaver Automated External
Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
APPROVALMMR
PAGE NO.
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* CHANGE ** ADDITION NEW INSTRUCTION COMPLETE REVISION
Recommended : ____________________________________ _________________Chief
Preventive Medicine Services Division Date
Concurred: _____________________________________ _________________General Manager
Healthcare Development Organization Date
Approved: _____________________________________ _________________
Vice PresidentMedical Services Organization Date
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SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GI NUMBER Approved150.002
GENERAL INSTRUCTION MANUAL
ISSUING ORG. SAUDI ARAMCO SAMSO ORGANIZATIONISSUE DATE
09/15/2008
REPLACES
03/09/2005
SUBJECT
Basic life Support (BLS) Heartsaver Automated External
Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
APPROVALMMR
PAGE NO.
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* CHANGE ** ADDITION NEW INSTRUCTION COMPLETE REVISION
APPENDIX A
SAUDI ARAMCO FACILITY AED REPORT FORM FOR
CARDIAC ARRESTS
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SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GI NUMBER Approved150.002
GENERAL INSTRUCTION MANUAL
ISSUING ORG. SAUDI ARAMCO SAMSO ORGANIZATIONISSUE DATE
09/15/2008
REPLACES
03/09/2005
SUBJECT
Basic life Support (BLS) Heartsaver Automated External
Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
APPROVALMMR
PAGE NO.
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* CHANGE ** ADDITION NEW INSTRUCTION COMPLETE REVISION
CONFIDENTIAL
SAUDI ARAMCO FACILITY AED REPORT FORM FOR CARDIAC ARRESTS
To be completed immediatelyafter a cardiac arrest occurs at your facility or the facility where an AED is put on a patient.Form should be filled out by the main caregiver at the scene and the Facility AED Operator and returned to SAMSOs or MDFs EMS, as
applicable, within 48 hours.Please Return Completed Form with your AED Summary Report to:
1. Facility Name: ____________________________________________________________________
2. Incident Location: _________________________________________________________________
3. Date of Incident: ______/______/_____
Mo Day Yr
4. Estimated Time of Incident: ___:____ am/pm 4.a. Estimated Time that 110 Call was placed: ___:____ am/pm
Hr Min Hr Min
5. Name of Patient: ___________________________________________________________________
First Middle Last
6. Patient Gender Male [ ] Female [ ] 7. Estimated age of Patient: __________________ yrs
8. Did the patient collapse (become unresponsive)? Yes [ ] No [ ]
8a. If Yes, what were the events immediately prior to the collapse (check all that apply):
Difficulty Breathing [ ] Chest Pain [ ] No Signs or Symptoms [ ] Drowning [ ]Electrical Shock [ ] Injury [ ] Unknown [ ]
8b. Was someone present to see the person collapse? Yes [ ] No [ ]
If yes, was that person a trained AED Employee? Yes [ ] No [ ]
8c. After the collapse at the time of patient assessment and just prior to the Facility AED pads being applied:Was the person breathing? Yes [ ] No [ ]Did the person have a pulse? Yes [ ] No [ ]
9. Was BLS given prior to 110 EMS arrivals? Yes [ ] Go to #9a No [ ] Go to # 10a
9a. Estimated time BLS Started: ___:___ am/pmHr Min
9b. Was BLS started prior to the arrival of a trained AED employee? Yes [ ] No [ ]9c. Who Started BLS? Bystander [ ] Trained AED Employee [ ]
10. Was Facility AED brought to the patients side prior to 110 EMS arrivals? Yes [ ] No [ ]
10a. If No, briefly describe why and skip to question 17: _____________________________________10b. If Yes, estimated time (based on your watch) Facility AED at patients side: ___:____am/pm
Hr Min
TURN OVER AND COMPLETE BOTH SIDES
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SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GI NUMBER Approved150.002
GENERAL INSTRUCTION MANUAL
ISSUING ORG. SAUDI ARAMCO SAMSO ORGANIZATIONISSUE DATE
09/15/2008
REPLACES
03/09/2005
SUBJECT
Basic life Support (BLS) Heartsaver Automated External
Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
APPROVALMMR
PAGE NO.
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* CHANGE ** ADDITION NEW INSTRUCTION COMPLETE REVISION
CONFIDENTIAL
11. Were the Facility AED pads put on the patient? Yes [ ] No [ ]
11a. If yes, was the person who put the AED pads on the patient:
A trained AED Facility Employee [ ] An untrained AED Facility Employee [ ] A bystander [ ]
12. Was the Facility AED turned on? Yes [ ] No [ ]
12a. If Yes, estimated time (based on your watch) Facility AED turned on? : ___:___am/pm
Hr Min
13. Did the facility AED ever shock the patient? Yes [ ] No [ ]
13a. If Yes, estimated t ime (based on your watch) of 1st shock by facility AED? : ___:___am/pmHr Min
13b. If shocks were given, how many shocks were delivered prior to the EMS ambulance arrival?
14. Name of person operating the Facility AED: ___________________________________________________________________________________First Middle Last
14a. Is this person a trained AED employee? Yes [ ] No [ ]
14b. Highest level of medical training of person administering the Facility AED:
Public AED trained [ ] First responder AED trained [ ] EMT-B [ ] CRT EMT-P [ ]Nurse/Physician [ ] Other healthcare provider [ ] No known training [ ]
15. Was there any mechanical difficulty or failure associated with the use of the Facility AED? Yes [ ] No [ ]
15a. If yes, briefly explain:____________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________
16. Were there any unexpected events or injuries that occurred during the use of the Facility AED? Yes [ ] No [ ]
16a. If yes, briefly explain:
___________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________17. Indicate the patients status at the time of the EMS arrival:
17a. Pulse restored Yes [ ] No [ ] Dont Know [ ] If Yes, time pulse restored ________________
17b. Breathing restored Yes [ ] No [ ] Dont Know [ ] If Yes, time breathing restored_____________17c. Responsiveness restored Yes [ ] No [ ] Dont Know [ ] If Yes, time patient responsive ____________
18. Was the patient transported to the hospital? Yes [ ] No [ ]
18a. If Yes, how was the patient transported? EMS Ambulance [ ] Private Vehicle [ ] Other________________________________
Report Completed by: __________________________________________________________________________________________________________
Please Print Name Date______________________________________________________________________________________________________
Signature Date
_________________________ ______________________________________________________
Title Office PhoneMake Model of the Facility AED that was used? ______________________________ _____________________________________________________
Manufacture Model
RETURN TO SAMSOs EMS OR MDFs EMS AS APPLICABLE WITHIN 48 HOURS FOLLOWING INCIDENT:
PLEASE FORWARD QUESTIONS TO YOUR FACILITY AED COORDINATOR
Facility Name: _________________________________
c.c: Occupational Medicine Section, PMSD
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SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GI NUMBER Approved150.002
GENERAL INSTRUCTION MANUAL
ISSUING ORG. SAUDI ARAMCO SAMSO ORGANIZATIONISSUE DATE
09/15/2008
REPLACES
03/09/2005
SUBJECT
Basic life Support (BLS) Heartsaver Automated External
Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
APPROVALMMR
PAGE NO.
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* CHANGE ** ADDITION NEW INSTRUCTION COMPLETE REVISION
APPENDIX B
SAUDI ARAMCO AED DAILY INSPECTION LOG FORM
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SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GI NUMBER Approved150.002
GENERAL INSTRUCTION MANUAL
ISSUING ORG. SAUDI ARAMCO SAMSO ORGANIZATIONISSUE DATE
09/15/2008
REPLACES
03/09/2005
SUBJECT
Basic life Support (BLS) Heartsaver Automated External
Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
APPROVALMMR
PAGE NO.
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* CHANGE ** ADDITION NEW INSTRUCTION COMPLETE REVISION
SAUDI ARAMCO AED DAILY AND MONTHLY SAFETY INSPECTION RECORD
______________ (Month/Year) AED Machine Serial #:________________ AED Location: ___________________
DAILY CHECK
Day MM/DD/YY InspectorsInitials
Case Intact?
Yes No
StatusIndicator
GreenYes No
PadsExpired
Yes No
All Supplies inCase?
Yes No
1
2
34
5
6
7
8
9
10
11
12
13
14
1516
17
18
19
20
21
22
23
24
25
26
2728
29
30
31
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SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GI NUMBER Approved150.002
GENERAL INSTRUCTION MANUAL
ISSUING ORG. SAUDI ARAMCO SAMSO ORGANIZATIONISSUE DATE
09/15/2008
REPLACES
03/09/2005
SUBJECT
Basic life Support (BLS) Heartsaver Automated External
Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
APPROVALMMR
PAGE NO.
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ctd SAUDI ARAMCO AED DAILY AND MONTHLY SAFETY INSPECTION RECORD
______________ (Month/Year) AED Machine Serial #:________________ AED Location: ___________________
MONTHLY CHECK
INSTRUCTIONS YES NO
1. Open AED lid
2. Wait for the AED to indicate status:Observe the change of the Status Indicator to Red. After approximately 5 seconds,verify that the Status Indicator returns to Green.
3. Check the expiration date on the electrodes.
4. Listen for the voice prompts.5. Close the lid and confirm that Status Indicator remains Green.
MONTHLY CHECK COMPLETED BY:_____________________ BADGE #: ____________ DATE: ___________
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SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GI NUMBER Approved150.002
GENERAL INSTRUCTION MANUAL
ISSUING ORG. SAUDI ARAMCO SAMSO ORGANIZATIONISSUE DATE
09/15/2008
REPLACES
03/09/2005
SUBJECT
Basic life Support (BLS) Heartsaver Automated External
Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
APPROVALMMR
PAGE NO.
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* CHANGE ** ADDITION NEW INSTRUCTION COMPLETE REVISION
INSTRUCTIONS FOR COMPLETING AED DAILY AND MONTHLY INSPECTION RECORD
DATE: The AED machine should be inspected daily. Enter the date the AED machinewas inspected.
INSPECTORS INITIALS: Enter the inspectors legible initials. Only trained individuals may perform thedaily inspection.
CASE INTACT? Yes or No. Check to see if the storage case (either soft, flexible or intact: wall-mounted) is present, serviceable and undamaged. If all ok, enter yes, if not,
enter no.
To report deficiency, immediatelycomplete the Saudi Aramco Return Form #attached and contact the local vendor.
STATUS INDICATOR: Yes or No. Check to see if the status indicator in the handle is green. If theindicator is red, the unit is NOT ready for a rescue and should beimmediatelypulled from service. Complete Saudi Aramco Return Form# SA 9667 (insert link when is up on e-forms) and contact the local vendorimmediately for repair.
PADS EXPIRED? Yes or No. Check to see if expiration date of the pads (electrodes) has exceeded.Sixty (60) days prior to the expiration date. Plan ahead to order the replacementpads from local vendor.
ALL SUPPLIES IN Yes or No. If everything is present enter yes, if everything is not present,CARRYING CASE: enter no. Immediatelyorder the missing supplies from the local vendor.
MONTHLY CHECKS: Follow the instructions on the Saudi Aramco AED Daily and Monthly SafetyInspection Record.
CONTACTLocal Vendor
E-mail: [email protected] Tel: 02 667-8811 Ext 226
Office Fax: 02 669-1188Mobile: 0506 311 179
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SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GI NUMBER Approved150.002
GENERAL INSTRUCTION MANUAL
ISSUING ORG. SAUDI ARAMCO SAMSO ORGANIZATIONISSUE DATE
09/15/2008
REPLACES
03/09/2005
SUBJECT
Basic life Support (BLS) Heartsaver Automated External
Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
APPROVALMMR
PAGE NO.
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Saudi Aramco AED Site Assessment Form
This Form is to help Saudi Aramco Departments determine whether an on-site AED program is advisable.
Use one Form per facility
Organization Name: Facility Location:
Building: Region:
(AEDSiteCoordinator)
1. SITE GEOGRAPHY
1.1 How many buildings are on your site: ___________
1.2 Number of floors: ___________
1.3 List all areas that may not be easily accessible by responders including closed or locked or restrictedareas:
a)_________________________ c)_________________________
b) _________________________ d) _________________________
2. POPULATION CHARACTERISTICS
2.1 Number of Saudi Aramco employees: _________
2.2 Number of Contractor employees: _________
2.3 Approximate average age of workforce: 20-30 30-40 40-50 < 50
2.4 Approximate % of employees over 45 years: __________
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SAUDI ARABIAN OIL COMPANY (Saudi Aramco) GI NUMBER Approved150.002
GENERAL INSTRUCTION MANUAL
ISSUING ORG. SAUDI ARAMCO SAMSO ORGANIZATIONISSUE DATE
09/15/2008
REPLACES
03/09/2005
SUBJECT
Basic life Support (BLS) Heartsaver Automated External
Defibrillator(AED) / Standard First Aid (SFA) and First Aid Kit
APPROVALMMR
PAGE NO.
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Saudi Aramco AED Site Assessment Form (Page 1 of 2)
3. EMS CAPABILITIES
3.1 Where is the primary EMS unit located?
Within 3 KM within 5 KM within 10 KM >15 KM
3.2 What is the estimated response time from your location to the nearest EMS?
0-3 Min 3-5 Min 5-10 Min 10-15 Min 20 + Min
4. TRAINING COURSES
4.1 Is BLS/AED training conducted by one of your employees at your department/division?
Yes No
If Yes How often _____________________
By whom_______________________
# trained________________________
AED Site Coordinator Signature: __________________________________
Date: __________________________________________________________