[Congressional Record Volume 144, Number 81 (Friday, June 19, 1998)]
[Senate]
[Pages S6699-S6700]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. GORTON (for himself, Mrs. Murray, Mr. Grams, and Mr. 
        Bingaman):
  S. 2196. A bill to amend the Public Health Service Act to provide for 
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; to the Committee on 
Labor and Human Resources.


                      cardiac arrest survival act

  Mr. GORTON. Mr. President, every day almost 1,000 Americans suffer 
from Sudden Cardiac Arrest. It can claim the life of a promising young 
athlete, a friend or family member regardless of age or health. Sudden 
Cardiac Arrest occurs when the heart's electrical impulses become 
chaotic causing the heart to stop pumping blood. Tragically, 95 percent 
of Americans who suffer from sudden cardiac arrest will die. Today, I 
am introducing a bill that can change that statistic.
  We know that quick implementation of ``Chain of Survival''--calling 
911, administering CPR and early access to defibrillation can 
dramatically improve survival rates for victims of Sudden Cardiac 
Arrest. Unfortunately, early access to defibrillation may be the most 
critical link in the chain and the most difficult to come by. The 
Cardiac Arrest Survival Act aims to improve community access to 
automatic external defibrillators (AEDs), a machine designed to shock 
the heart and restore its normal rhythm. If every community across 
America made this easy-to-use technology more readily available, we 
could increase the survival rate of cardiac arrest and possibly save 
250 lives each day and 100,000 lives each year.
  My home state of Washington has a long history of encouraging the use 
of AEDs. King County, Washington boasts one of the highest cardiac 
arrest survival rates in the nation at 30 percent--far above the 
national average survival rate of 5 percent. Communities that have 
improved survival rates have ensured that Emergency Medical Technicians 
are trained and equipped with automatic external defibrillators. Some 
communities have located AEDs in public places like sports stadiums, 
airports and shopping malls, and others have worked to ensure that 
police and firefighters, often the first to respond to an emergency, 
are trained and equipped with AEDs.
  Although the technology is proven effective, access to defibrillators 
outside the hospital setting is limited. Patient care and survival 
suffer from a patchwork of different state laws. Less than half of the 
nation's Emergency Medical Technicians are even trained and equipped to 
use AEDs. The Cardiac Arrest Survival Act aims to reduce the number of 
cardiac arrest fatalities by encouraging a uniform system of state laws 
and to improve current emergency medical training programs.
  The bill asks the National Heart, Lung, and Blood Institute to work 
on model state legislation that addresses some of the barriers to 
community access to AEDs such as good samaritan immunity and public 
placement of these machines. NHLBI will also work with the National 
Highway Transportation and Safety Administration to update the current 
medical training curriculum to reflect the improvement in technology. 
The bill will also coordinate a database to collect information on 
cardiac arrest from existing databases on emergency care. While the 
bill is far from mandating anything, I am convinced we can reduce the 
number of cardiac arrest fatalities by encouraging states to train more 
people to use AEDs right on the scene in a way that the state of 
Washington is already doing.
  The Cardiac Arrest Survival Act is the Senate companion to a bill 
introduced by Congressman Stearns in the House of Representatives that 
currently has 80 cosponsors. The bill enjoys broad support from more 
than seventy associations including the American Heart Association, the 
American Red Cross, the American Academy of Pediatrics, the 
Congressional Fire Services Institute Advisory Committee with some 45 
members, the Washington State Medical Association, the Washington State 
Hospital Association and a number of other supporters. I am also 
pleased to be joined by my colleagues Senators Murray, Grams, and 
Bingaman as original cosponsors of the bill, the full text of which I 
ask be printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 2196

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Cardiac Arrest Survival 
     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, because 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 electrical shocks.
       (3) Survival from cardiac arrest requires successful 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 services system.
       (5) The first persons on the scene when an arrest occurs 
     are typically lay persons who are friends or family of the 
     victim, fire services, public safety personnel, basic life 
     support emergency medical services 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 nontraumatic cardiac arrest. 
     The Federal response should include, but not be limited to--
       (A) significantly expanded research concerning the efficacy 
     of various methods of providing immediate out-of-hospital 
     lifesaving interventions to the nontraumatic cardiac arrest 
     patient;

[[Page S6700]]

       (B) the development of research-based, nationally uniform, 
     easily learned and well retained model core educational 
     content concerning the use of such lifesaving interventions 
     by health care professionals, allied health personnel, 
     emergency medical services personnel, public 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 legislation to reduce 
     identified barriers and to enhance each State's response to 
     this significant problem.

     SEC. 3. NATIONAL INSTITUTES OF HEALTH MODEL PROGRAM 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 following 
     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 coordination 
     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 Transportation, of a core content for a model 
     State training program applicable to cardiac arrest for 
     inclusion in appropriate current emergency medical services 
     educational curricula and training programs that address 
     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 professionals, allied 
     health personnel, emergency medical 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 resuscitation and defibrillation;
       ``(B) shall include age-specific criteria for the use of 
     particular techniques, which shall include 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 effectiveness of the training 
     program.
       ``(3) The definition and identification of cardiac arrest 
     care providers, by personal relationship, exposure to arrest 
     or trauma, occupation (including health professionals), or 
     otherwise, who could provide benefit to victims of out-of-
     hospital arrest by comprehension of such core content.
       ``(4) The establishment of criteria for completion and 
     comprehension of such core content, including consideration 
     of inclusion in health and safety educational curricula.
       ``(5) The identification and development of equipment and 
     supplies that should be accessible to cardiac arrest care 
     providers to permit lifesaving interventions by preplacement 
     of such equipment in appropriate locations insofar as such 
     activities are consistent with the development of the core 
     content and utilize information derived from such studies by 
     the National Institutes of Health on investigation in cardiac 
     resuscitation.
       ``(6) The development in accordance with this paragraph of 
     model State legislation (or Federal legislation 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 drafting of model State legislation. The 
     model legislation shall be developed in accordance with the 
     following:
       ``(A) The purpose of the model legislation shall be to 
     ensure--
       ``(i) access to emergency medical services through 
     consideration of a requirement for public placement of 
     lifesaving equipment; and
       ``(ii) good samaritan immunity for cardiac arrest care 
     providers; those involved with the instruction of the 
     training programs; and owners and managers of property where 
     equipment is placed.
       ``(B) In the development of the model legislation, there 
     shall be consideration of requirements for training in the 
     core content and use of lifesaving equipment for State 
     licensure or credentialing of health professionals or other 
     occupations or employment of other individuals who may be 
     defined as cardiac arrest care providers under paragraph (3).
       ``(7) The coordination of a national database for reporting 
     and collecting information relating to the incidence of 
     cardiac arrest, the circumstances surrounding such arrests, 
     the rate of survival, the effect of age, and whether 
     interventions, including cardiac arrest care provider 
     interventions, or other aspects of the chain of survival, 
     improve the rate of survival. The development of such 
     database shall be coordinated with other existing databases 
     on emergency care that have been developed under the 
     authority of the National Highway Traffic Safety 
     Administration and the Centers for Disease Control and 
     Prevention.''.
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