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Automated External Defibrillator AED Incident Report Form - wichita kumc

Automated External Defibrillator AED Incident Report Form - wichita kumc 2025

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The document is an Automated External Defibrillator (AED) Incident Report Form designed to collect detailed information about incidents involving the use or potential use of an AED. It includes sections for documenting the location, time, and circumstances of the incident, as well as the condition of the victim and actions taken, such as CPR and calling emergency services. The form is intended to be completed by individuals who witnessed the event and is to be submitted to the AED Committee for review.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the 'Location of Victim' where the incident occurred. This helps in documenting the exact site for future reference.
Fill in the 'Date of Incident' and 'Time of Incident' fields accurately to ensure a clear timeline of events.
Provide your name and contact information in the section for person(s) who found the victim, as this is crucial for follow-up inquiries.
Indicate whether the victim had a pulse and was breathing by selecting 'Yes' or 'No'. Include details on how these checks were performed.
Document if 911 was called and whether CPR was conducted, along with the time and name of the person conducting CPR.
Specify if an AED was applied, including details about who operated it and its location within the building.
Concisely describe the event that led to using or considering an AED, as well as the patient's condition upon EMS arrival.
Finally, complete your information at the bottom of the form, ensuring all sections are filled out before submission.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Can anyone use an automated external defibrillator (AED) without training?

AEDs are compact, portable, easy to use, safe and very effective. They can be used by anyone, whether or not they have had formal training. An AED gives the person using it voice instructions.

What does automated external defibrillator (AED) mean?

An automated external defibrillator (AED) is a medical device designed to analyze the heart rhythm and deliver an electric shock to victims of ventricular fibrillation to restore the heart rhythm to normal.

What is an AED incident report?

The Early Defibrillation Incident Report is a part of the patient care record and is confidential to both the patient and the facility. This report is not to be copied or altered once it is completed. Discussion of all aspects of the event is to be limited to team members, in debriefing or training sessions.

How to perform an AED inspection?

To inspect an AED (Automated External Defibrillator), follow these steps: Check the expiration date of the AED pads and battery. Turn on the AED and make sure it is functioning properly. Check the AED pads for any damage, such as tears or discoloration. Make sure the AED is clean and free of debris.