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Maryland - AED Statutes & Regulations

AED owners are legally responsible to ensure compliance and emergency readiness of their AEDs. Each unit must meet certain requirements from the FDA, the local state, and individual AED manufacturers, which can be a challenging task to maintain. Thousands of customers rely on us to manage their AED compliance through our easy to use tool called LifeShield. Learn more about how we support our clients with an unmatched AED compliance program offering here.

 

Maryland Summary
Requirement Summary
Good Samaritan Law An individual rescuer acting in good faith is also protected if the acts or omissions were undertaken in a reasonably prudent manner without compensation.

A registered facility has Good Samaritan protection if it has satisfied the EMS Board's requirements.
EMS Notification Each facility that wishes to make an AED available must become certified by the EMS Board.

EMS should be notified as soon as possible after using an AED.
AED Maintenance AED maintenance, placement, operation, reporting, and quality improvement procedures as required. Maintain each AED and all related equipment and supplies in accordance with the standards established by the device manufacturer and the FDA.
Public Pools All swimming pools operated by the counties or municipalities must have a registered AED on the premises and an individual trained in AED use present at each swimming pool.
Schools All public schools must have a registered AED on site.

An individual trained in AED use present at all school-sponsored athletic events.

Students entering 9th grade must receive CPR/AED training before graduation.
Medical Oversight An in-state licensed physician or regional council AED committee must provide AED program medical oversight services.
Dental Facilities Dental facilities are required to have a defibrillator or an AED.
Maryland Statutes and Regulations
Statute Abstract
Maryland Code - Education, § 13-517 EDUC Automated External Defibrillator Program established; administration by EMS board.

(a) Definitions. (1) In this section the following words have the meanings indicated.

(2)Automated external defibrillator (AED) means a medical heart monitor and defibrillator device that:

(i) Is cleared for market by the federal Food and Drug Administration;

(ii) Recognizes the presence or absence of ventricular fibrillation or rapid ventricular tachycardia;

(iii) Determines, without intervention by an operator, whether defibrillation should be performed;

(iv) On determining that defibrillation should be performed, automatically charges; and

(v) 1. Requires operator intervention to deliver the electrical impulse; or

2. Automatically continues with delivery of electrical impulse.

(3) Certificate means a certificate issued by the EMS Board to a registered facility.

(4) Facility means an agency, association, corporation, firm, partnership, or other entity.

(5) Jurisdictional emergency medical services operational program means the institution, agency, corporation, or other entity that has been approved by the EMS Board to provide oversight of emergency medical services for each of the local government and State and federal emergency medical services programs.

(6) Program means the Public Access Automated External Defibrillator Program.

(7) Regional administrator means the individual employed by the Institute as regional administrator in each EMS region.

(8) Regional council means an EMS advisory body as created by the Code of Maryland Regulations 30.05.

(9) Regional council AED committee means a committee appointed by the regional council consisting of:

(i) The regional medical director;

(ii) The regional administrator; and

(iii) Three or more individuals with knowledge of and expertise in AEDs.

(10) Registered facility means an organization, business association, agency, or other entity that meets the requirements of the EMS Board for registering with the Program.

(b) Established; purpose. (1) There is a Public Access Automated External Defibrillator Program.

(2) The purpose of the Program is to coordinate an effective statewide public access defibrillation program.

(3) The Program shall be administered by the EMS Board.

(c) Powers of EMS Board. The EMS Board may:

(1) Adopt regulations for the administration of the Program;

(2) Issue and renew certificates to facilities that meet the requirements of this section;

(3) Deny, suspend, revoke, or refuse to renew the certificate of a registered facility for failure to meet the requirements of this section;

(4) Approve educational and training programs required under this section that:

(i) Are conducted by any private or public entity;

(ii) Include training in cardiopulmonary resuscitation and automated external defibrillation; and

(iii) May include courses from nationally recognized entities such as the American Heart Association, the American Red Cross, and the National Safety Council;

(5) Approve the protocol for the use of an AED; and

(6) Delegate to the Institute any portion of its authority under this section.

(d) Facility certification required. — (1) Each facility that desires to make automated external defibrillation available shall possess a valid certificate from the EMS Board.

(2) This subsection does not apply to:

(i) A jurisdictional emergency medical services operational program;

(ii) A licensed commercial ambulance service;

(iii) A health care facility as defined in § 19-114 of the Health General Article; or

(iv) A place of business for health care practitioners who are licensed as dentists under Title 4 of the Health Occupations Article or as physicians under Title 14 of the Health Occupations Article and are authorized to use an AED in accordance with that license.

(e) Facility certification Requirements. To qualify for a certificate a facility shall:

(1) Comply with the written protocol approved by the EMS Board for the use of an AED which includes notification of the emergency medical services system through the use of the 911 universal emergency access number as soon as possible on the use of an AED;

(2) Have established automated external defibrillator maintenance, placement, operation, reporting, and quality improvement procedures as required by the EMS Board;

(3) Maintain each AED and all related equipment and supplies in accordance with the standards established by the device manufacturer and the federal Food and Drug Administration; and

(4) Ensure that each individual who is expected to operate an AED for the registered facility has successfully completed an educational training course and refresher training as required by the EMS Board.

(f) Report of use of AED. A registered facility shall report the use of an AED to the Institute for review by the regional council AED committee.

(g) Report of use of AED Procedures. A facility that desires to establish or renew a certificate shall:

(1) Submit an application on the form that the EMS Board requires; and

(2) Meet the requirements under this section.

(h) Certificate Contents. (1) The EMS Board shall issue a new or a renewed certificate to a facility that meets the requirements of this section.

(2) Each certificate shall include:

(i) The type of certificate;

(ii) The full name and address of the facility;

(iii) A unique identification number; and

(iv) The dates of issuance and expiration of the certificate.

(3) A certificate is valid for 3 years.

(i) Cease and desist orders. The EMS Board may issue a cease and desist order or obtain injunctive relief if a facility makes automated external defibrillation available in violation of this section.

(j) Immunities. (1) In addition to any other immunities available under statutory or common law, a registered facility is not civilly liable for any act or omission in the provision of automated external defibrillation if the registered facility:

(i) Has satisfied the requirements for making automated external defibrillation available under this section; and

(ii) Possesses a valid certificate at the time of the act or omission.

(2) In addition to any other immunities available under statutory or common law, a member of the regional council AED committee is not civilly liable for any act or omission in the provision of automated external defibrillation.

(3) In addition to any other immunities available under statutory or common law, an individual is not civilly liable for any act or omission if:

(i) The individual is acting in good faith while rendering automated external defibrillation to a person who is a victim or reasonably believed by the individual to be a victim of a sudden cardiac arrest;

(ii) The assistance or aid is provided in a reasonably prudent manner; and

(iii) The automated external defibrillation is provided without fee or other compensation.

(4) The immunities in this subsection are not available if the conduct of the registered facility or an individual amounts to gross negligence, willful or wanton misconduct, or intentionally tortious conduct.

(5) This subsection does not affect, and may not be construed as affecting, any immunities from civil or criminal liability or defenses established by any other provision of the Code or by common law to which a registered facility, a member of the regional council AED committee, or an individual may be entitled.

(k) Opportunity for hearing. (1) A registered facility aggrieved by a decision of the Institute acting under the delegated authority of the EMS Board under this section shall be afforded an opportunity for a hearing before the EMS Board.

(2) A registered facility aggrieved by a decision of the EMS Board under this section shall be afforded an opportunity for a hearing in accordance with Title 10, Subtitle 2 of the State Government Article.

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings.

A. Automated external defibrillator or AED means a medical device that combines a heart monitor and a defibrillator approved by the United States Food and Drug Administration that:

(1) Is capable of recognizing the presence or absence of ventricular fibrillation or rapid ventricular tachycardia;

(2) Is capable of determining, without intervention by an operator, whether defibrillation should be performed on an individual; and

(3) Upon determination that defibrillation should be performed, automatically charges and requests delivery of an electrical impulse to an individual’s heart.

2 to 5. Deleted.

6. Immunity. The following persons and entities are immune from civil liability for damages relating to the use, possession or purchase of an AED and arising out of acts or omissions relating to preparing for and responding to suspected sudden cardiac arrest emergencies absent gross negligence or willful or wanton misconduct:

A. Any person or entity that acquires an AED;

B. Any person or entity that owns, manages or is otherwise responsible for the premises on which an AED is located;

C. Any person who retrieves an AED in response to a perceived sudden cardiac arrest emergency;

D. Any person who uses, attempts to use or fails to use an AED in response to a perceived sudden cardiac arrest emergency;

E. Any physician or other authorized person who issues a prescription for the purchase of an AED;

F. Any person or entity that is involved with the design, management or operation of an AED program; and

G. Any person or entity that provides instruction in the use of an AED.
Maryland Code - Education, § 7-425 EDUC Provisions and regulations of automated external defibrillator programs.

(a) In general. (1) Each county board shall develop and implement an automated external defibrillator program that meets the requirements of § 13-517 of this article for each high school in the county.

(2) The program required under paragraph (1) of this subsection shall include provisions that:

(i) Ensure that an automated external defibrillator is provided on-site; and

(ii) An individual trained in the operation and use of an automated external defibrillator is present at all school-sponsored athletic events.

(b) Regulations.The Department, in consultation with the Department of Health and Mental Hygiene, the Maryland State School Health Council, and the Maryland Institute for Emergency Medical Services Systems, shall adopt regulations that:

(1) Establish guidelines for periodic inspections and annual maintenance of the automated external defibrillators; and

(2) Assist county boards in carrying out the provisions of this section.
Maryland Code - Courts and Judicial Procedures, § 5-603 CTS. & JUD. PROC. Immunity of persons providing emergency medical care.

(a) In general. A person described in subsection (b) of this section is not civilly liable for any act or omission in giving any assistance or medical care, if:

(1) The act or omission is not one of gross negligence;

(2) The assistance or medical care is provided without fee or other compensation; and

(3) The assistance or medical care is provided:

(i) At the scene of an emergency;

(ii) In transit to a medical facility; or

(iii) Through communications with personnel providing emergency assistance.

(b) Applicability. Subsection (a) of this section applies to the following:

(1) An individual who is licensed by this State to provide medical care;

(2) A member of any State, county, municipal, or volunteer fire department, ambulance and rescue squad, or law enforcement agency, the National Ski Patrol System, or a corporate fire department responding to a call outside of its corporate premises, if the member:

(i) Has completed an American Red Cross course in advanced first aid and has a current card showing that status;

(ii) Has completed an equivalent of an American Red Cross course in advanced first aid, as determined by the Secretary of Health and Mental Hygiene; or

(iii) Is certified or licensed by this State as an emergency medical services provider;

(3) A volunteer fire department or ambulance and rescue squad whose members have immunity; and

(4) A corporation when its fire department personnel are immune under paragraph (2) of this subsection.

(c) Immunity for individual not covered by this section. An individual who is not covered otherwise by this section is not civilly liable for any act or omission in providing assistance or medical aid to a victim at the scene of an emergency, if:

(1) The assistance or aid is provided in a reasonably prudent manner;

(2) The assistance or aid is provided without fee or other compensation; and

(3) The individual relinquishes care of the victim when someone who is licensed or certified by this State to provide medical care or services becomes available to take responsibility.
Maryland Code - Courts and Judicial Procedures, § 5-608 CTS. & JUD. PROC. Immunity of persons providing support for emergency medical system.

An individual is not civilly liable for any act or omission while providing support to the emergency medical system by giving care, equipment, facilities, or consultation, if:

(1) The individual is a member or employee of any federal, State, county, or city government, hospital, emergency medical service council, or agency that operates as a nonprofit group;

(2) The act or omission is not one of gross negligence; and

(3) The service is provided without fee to the emergency victim.
§ 1-1310 LOCAL GOV'T. Swimming pool automated external defibrillator programs.

(a) "Swimming pool" defined. In this section, "swimming pool" means a pool that is owned and operated by the governing body of a county or municipality.

(b) Development and implementation of programs. (1) Each county or municipality that owns or operates a swimming pool shall develop and implement an automated external defibrillator program that meets the requirements of § 13-517 of the Education Article for each swimming pool owned or operated by the county or municipality.

(2) The program required under paragraph (1) of this subsection shall include provisions that:

(i) ensure an automated external defibrillator is provided on-site; and

(ii) an individual trained in the operation and use of an automated external defibrillator is present at each swimming pool.

(c) Regulations. The Department of Health and Mental Hygiene and the Maryland Institute for Emergency Medical Services Systems jointly shall adopt regulations that:

(1) establish guidelines for periodic inspections and annual maintenance of the automated external defibrillators; and

(2) assist each county or municipality in carrying out the provisions of this section.
Maryland Code of Regulations - 30.06.01.01 Definitions

A. In this subtitle, the following terms have the meanings indicated.

B. Terms Defined.

(1) "Automated external defibrillator (AED)" means a medical heart monitor and defibrillator device that:

(a) Is cleared for market by the federal Food and Drug Administration;

(b) Recognizes the presence or absence of ventricular fibrillation or rapid ventricular tachycardia;

(c) Determines, without intervention by the operator, whether defibrillation should be performed;

(d) On determining that defibrillation should be performed, automatically charges; and

(e) Either:

(i) Requires operator intervention to deliver the electrical impulse, or

(ii) Automatically continues with delivery of electrical impulse.

(2) "Event (code) summary" means the electronic report of an AED operation produced by an AED.

(3) Expected operator means any individual identified by a registered facility to operate an AED at a registered facility

(4) "Facility" means an agency, association, corporation, firm, partnership, or other entity.

(5) "Operate" means to use or attempt to use an AED to defibrillate an individual whether or not any electrical impulse is delivered.

(6) "Public safety answering point (PSAP)" has the meaning stated in Public Safety Article, §1-301(q), Annotated Code of Maryland.

(7) Registered Facility.

(a) "Registered facility" means an organization, business, association, or agency that meets the requirements of the EMS Board for providing automated external defibrillation.

(b) "Registered facility" may include multiple sites.

(8) "Response" means the removal of the AED from its storage location for the purposes of rendering care whether or not the care is actually rendered.

(9) "Site" means a building, plant, unit, branch, vehicle, or other ancillary location that is part of or affiliated with a facility.
Maryland Code of Regulations - 30.06.02.01 Criteria for Registration of Facilities.

To be eligible for registration, or renewal of registration, to operate an AED under this subtitle, a registered facility shall:

A. Designate an AED coordinator who shall:

(1) Have successfully completed CPR and AED Training, and subsequent refresher training, in accordance with their training course requirements that at a minimum includes content consistent with the recommendations for layperson CPR and AED training in the most current publication of the American Heart Association Guidelines for CPR and ECC;

(2) Be responsible for implementing and administering the AED program at the registered facility; and

(3) Ensure that monthly safety inspections of all supplemental and AED equipment, including assurance of adequate battery charge, per the manufacturer’s guidelines are conducted and maintain written logs of the inspections.

B. Provide information regarding the operation, maintenance, and location of the registered facility's AEDs to all individuals employed by or volunteering for the registered facility;

C. Place all AEDs in locations which are visible and readily accessible to any person willing to operate the AED in the event of a cardiac arrest;

D. Have a telephone or other communication service available at all times at each site at which an AED is operated, for the notification of the public safety answering point;

E. Submit data or other information concerning the AED program which may be periodically requested by MIEMSS; and

F. Ensure that expected operators have completed CPR and AED Training, and subsequent refresher training, in accordance with their training course requirements that at a minimum includes content consistent with the recommendations for layperson CPR and AED training in the most current publication of the American Heart Association Guidelines for CPR and ECC.
Maryland Code of Regulations - 30.06.02.02-08 Protocol:

All personnel who are expected to operate an AED at a registered facility shall utilize the AED in accordance with their training. When an individual's training conflicts with the auditory and visual prompts of the device, the individual shall follow the auditory and visual prompts.

Quality Assurance:
Each registered facility shall:



A. Comply the federal Safe Medical Devices Act of 1990 and the Medical Device Amendments of 1992;

B. Maintain:

(1) The certificate issued by MIEMSS in a place where it is readily available;

(2) Each AED and all related equipment and supplies in accordance with the standards established by the device manufacturer and the federal Food and Drug Administration;

(3) Supplemental equipment with the AED at all times as follows:

(a) Two sets of defibrillator chest pads;

(b) Disposable gloves; and

(c) Maryland Facility AED Report Forms for Cardiac Arrest;

C. Submit:

(1) A report for each incident of suspected cardiac arrest at the facility on the Maryland Facility AED Report Form for Cardiac Arrests, including, when available, any event (code) summary, recording, or tape created by the AED to MIEMSS, and be available for follow up as necessary; and

(2) If the AED fails when operated, in addition to submitting the required report to the federal Food and Drug Administration, a copy of the report to MIEMSS; and

D. Ensure the confidentiality of any medical records maintained by the registered facility as required by law.

Application and Registration Process:
A. A facility seeking registration or renewal of registration shall submit an application and all required documentation to MIEMSS on the form required by MIEMSS.



B. MIEMSS may make the inspection and require the verification necessary to ensure that an applicant meets the requirements of this chapter, including an inspection of the facility, any sites, equipment, and records.



C. MIEMSS shall issue a certificate of registration or renewal to a facility that meets the requirements of Regulation .01 of this chapter.



D. The certificate of registration or renewal is valid for a period of 3 years.

Denial of Registration:
A. MIEMSS may deny an application if it finds that the applicant fails to meet the requirements of this chapter.

B. Notice of Denial.

(1) MIEMSS shall issue a written notice of denial to an applicant that includes the reasons for denial.

(2) The notice shall conform to the requirements of State Government Article, §10-207, Annotated Code of Maryland.

C. An applicant denied approval may file an appeal with the EMS Board under Regulation .05 of this chapter.

D. If an applicant does not file a timely appeal under Regulation .05 of this chapter, the decision is final.

E. If an application is denied, the applicant may reapply under this chapter.

Compliance:
A. MIEMSS may initiate a compliance review of a registered facility upon information that the registered facility has failed to comply with this subtitle.

B. MIEMSS shall give written notice of the compliance review to the registered facility.

C. In the course of its compliance review, MIEMSS may:

(1) Inspect all:

(a) Sites where the registered facility maintains an AED;

(b) Records relating to the AED maintained by the facility; and

(c) Equipment related to the AED; and

(2) Interview employees of the registered facility regarding the AED program.

D. If MIEMSS finds that a registered facility has failed to comply with this subtitle, MIEMSS may:

(1) Suspend the facility's registration;

(2) Revoke the facility's registration;

(3) Refuse to renew a facility's registration; or

(4) Take other action as appropriate.

E. Within 30 days after the conclusion of the compliance review, MIEMSS shall provide its findings, decision and any proposed action in writing to the:

(1) Registered facility; and

(2) EMS Board.

F. The report shall:

(1) Conform to the requirements of State Government Article, §10-207, Annotated Code of Maryland; and

(2) Contain the reasons for the decision and the proposed action.

G. Upon receipt of the report and proposed action, a registered facility may file an appeal with the EMS Board under Regulation .05 of this chapter.

H. If an applicant does not file a timely appeal under Regulation .05 of this chapter, MIEMSS' proposed decision is final.

Procedure of Appeals:
A. An applicant or registered facility may appeal a disputed decision by filing a notice of appeal to the EMS Board with the Executive Director of MIEMSS not later than 20 days after receipt of the decision.

B. The appeal shall state with specificity the reasons why the disputed decision should be modified.

C. An applicant or registered facility that files an appeal shall be granted a hearing before the:

(1) EMS Board; or

(2) Office of Administrative Hearings, if the Board so elects and notifies the applicant or registered facility.

D. An appeal hearing shall be governed by COMAR 28.02.01.

E. If the hearing is conducted by the Office of Administrative Hearings, COMAR 30.02.06.22 and .23 also apply.

F. An applicant or registered facility which has participated in a hearing under this regulation may seek judicial review of the EMS Board's final action under State Government Article, §10-222, Annotated Code of Maryland. The EMS Board shall be party to the proceeding.

Confidentiality of Records
MIEMSS shall maintain the confidentiality of records referred to in this subtitle in accordance with:

A. Health-General Article, Title 4, Subtitle 3, Annotated Code of Maryland;

B. Health Occupations Article, Title 1, Subtitle 4, Annotated Code of Maryland; and

C. State Government Article, Title 10, Subtitle 6, Part III, Annotated Code of Maryland.
Maryland Code of Regulations - 30.06.03.02 Authorized Facility Medical Direction.

A. Each authorized facility shall have medical direction through either:

(1) A sponsoring physician; or

(2) The regional council AED committee for the region in which the facility is located.

B. A sponsoring physician shall meet the following qualifications:

(1) Be licensed to practice medicine in Maryland;

(2) Be knowledgeable in the operation of the AEDs available at the facility; and

(3) Possess current knowledge of the:

(a) Maryland EMS System,

(b) AED protocol in Regulation .03 of this chapter, and

(c) AED quality assurance process in COMAR 30.06.04.

C. The regional council AED committee shall meet the following qualifications:

(1) Be knowledgeable in the operation of the AEDs available at the facility; and

(2) Possess current knowledge of the:

(a) Maryland EMS System;

(b) AED protocol in Regulation .03 of this chapter; and

(c) AED quality assurance process in COMAR 30.06.04.

D. The sponsoring physician or regional council AED committee shall perform the following duties:

(1) Be responsible for providing medical direction for the operation of AEDs at the authorized facility;

(2) Require that all personnel operating an AED for the authorized facility meet the training requirements of COMAR 30.06.05;

(3) Oversee the quality assurance program as required in COMAR 30.06.04;

(4) Liaise with the local EMS jurisdictional operational program medical director and the State EMS Medical Director; and

(5) Require that all personnel in the AED program are following the protocol required in Regulation .03 of this chapter when operating the AED.

E. The authorized facility shall notify the office of the State EMS Medical Director immediately of any change in its medical direction.
Maryland Code of Regulations - 30.06.03.03 Protocol.

A. All personnel expected to operate an AED at an authorized facility shall utilize the AED in accordance with their training. When an individual’s training conflicts with the auditory and visual prompts of the device, the individual shall follow the auditory and visual prompts.

B. In utilizing the AED, the following are to be considered:

(1) Indications:

(a) Sudden cardiac arrest - Patient without signs of circulation and not breathing;

(b) Infant 12 months - Child 8 years - If available, pediatric AED only;

(c) Child 8 years old or older - Adult AED;

(2) Contraindications:

(a) Infant less than 12 months old (estimate based upon information available to individual operating AED);

(b) Patient is breathing, responsive, speaking, or making intentional movements;

(3) Potential adverse effects/complications:

(a) Burns to skin;

(b) Deactivation of patient’s implanted pacemaker;

(c) Injury to patient, self, or bystanders;

(4) Precautions/critical concepts:

(a) Wet conditions - Make sure the patient and environment are dry (this includes removing nitroglycerin paste from the chest with a dry cloth);

(b) Metal surfaces - Make sure patient is not touching any metal surfaces;

(c) Combustible materials or hazardous (explosive) environment - Remove patient, if possible, from area which presents hazard;

(d) Do not touch patient while AED is assessing, charging, or shocking patient;

(e) Ensure patient is clear (no one is touching patient) when shock button is pushed;

(f) If patient has internal pacemaker/defibrillator, position pad 1 hand’s width (approximately 5 inches) from the pacemaker/defibrillator site;

(g) If patient has a nitroglycerin patch, position patches away from the patch;

(h) Never defibrillate while moving patient;

(i) Location of AED(s) should provide optimal accessibility to the maximum number of individuals and authorized operator(s) at the facility;

(j) Upon placement of AED consider the following:

(i) No obstacles in the way of AED;

(ii) Avoid locked doors preventing quick access to AED;

(iii) Areas of facility with large numbers of high-risk individuals;

(iv) Length of time and distance to AED;

(v) The AED is placed in a location clearly visible to the authorized operators.
Maryland Code of Regulations - 10.17.02.01-08 Scope
This chapter establishes guidelines for periodic inspections and annual maintenance of the automated external defibrillators at swimming pools.

Definitions


A. In this chapter, the following terms have the meanings indicated.



B. Terms Defined.



(1) "AED" means automated external defibrillator as defined in COMAR 30.06.01.01.



(2) "AED coordinator" means an individual designated by the county or municipality to meet the requirement of COMAR 30.06.02.



(3) "Swimming pool" means a pool that is owned and operated by the governing body of a county or municipality.

AED Program Requirements
Each county or municipality that owns and operates a swimming pool shall develop and implement an automated external defibrillator program that meets the requirements in the Education Article, §13-517, Annotated Code of Maryland, and COMAR 30.06.02.

Installation
An AED shall be located within the pool barrier, as defined in COMAR 10.17.01.05.

Registration
Each swimming pool owned and operated by a county or municipality shall be registered as specified in COMAR 30.06.02.04.

Training
The AED coordinator shall ensure that at least one individual who has a current AED certification from a national organization is onsite while the swimming pool is open.

Quality Assurance and Maintenance
A county or municipality that owns and operates a swimming pool shall:

A. Maintain the certificate, equipment and supplies as required by COMAR 30.06.02; and

B. Submit the reports as required by COMAR 30.06.02 to the Maryland Institute for Emergency Medical Services Systems (MIEMSS).

Inspections

A. The Department shall:

(1) Monitor a swimming pool for compliance with this chapter; and

(2) Inspect the swimming pool as necessary for the enforcement of this chapter.

B. Right to Inspect.

(1) The Department may enter, at reasonable times, the property of a swimming pool for the purposes of inspecting, monitoring, and verifying information relative to the enforcement of this chapter.

(2) A person may not deny or interfere with the Department's entry into a swimming pool under this chapter.

(3) An operator shall permit a representative of the Department to examine and copy records of the swimming pool to verify information relative to the enforcement of this chapter.

C. Report of Inspection. During a swimming pool inspection, the Department shall:

(1) Record the inspection results on an inspection form prescribed by the Department;

(2) Identify on the inspection form the conditions found that violate the provisions of this chapter;

(3) Notify the swimming pool operator on the inspection form to correct violations by a specific date; and

(4) Provide one copy of the inspection report to the swimming pool operator.

D. The completed inspection report is a public document that is available for public disclosure in accordance with State Government Article, §10-611 10-628, Annotated Code of Maryland.
Maryland Code of Regulations - 10.44.12.01, .02, .11 Dental Office AEDs.

01 Scope.

A. This chapter covers the use of anesthesia and sedation by dentists in Maryland for the practice of dentistry.

B. The use of local anesthesia by a dentist is not governed by this chapter.

C. The administration of anesthesia and sedation by dentists in hospitals licensed in Maryland is not governed by this chapter.

.02 Purpose.

Dentists are increasingly administering anesthesia and sedation on an outpatient basis. It is in the best interests of the public and the dentists of Maryland to require dentists who administer anesthesia and sedation to meet certain minimal training and competency standards. Requiring a dentist to obtain a permit before the dentist may administer anesthesia, sedation, or both is the best method to ensure that such administration is performed by competent dentists trained in the use of such techniques.

.11 Facility Evaluation Criteria.

A. Except as otherwise provided in this regulation, to qualify for a permit, the facility and the applicant shall pass an evaluation of facility equipment, medications, and clinical records to include at least the following:

. . .

(15) Defibrillator or automated external defibrillator (AED) for adult patients;

AED owners are legally responsible to ensure compliance and emergency readiness of their AEDs. Each unit must meet certain requirements from the FDA, the local state, and individual AED manufacturers, which can be a challenging task to maintain. Thousands of customers rely on us to manage their AED compliance through our easy to use tool called LifeShield. Learn more about how we support our clients with an unmatched AED compliance program offering here.


Maryland Summary
Requirement Summary
Good Samaritan Law An individual rescuer acting in good faith is also protected if the acts or omissions were undertaken in a reasonably prudent manner without compensation.

A registered facility has Good Samaritan protection if it has satisfied the EMS Board's requirements.
EMS Notification Each facility that wishes to make an AED available must become certified by the EMS Board.

EMS should be notified as soon as possible after using an AED.
AED Maintenance AED maintenance, placement, operation, reporting, and quality improvement procedures as required. Maintain each AED and all related equipment and supplies in accordance with the standards established by the device manufacturer and the FDA.
Public Pools All swimming pools operated by the counties or municipalities must have a registered AED on the premises and an individual trained in AED use present at each swimming pool.
Schools All public schools must have a registered AED on site.

An individual trained in AED use present at all school-sponsored athletic events.

Students entering 9th grade must receive CPR/AED training before graduation.
Medical Oversight An in-state licensed physician or regional council AED committee must provide AED program medical oversight services.
Dental Facilities Dental facilities are required to have a defibrillator or an AED.
Maryland Statutes and Regulations
Statute Abstract
Maryland Code - Education, § 13-517 EDUC Automated External Defibrillator Program established; administration by EMS board.

(a) Definitions. (1) In this section the following words have the meanings indicated.

(2)Automated external defibrillator (AED) means a medical heart monitor and defibrillator device that:

(i) Is cleared for market by the federal Food and Drug Administration;

(ii) Recognizes the presence or absence of ventricular fibrillation or rapid ventricular tachycardia;

(iii) Determines, without intervention by an operator, whether defibrillation should be performed;

(iv) On determining that defibrillation should be performed, automatically charges; and

(v) 1. Requires operator intervention to deliver the electrical impulse; or

2. Automatically continues with delivery of electrical impulse.

(3) Certificate means a certificate issued by the EMS Board to a registered facility.

(4) Facility means an agency, association, corporation, firm, partnership, or other entity.

(5) Jurisdictional emergency medical services operational program means the institution, agency, corporation, or other entity that has been approved by the EMS Board to provide oversight of emergency medical services for each of the local government and State and federal emergency medical services programs.

(6) Program means the Public Access Automated External Defibrillator Program.

(7) Regional administrator means the individual employed by the Institute as regional administrator in each EMS region.

(8) Regional council means an EMS advisory body as created by the Code of Maryland Regulations 30.05.

(9) Regional council AED committee means a committee appointed by the regional council consisting of:

(i) The regional medical director;

(ii) The regional administrator; and

(iii) Three or more individuals with knowledge of and expertise in AEDs.

(10) Registered facility means an organization, business association, agency, or other entity that meets the requirements of the EMS Board for registering with the Program.

(b) Established; purpose. (1) There is a Public Access Automated External Defibrillator Program.

(2) The purpose of the Program is to coordinate an effective statewide public access defibrillation program.

(3) The Program shall be administered by the EMS Board.

(c) Powers of EMS Board. The EMS Board may:

(1) Adopt regulations for the administration of the Program;

(2) Issue and renew certificates to facilities that meet the requirements of this section;

(3) Deny, suspend, revoke, or refuse to renew the certificate of a registered facility for failure to meet the requirements of this section;

(4) Approve educational and training programs required under this section that:

(i) Are conducted by any private or public entity;

(ii) Include training in cardiopulmonary resuscitation and automated external defibrillation; and

(iii) May include courses from nationally recognized entities such as the American Heart Association, the American Red Cross, and the National Safety Council;

(5) Approve the protocol for the use of an AED; and

(6) Delegate to the Institute any portion of its authority under this section.

(d) Facility certification required. — (1) Each facility that desires to make automated external defibrillation available shall possess a valid certificate from the EMS Board.

(2) This subsection does not apply to:

(i) A jurisdictional emergency medical services operational program;

(ii) A licensed commercial ambulance service;

(iii) A health care facility as defined in § 19-114 of the Health General Article; or

(iv) A place of business for health care practitioners who are licensed as dentists under Title 4 of the Health Occupations Article or as physicians under Title 14 of the Health Occupations Article and are authorized to use an AED in accordance with that license.

(e) Facility certification Requirements. To qualify for a certificate a facility shall:

(1) Comply with the written protocol approved by the EMS Board for the use of an AED which includes notification of the emergency medical services system through the use of the 911 universal emergency access number as soon as possible on the use of an AED;

(2) Have established automated external defibrillator maintenance, placement, operation, reporting, and quality improvement procedures as required by the EMS Board;

(3) Maintain each AED and all related equipment and supplies in accordance with the standards established by the device manufacturer and the federal Food and Drug Administration; and

(4) Ensure that each individual who is expected to operate an AED for the registered facility has successfully completed an educational training course and refresher training as required by the EMS Board.

(f) Report of use of AED. A registered facility shall report the use of an AED to the Institute for review by the regional council AED committee.

(g) Report of use of AED Procedures. A facility that desires to establish or renew a certificate shall:

(1) Submit an application on the form that the EMS Board requires; and

(2) Meet the requirements under this section.

(h) Certificate Contents. (1) The EMS Board shall issue a new or a renewed certificate to a facility that meets the requirements of this section.

(2) Each certificate shall include:

(i) The type of certificate;

(ii) The full name and address of the facility;

(iii) A unique identification number; and

(iv) The dates of issuance and expiration of the certificate.

(3) A certificate is valid for 3 years.

(i) Cease and desist orders. The EMS Board may issue a cease and desist order or obtain injunctive relief if a facility makes automated external defibrillation available in violation of this section.

(j) Immunities. (1) In addition to any other immunities available under statutory or common law, a registered facility is not civilly liable for any act or omission in the provision of automated external defibrillation if the registered facility:

(i) Has satisfied the requirements for making automated external defibrillation available under this section; and

(ii) Possesses a valid certificate at the time of the act or omission.

(2) In addition to any other immunities available under statutory or common law, a member of the regional council AED committee is not civilly liable for any act or omission in the provision of automated external defibrillation.

(3) In addition to any other immunities available under statutory or common law, an individual is not civilly liable for any act or omission if:

(i) The individual is acting in good faith while rendering automated external defibrillation to a person who is a victim or reasonably believed by the individual to be a victim of a sudden cardiac arrest;

(ii) The assistance or aid is provided in a reasonably prudent manner; and

(iii) The automated external defibrillation is provided without fee or other compensation.

(4) The immunities in this subsection are not available if the conduct of the registered facility or an individual amounts to gross negligence, willful or wanton misconduct, or intentionally tortious conduct.

(5) This subsection does not affect, and may not be construed as affecting, any immunities from civil or criminal liability or defenses established by any other provision of the Code or by common law to which a registered facility, a member of the regional council AED committee, or an individual may be entitled.

(k) Opportunity for hearing. (1) A registered facility aggrieved by a decision of the Institute acting under the delegated authority of the EMS Board under this section shall be afforded an opportunity for a hearing before the EMS Board.

(2) A registered facility aggrieved by a decision of the EMS Board under this section shall be afforded an opportunity for a hearing in accordance with Title 10, Subtitle 2 of the State Government Article.

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings.

A. Automated external defibrillator or AED means a medical device that combines a heart monitor and a defibrillator approved by the United States Food and Drug Administration that:

(1) Is capable of recognizing the presence or absence of ventricular fibrillation or rapid ventricular tachycardia;

(2) Is capable of determining, without intervention by an operator, whether defibrillation should be performed on an individual; and

(3) Upon determination that defibrillation should be performed, automatically charges and requests delivery of an electrical impulse to an individual’s heart.

2 to 5. Deleted.

6. Immunity. The following persons and entities are immune from civil liability for damages relating to the use, possession or purchase of an AED and arising out of acts or omissions relating to preparing for and responding to suspected sudden cardiac arrest emergencies absent gross negligence or willful or wanton misconduct:

A. Any person or entity that acquires an AED;

B. Any person or entity that owns, manages or is otherwise responsible for the premises on which an AED is located;

C. Any person who retrieves an AED in response to a perceived sudden cardiac arrest emergency;

D. Any person who uses, attempts to use or fails to use an AED in response to a perceived sudden cardiac arrest emergency;

E. Any physician or other authorized person who issues a prescription for the purchase of an AED;

F. Any person or entity that is involved with the design, management or operation of an AED program; and

G. Any person or entity that provides instruction in the use of an AED.
Maryland Code - Education, § 7-425 EDUC Provisions and regulations of automated external defibrillator programs.

(a) In general. (1) Each county board shall develop and implement an automated external defibrillator program that meets the requirements of § 13-517 of this article for each high school in the county.

(2) The program required under paragraph (1) of this subsection shall include provisions that:

(i) Ensure that an automated external defibrillator is provided on-site; and

(ii) An individual trained in the operation and use of an automated external defibrillator is present at all school-sponsored athletic events.

(b) Regulations.The Department, in consultation with the Department of Health and Mental Hygiene, the Maryland State School Health Council, and the Maryland Institute for Emergency Medical Services Systems, shall adopt regulations that:

(1) Establish guidelines for periodic inspections and annual maintenance of the automated external defibrillators; and

(2) Assist county boards in carrying out the provisions of this section.
Maryland Code - Courts and Judicial Procedures, § 5-603 CTS. & JUD. PROC. Immunity of persons providing emergency medical care.

(a) In general. A person described in subsection (b) of this section is not civilly liable for any act or omission in giving any assistance or medical care, if:

(1) The act or omission is not one of gross negligence;

(2) The assistance or medical care is provided without fee or other compensation; and

(3) The assistance or medical care is provided:

(i) At the scene of an emergency;

(ii) In transit to a medical facility; or

(iii) Through communications with personnel providing emergency assistance.

(b) Applicability. Subsection (a) of this section applies to the following:

(1) An individual who is licensed by this State to provide medical care;

(2) A member of any State, county, municipal, or volunteer fire department, ambulance and rescue squad, or law enforcement agency, the National Ski Patrol System, or a corporate fire department responding to a call outside of its corporate premises, if the member:

(i) Has completed an American Red Cross course in advanced first aid and has a current card showing that status;

(ii) Has completed an equivalent of an American Red Cross course in advanced first aid, as determined by the Secretary of Health and Mental Hygiene; or

(iii) Is certified or licensed by this State as an emergency medical services provider;

(3) A volunteer fire department or ambulance and rescue squad whose members have immunity; and

(4) A corporation when its fire department personnel are immune under paragraph (2) of this subsection.

(c) Immunity for individual not covered by this section. An individual who is not covered otherwise by this section is not civilly liable for any act or omission in providing assistance or medical aid to a victim at the scene of an emergency, if:

(1) The assistance or aid is provided in a reasonably prudent manner;

(2) The assistance or aid is provided without fee or other compensation; and

(3) The individual relinquishes care of the victim when someone who is licensed or certified by this State to provide medical care or services becomes available to take responsibility.
Maryland Code - Courts and Judicial Procedures, § 5-608 CTS. & JUD. PROC. Immunity of persons providing support for emergency medical system.

An individual is not civilly liable for any act or omission while providing support to the emergency medical system by giving care, equipment, facilities, or consultation, if:

(1) The individual is a member or employee of any federal, State, county, or city government, hospital, emergency medical service council, or agency that operates as a nonprofit group;

(2) The act or omission is not one of gross negligence; and

(3) The service is provided without fee to the emergency victim.
§ 1-1310 LOCAL GOV'T. Swimming pool automated external defibrillator programs.

(a) "Swimming pool" defined. In this section, "swimming pool" means a pool that is owned and operated by the governing body of a county or municipality.

(b) Development and implementation of programs. (1) Each county or municipality that owns or operates a swimming pool shall develop and implement an automated external defibrillator program that meets the requirements of § 13-517 of the Education Article for each swimming pool owned or operated by the county or municipality.

(2) The program required under paragraph (1) of this subsection shall include provisions that:

(i) ensure an automated external defibrillator is provided on-site; and

(ii) an individual trained in the operation and use of an automated external defibrillator is present at each swimming pool.

(c) Regulations. The Department of Health and Mental Hygiene and the Maryland Institute for Emergency Medical Services Systems jointly shall adopt regulations that:

(1) establish guidelines for periodic inspections and annual maintenance of the automated external defibrillators; and

(2) assist each county or municipality in carrying out the provisions of this section.
Maryland Code of Regulations - 30.06.01.01 Definitions

A. In this subtitle, the following terms have the meanings indicated.

B. Terms Defined.

(1) "Automated external defibrillator (AED)" means a medical heart monitor and defibrillator device that:

(a) Is cleared for market by the federal Food and Drug Administration;

(b) Recognizes the presence or absence of ventricular fibrillation or rapid ventricular tachycardia;

(c) Determines, without intervention by the operator, whether defibrillation should be performed;

(d) On determining that defibrillation should be performed, automatically charges; and

(e) Either:

(i) Requires operator intervention to deliver the electrical impulse, or

(ii) Automatically continues with delivery of electrical impulse.

(2) "Event (code) summary" means the electronic report of an AED operation produced by an AED.

(3) Expected operator means any individual identified by a registered facility to operate an AED at a registered facility

(4) "Facility" means an agency, association, corporation, firm, partnership, or other entity.

(5) "Operate" means to use or attempt to use an AED to defibrillate an individual whether or not any electrical impulse is delivered.

(6) "Public safety answering point (PSAP)" has the meaning stated in Public Safety Article, §1-301(q), Annotated Code of Maryland.

(7) Registered Facility.

(a) "Registered facility" means an organization, business, association, or agency that meets the requirements of the EMS Board for providing automated external defibrillation.

(b) "Registered facility" may include multiple sites.

(8) "Response" means the removal of the AED from its storage location for the purposes of rendering care whether or not the care is actually rendered.

(9) "Site" means a building, plant, unit, branch, vehicle, or other ancillary location that is part of or affiliated with a facility.
Maryland Code of Regulations - 30.06.02.01 Criteria for Registration of Facilities.

To be eligible for registration, or renewal of registration, to operate an AED under this subtitle, a registered facility shall:

A. Designate an AED coordinator who shall:

(1) Have successfully completed CPR and AED Training, and subsequent refresher training, in accordance with their training course requirements that at a minimum includes content consistent with the recommendations for layperson CPR and AED training in the most current publication of the American Heart Association Guidelines for CPR and ECC;

(2) Be responsible for implementing and administering the AED program at the registered facility; and

(3) Ensure that monthly safety inspections of all supplemental and AED equipment, including assurance of adequate battery charge, per the manufacturer’s guidelines are conducted and maintain written logs of the inspections.

B. Provide information regarding the operation, maintenance, and location of the registered facility's AEDs to all individuals employed by or volunteering for the registered facility;

C. Place all AEDs in locations which are visible and readily accessible to any person willing to operate the AED in the event of a cardiac arrest;

D. Have a telephone or other communication service available at all times at each site at which an AED is operated, for the notification of the public safety answering point;

E. Submit data or other information concerning the AED program which may be periodically requested by MIEMSS; and

F. Ensure that expected operators have completed CPR and AED Training, and subsequent refresher training, in accordance with their training course requirements that at a minimum includes content consistent with the recommendations for layperson CPR and AED training in the most current publication of the American Heart Association Guidelines for CPR and ECC.
Maryland Code of Regulations - 30.06.02.02-08 Protocol:

All personnel who are expected to operate an AED at a registered facility shall utilize the AED in accordance with their training. When an individual's training conflicts with the auditory and visual prompts of the device, the individual shall follow the auditory and visual prompts.

Quality Assurance:
Each registered facility shall:



A. Comply the federal Safe Medical Devices Act of 1990 and the Medical Device Amendments of 1992;

B. Maintain:

(1) The certificate issued by MIEMSS in a place where it is readily available;

(2) Each AED and all related equipment and supplies in accordance with the standards established by the device manufacturer and the federal Food and Drug Administration;

(3) Supplemental equipment with the AED at all times as follows:

(a) Two sets of defibrillator chest pads;

(b) Disposable gloves; and

(c) Maryland Facility AED Report Forms for Cardiac Arrest;

C. Submit:

(1) A report for each incident of suspected cardiac arrest at the facility on the Maryland Facility AED Report Form for Cardiac Arrests, including, when available, any event (code) summary, recording, or tape created by the AED to MIEMSS, and be available for follow up as necessary; and

(2) If the AED fails when operated, in addition to submitting the required report to the federal Food and Drug Administration, a copy of the report to MIEMSS; and

D. Ensure the confidentiality of any medical records maintained by the registered facility as required by law.

Application and Registration Process:
A. A facility seeking registration or renewal of registration shall submit an application and all required documentation to MIEMSS on the form required by MIEMSS.



B. MIEMSS may make the inspection and require the verification necessary to ensure that an applicant meets the requirements of this chapter, including an inspection of the facility, any sites, equipment, and records.



C. MIEMSS shall issue a certificate of registration or renewal to a facility that meets the requirements of Regulation .01 of this chapter.



D. The certificate of registration or renewal is valid for a period of 3 years.

Denial of Registration:
A. MIEMSS may deny an application if it finds that the applicant fails to meet the requirements of this chapter.

B. Notice of Denial.

(1) MIEMSS shall issue a written notice of denial to an applicant that includes the reasons for denial.

(2) The notice shall conform to the requirements of State Government Article, §10-207, Annotated Code of Maryland.

C. An applicant denied approval may file an appeal with the EMS Board under Regulation .05 of this chapter.

D. If an applicant does not file a timely appeal under Regulation .05 of this chapter, the decision is final.

E. If an application is denied, the applicant may reapply under this chapter.

Compliance:
A. MIEMSS may initiate a compliance review of a registered facility upon information that the registered facility has failed to comply with this subtitle.

B. MIEMSS shall give written notice of the compliance review to the registered facility.

C. In the course of its compliance review, MIEMSS may:

(1) Inspect all:

(a) Sites where the registered facility maintains an AED;

(b) Records relating to the AED maintained by the facility; and

(c) Equipment related to the AED; and

(2) Interview employees of the registered facility regarding the AED program.

D. If MIEMSS finds that a registered facility has failed to comply with this subtitle, MIEMSS may:

(1) Suspend the facility's registration;

(2) Revoke the facility's registration;

(3) Refuse to renew a facility's registration; or

(4) Take other action as appropriate.

E. Within 30 days after the conclusion of the compliance review, MIEMSS shall provide its findings, decision and any proposed action in writing to the:

(1) Registered facility; and

(2) EMS Board.

F. The report shall:

(1) Conform to the requirements of State Government Article, §10-207, Annotated Code of Maryland; and

(2) Contain the reasons for the decision and the proposed action.

G. Upon receipt of the report and proposed action, a registered facility may file an appeal with the EMS Board under Regulation .05 of this chapter.

H. If an applicant does not file a timely appeal under Regulation .05 of this chapter, MIEMSS' proposed decision is final.

Procedure of Appeals:
A. An applicant or registered facility may appeal a disputed decision by filing a notice of appeal to the EMS Board with the Executive Director of MIEMSS not later than 20 days after receipt of the decision.

B. The appeal shall state with specificity the reasons why the disputed decision should be modified.

C. An applicant or registered facility that files an appeal shall be granted a hearing before the:

(1) EMS Board; or

(2) Office of Administrative Hearings, if the Board so elects and notifies the applicant or registered facility.

D. An appeal hearing shall be governed by COMAR 28.02.01.

E. If the hearing is conducted by the Office of Administrative Hearings, COMAR 30.02.06.22 and .23 also apply.

F. An applicant or registered facility which has participated in a hearing under this regulation may seek judicial review of the EMS Board's final action under State Government Article, §10-222, Annotated Code of Maryland. The EMS Board shall be party to the proceeding.

Confidentiality of Records
MIEMSS shall maintain the confidentiality of records referred to in this subtitle in accordance with:

A. Health-General Article, Title 4, Subtitle 3, Annotated Code of Maryland;

B. Health Occupations Article, Title 1, Subtitle 4, Annotated Code of Maryland; and

C. State Government Article, Title 10, Subtitle 6, Part III, Annotated Code of Maryland.
Maryland Code of Regulations - 30.06.03.02 Authorized Facility Medical Direction.

A. Each authorized facility shall have medical direction through either:

(1) A sponsoring physician; or

(2) The regional council AED committee for the region in which the facility is located.

B. A sponsoring physician shall meet the following qualifications:

(1) Be licensed to practice medicine in Maryland;

(2) Be knowledgeable in the operation of the AEDs available at the facility; and

(3) Possess current knowledge of the:

(a) Maryland EMS System,

(b) AED protocol in Regulation .03 of this chapter, and

(c) AED quality assurance process in COMAR 30.06.04.

C. The regional council AED committee shall meet the following qualifications:

(1) Be knowledgeable in the operation of the AEDs available at the facility; and

(2) Possess current knowledge of the:

(a) Maryland EMS System;

(b) AED protocol in Regulation .03 of this chapter; and

(c) AED quality assurance process in COMAR 30.06.04.

D. The sponsoring physician or regional council AED committee shall perform the following duties:

(1) Be responsible for providing medical direction for the operation of AEDs at the authorized facility;

(2) Require that all personnel operating an AED for the authorized facility meet the training requirements of COMAR 30.06.05;

(3) Oversee the quality assurance program as required in COMAR 30.06.04;

(4) Liaise with the local EMS jurisdictional operational program medical director and the State EMS Medical Director; and

(5) Require that all personnel in the AED program are following the protocol required in Regulation .03 of this chapter when operating the AED.

E. The authorized facility shall notify the office of the State EMS Medical Director immediately of any change in its medical direction.
Maryland Code of Regulations - 30.06.03.03 Protocol.

A. All personnel expected to operate an AED at an authorized facility shall utilize the AED in accordance with their training. When an individual’s training conflicts with the auditory and visual prompts of the device, the individual shall follow the auditory and visual prompts.

B. In utilizing the AED, the following are to be considered:

(1) Indications:

(a) Sudden cardiac arrest - Patient without signs of circulation and not breathing;

(b) Infant 12 months - Child 8 years - If available, pediatric AED only;

(c) Child 8 years old or older - Adult AED;

(2) Contraindications:

(a) Infant less than 12 months old (estimate based upon information available to individual operating AED);

(b) Patient is breathing, responsive, speaking, or making intentional movements;

(3) Potential adverse effects/complications:

(a) Burns to skin;

(b) Deactivation of patient’s implanted pacemaker;

(c) Injury to patient, self, or bystanders;

(4) Precautions/critical concepts:

(a) Wet conditions - Make sure the patient and environment are dry (this includes removing nitroglycerin paste from the chest with a dry cloth);

(b) Metal surfaces - Make sure patient is not touching any metal surfaces;

(c) Combustible materials or hazardous (explosive) environment - Remove patient, if possible, from area which presents hazard;

(d) Do not touch patient while AED is assessing, charging, or shocking patient;

(e) Ensure patient is clear (no one is touching patient) when shock button is pushed;

(f) If patient has internal pacemaker/defibrillator, position pad 1 hand’s width (approximately 5 inches) from the pacemaker/defibrillator site;

(g) If patient has a nitroglycerin patch, position patches away from the patch;

(h) Never defibrillate while moving patient;

(i) Location of AED(s) should provide optimal accessibility to the maximum number of individuals and authorized operator(s) at the facility;

(j) Upon placement of AED consider the following:

(i) No obstacles in the way of AED;

(ii) Avoid locked doors preventing quick access to AED;

(iii) Areas of facility with large numbers of high-risk individuals;

(iv) Length of time and distance to AED;

(v) The AED is placed in a location clearly visible to the authorized operators.
Maryland Code of Regulations - 10.17.02.01-08 Scope
This chapter establishes guidelines for periodic inspections and annual maintenance of the automated external defibrillators at swimming pools.

Definitions


A. In this chapter, the following terms have the meanings indicated.



B. Terms Defined.



(1) "AED" means automated external defibrillator as defined in COMAR 30.06.01.01.



(2) "AED coordinator" means an individual designated by the county or municipality to meet the requirement of COMAR 30.06.02.



(3) "Swimming pool" means a pool that is owned and operated by the governing body of a county or municipality.

AED Program Requirements
Each county or municipality that owns and operates a swimming pool shall develop and implement an automated external defibrillator program that meets the requirements in the Education Article, §13-517, Annotated Code of Maryland, and COMAR 30.06.02.

Installation
An AED shall be located within the pool barrier, as defined in COMAR 10.17.01.05.

Registration
Each swimming pool owned and operated by a county or municipality shall be registered as specified in COMAR 30.06.02.04.

Training
The AED coordinator shall ensure that at least one individual who has a current AED certification from a national organization is onsite while the swimming pool is open.

Quality Assurance and Maintenance
A county or municipality that owns and operates a swimming pool shall:

A. Maintain the certificate, equipment and supplies as required by COMAR 30.06.02; and

B. Submit the reports as required by COMAR 30.06.02 to the Maryland Institute for Emergency Medical Services Systems (MIEMSS).

Inspections

A. The Department shall:

(1) Monitor a swimming pool for compliance with this chapter; and

(2) Inspect the swimming pool as necessary for the enforcement of this chapter.

B. Right to Inspect.

(1) The Department may enter, at reasonable times, the property of a swimming pool for the purposes of inspecting, monitoring, and verifying information relative to the enforcement of this chapter.

(2) A person may not deny or interfere with the Department's entry into a swimming pool under this chapter.

(3) An operator shall permit a representative of the Department to examine and copy records of the swimming pool to verify information relative to the enforcement of this chapter.

C. Report of Inspection. During a swimming pool inspection, the Department shall:

(1) Record the inspection results on an inspection form prescribed by the Department;

(2) Identify on the inspection form the conditions found that violate the provisions of this chapter;

(3) Notify the swimming pool operator on the inspection form to correct violations by a specific date; and

(4) Provide one copy of the inspection report to the swimming pool operator.

D. The completed inspection report is a public document that is available for public disclosure in accordance with State Government Article, §10-611 10-628, Annotated Code of Maryland.
Maryland Code of Regulations - 10.44.12.01, .02, .11 Dental Office AEDs.

01 Scope.

A. This chapter covers the use of anesthesia and sedation by dentists in Maryland for the practice of dentistry.

B. The use of local anesthesia by a dentist is not governed by this chapter.

C. The administration of anesthesia and sedation by dentists in hospitals licensed in Maryland is not governed by this chapter.

.02 Purpose.

Dentists are increasingly administering anesthesia and sedation on an outpatient basis. It is in the best interests of the public and the dentists of Maryland to require dentists who administer anesthesia and sedation to meet certain minimal training and competency standards. Requiring a dentist to obtain a permit before the dentist may administer anesthesia, sedation, or both is the best method to ensure that such administration is performed by competent dentists trained in the use of such techniques.

.11 Facility Evaluation Criteria.

A. Except as otherwise provided in this regulation, to qualify for a permit, the facility and the applicant shall pass an evaluation of facility equipment, medications, and clinical records to include at least the following:

. . .

(15) Defibrillator or automated external defibrillator (AED) for adult patients;