A communication transmitted from Yi-An Huang, City Manager, relative to Awaiting Report Item Number #23-19 regarding Automated External Defibrillators at all public parks and practice fields

1 TO: Yi-An Huang, City Manager FROM: Derrick Neal, Chief Public Health Officer, Cambridge Public Health Department Thomas F. Cahill, Acting Fire Chief Christina Giacobbe, Director of Emergency Communications DATE: October 11, 2023 SUBJECT: Response to Policy Order #2, adopted March 6, 2023 Excerpt of Order: That the City Manager be and hereby is requested to work with the Department of Public Health and the Parks Department to determine the feasibility of installing AEDs at all public parks and practice fields, and any other public place as appropriate. OVERVIEW Recent high-profile events have drawn attention to the life-saving potential of readily accessible AEDs at outdoor athletic facilities in the event of a cardiac arrest. In response to the City Council’s Policy Order #2 adopted in March, the Cambridge Public Health Department (CPHD), Fire Department (CFD), Department of Public Works (DPW) and Recreation Department convened a planning group to assess the feasibility of installing AEDs in public parks and practice fields in Cambridge. The assessment effort was led by Captain Jeremy Walsh from CFD, who has overseen previous installations of AEDs in Cambridge. In 2019, the city made AEDs available in 27 city-owned buildings, with some locations housing multiple devices. The Fire Department contracted with Life Support Systems to provide both the AEDs and an annual agreement for an AED Service/Maintenance/Tracking Program that includes semi-annual service inspections and emergency service calls for each device. All schools in the city are also equipped with AEDs, as required by Massachusetts law. In addition, the Massachusetts Interscholastic Athletics Association, of which Cambridge Rindge and Latin School (CRLS) is a member, requires that AEDs be available at all athletics events, including practices. To ensure compliance with this requirement, the Athletics Department at CRLS purchased 10 portable AEDs that coaches carry for the team’s season. The high school’s two athletic trainers also travel with AEDs. In addition, AED training is required for all coaches, and Cambridge Fire Department staff provide training annually. Coaches are trained on symptoms of cardiac events in student-athletes and is conducted in conjunction with the existing mandated CPR training which is a State

2 Law for all coaches. Apart from the coverage provided by coaches and trainers during organized events, Human Service Program staff also have a portable unit at 99 Sherman Street that can be used to respond to emergencies at Danehy Park. Beyond that, AEDs are not available at outdoor athletics facilities in the city, despite heavy use of these facilities beyond organized Athletics Department events. At the time that AEDS were installed within city buildings, outdoor AEDs were considered, but the equipment that was available was deemed unsuitable. Since then, there have been advances in technology that support the installation of AEDS in outdoor locations in specifically designed cabinets and/or other types of AEDs that can be deployed in this capacity. Typical specifications include: ● Locked all-weather AED cabinets can protect AEDs from direct sunlight, cold temperatures, moisture, dust, tampering, and theft. ● A thermostat-controlled heater inside the enclosure ensures that AED pads remain at safe operating temperatures regardless of the environment outside. ● The public can gain 24/7 access to an AED by calling 911 to receive the access code that opens the locked cabinet. ● Powered devices that connect via cellular, Wi-Fi, Bluetooth & GPS Technologies. ● Battery operated devices that are rechargeable. ● Rapid Incident reporting for sharing vital information with first responders and physicians in the ER to support patient care. ● Connection to 911 RapidSOS platform. The planning team investigated several additional practical considerations, including the following: ● The Cambridge Emergency Communications Center (ECC) confirmed the ability to provide codes needed to access AEDs in response to 911 calls. ● All Cambridge 911 calls related to medical emergencies are generally routed to the ECC rather than to the State Police due to advancements by cell carriers. ● DPW confirmed the ability to provide the necessary power sources at outdoor athletic facilities, as the heater inside the AED cabinet requires 110VAC power. ● Life Support Systems, the current vendor, can provide additional AEDs and expand the existing maintenance contract to add outdoor AEDs as specified by the city. ● Outdoor cabinets meeting the specifications described above are available from Common Cents EMS Supply, LLC. ● Stop the Bleed Kits could be included in each outdoor cabinet.

3 ● Given that Narcan should not be stored at temperatures exceeding 77 degrees Fahrenheit, Narcan is not suitable for inclusion in the outdoor cabinets. During the assessment, we also learned that MIT is also considering deploying AEDs in the fields across their campus and will be utilizing Avive Connect AED. After learning about this initiative, the Fire and Emergency Communications Department set up a demo to review this AED option. In addition, we conversed with MIT regarding their decision, in which they are planning for implementation this month. Cambridge Fire, Emergency Communications and others will be attending their launch and installation to gain additional insight. Based on our initial assessment, the technology and features of this device are superior and we are recommending the use this technology at our playing fields and eventually citywide. The Avive Connect AED which uses proven defibrillation technology provides: • Fully automatic defibrillation • Audible instructions • CPD guidance and coaching • Indicators to convey functionality status • Patient analysis • Connects to 911 via RapidSOS portal that already exists today • Environmental Protection • Operation temperature 32 – 122F • Battery charging 32 – 113F • Short term storage temperature (up to 14 days) 4F to 140F • IP 54 (with Avive Pad Cartridge installed) – dust protected, splash and spray proof. • Lithium Ion, rechargeable • Battery capacity > 75 shocks 25 hours of continuous operation • Connectivity • Bluetooth connection to Avive App and cellular and Wi-Fi connection to cloud based REAL Connect Platform. • Maintenance Provisions • Battery will last up to 8.5 months, and when running low we will receive automated notice of status. • Provides daily updates on Avive AED Pad cartridges functional status and replacement options. • With GPS, we can track AED location. This feature allows us to see where the AED is, so we know where it is being used in the faciality as well as alert first responders to the exact location and if stolen. • Lost mode will enable us to track down the Avive Connect AED if it is misplaced or stolen. • Monitoring and Labeling allows us to customize settings to manage our fleet of AEDs. Provides notifications if AED fails a self-test, a device gets too cold or too hot or goes missing. • Software updates are conducted via cloud so there is limited out of service time.

4 The Recreation Department’s record of existing outdoor athletic facilities across the city lists 23 separate facilities. Three of these (Danehy Park, Hoyt Field, and the Fresh Pond Golf Course) would require more than one AED for adequate coverage, bringing the recommended number of outdoor AEDs to a total of 27. AEDs would be installed at ADA height to make them universally accessible. Where possible, AEDs would be located near existing emergency call boxes, which are sited in high-visibility areas. City-wide Implementation Implementation will involve the installation of 27 AED cabinets in the 23 athletic facilities across the city over the next 6 months. A list of athletic facilities is appended. These facilities host adults and youth for a variety of athletic pursuits, including basketball, soccer, softball, baseball, tennis, track and field, and golf. There are also a wide variety of passive recreation and multigenerational special events that take place at these facilities. COST The estimated per-unit costs for the Avive AEDS proposed for the program including initial installation, initial maintenance fees, secure cabinets, electrical work is $270,000. PUBLIC AWARENESS/EDUCATION To promote CPR and the availability of AEDs at outdoor facilities, the planning group recommended the following: ● Signage at larger facilities that indicates on a map of the property where the AED cabinets are located. ● A city-wide public awareness campaign that educates residents about the importance and availability of AEDs in the event of a suspected cardiac arrest at an outdoor athletic facility. This campaign could include publicity via the City’s daily email, the websites of city departments, social media, the parks permitting process (Recreation Department), youth and adult athletic leagues, etc. ● Promotion of CPR training with an AED component, including a video featuring Cambridge firefighters demonstrating CPR techniques; a QR code linking to the video could be displayed in parks and promotional materials. ● Abbreviated CPR training provided to the public at community events, in City Squares, shopping areas, etc. (Note: CFD has used this approach in the past to train large numbers of people in relatively short time periods.) IMPLEMENTATION APPROACHES

5 ● To make information broadly accessible across the city, educational materials should be translated into multiple languages and promoted through such means as the Community Engagement Team, the Cambridge Community Corps, nonprofit partners, and other community channels.

6 Cambridge Outdoor Athletic Facilities Name Location # of AEDs Recommended Proposed Pilot Sites 1 Ahern Field Charles St 1 2 Buckingham Field Larch Rd 1 3 Cambridge Common Garden St 1 4 Comeau Field Rindge Ave 1 5 Danehy Park 99 Sherman St 3 3 6 Donnelly Major Berkshire St 1 7 Glacken Field Huron Ave 1 8 Gore St Gore St 1 9 Hoyt Field Gilmore St 2 2 10 Lindstrom Field Memorial Dr 1 11 Magazine Beach Memorial Dr 1 12 Maher Field Concord Ave 1 13 Pacific St Pacific St 1 14 Rafferty Park Concord Ave 1 15 Raymond Park Raymond St 1 16 Rindge Field Pemberton St 1 17 Russell Field Clifton St 1 18 Sacramento Field Sacramento St 1 19 Samp Field N Cambridge 1 20 Sennott Park Broadway 1 21 St Peters Sherman St 1 22 Tobin Field Vassal Ln 1 23 Golf Course Huron Ave 2 2 Total 27 7