Colorado

(1) The general assembly hereby declares that it is the intent of the general assembly to encourage the use of automated external defibrillators for the purpose of saving the lives of people in cardiac arrest.

(2) As used in this section, unless the context otherwise requires:

(a) “AED” or “defibrillator” means an automated external defibrillator that:

(I) Has received approval of its premarket notification filed pursuant to 21 U.S.C. sec. 360(k), from the federal food and drug administration;

(II) Is capable of recognizing the presence or absence of ventricular fibrillation or rapid ventricular tachycardia, and is capable of determining, without intervention by an operator, whether defibrillation should be performed; and

(III) Upon determining that defibrillation should be performed, automatically charges and requests delivery of an electrical impulse to an individual's heart.

(b) “Licensed physician” means a physician licensed to practice medicine in this state.

(3)(a) In order to ensure public health and safety, a person or entity who acquires an AED shall ensure that:

(I) Expected AED users receive training in cardiopulmonary resuscitation (CPR) and AED use through a course that meets nationally recognized standards and is approved by the department of public health and environment;

(II) The defibrillator is maintained and tested according to the manufacturer's operational guidelines and that written records are maintained of this maintenance and testing;

(III) (Deleted by amendment, L. 2009, (SB 09-010), ch. 52, p. 186, § 1, effective March 25, 2009.)

(IV) Written plans are in place concerning the placement of AEDs, training of personnel, pre-planned coordination with the emergency medical services system, medical oversight, AED maintenance, identification of personnel authorized to use AEDs, and reporting of AED utilization, which written plans have been reviewed and approved by a licensed physician; and

(V) Any person who renders emergency care or treatment to a person in cardiac arrest by using an AED activates the emergency medical services system as soon as possible.

(b) Any person or entity that acquires an AED shall notify an agent of the applicable emergency communications or vehicle dispatch center of the existence, location, and type of AED.

(4)(a) Any person or entity whose primary duties do not include the provision of health care and who, in good faith and without compensation, renders emergency care or treatment by the use of an AED shall not be liable for any civil damages for acts or omissions made in good faith as a result of such care or treatment or as a result of any act or failure to act in providing or arranging further medical treatment, unless the acts or omissions were grossly negligent or willful and wanton.

(b) The limited immunity provided in paragraph (a) of this subsection (4) extends to:

(I) The licensed physician who reviewed and approved the written plans described in subparagraph (IV) of paragraph (a) of subsection (3) of this section;

(II) The person or entity who provides the CPR and AED site placement;

(III) Any person or entity that provides teaching or training programs for CPR to the site at which the AED is placed, which programs include training in the use of an AED; and

(IV) The person or entity responsible for the site where the AED is located.

(c) The limited immunity provided in this subsection (4) applies regardless of whether the requirements of subsection (3) of this section are met; except that the person or entity responsible for the site where the AED is located shall receive the limited immunity only if the requirements of subparagraph (II) of paragraph (a) of subsection (3) of this section are met.

(5) The requirements of subsection (3) of this section shall not apply to any individual using an AED during a medical emergency if that individual is acting as a good samaritan under section 13-21-108.

(1) As used in this section, unless the context otherwise requires:

(a) "Currently certified in CPR" means that the person has completed training in cardiopulmonary resuscitation from a nationally recognized evidence-based certification program within the preceding two years.

(b) "Local education provider" means a school district, a charter school authorized by a school district pursuant to part 1 of article 30.5 of this title, a charter school authorized by the state charter school institute pursuant to part 5 of article 30.5 of this title, or a board of cooperative services created and operating pursuant to article 5 of this title that operates one or more public schools.

(c) "State board of education" means the state board of education created and existing pursuant to section 1 of article IX of the state constitution.

(2) No later than January 1, 2015, coaches of athletic programs employed by local education providers must be currently certified in CPR and must have received instruction in the effective use of an automated external defibrillator. The state board shall promulgate rules concerning the coaching staff positions that are included in this requirement.

(3) Nothing in this section abrogates or limits:

(a) The protections applicable to:

(I) Any person or entity that renders emergency assistance through the use of an automated external defibrillator pursuant to section 13-21-108.1, and article 53 of title 25; or

(II) Volunteers and board members pursuant to sections 13-21-115.7 and 13-21-116, C.R.S.; or

(b) The limits or protections applicable to public entities and public employees pursuant to the "Colorado Governmental Immunity Act", article 10 of title 24, C.R.S.

(1) As used in this section, unless the context otherwise requires:

(a) "Department" means the department of education created and existing pursuant to section 24-1-115, C.R.S.

(b) "Fund" means the school cardiopulmonary resuscitation and automated external defibrillator training fund created in subsection (5) of this section.

(c) "Local education provider" means a school district, a charter school authorized by a school district pursuant to part 1 of article 30.5 of this title, a charter school authorized by the state charter school institute pursuant to part 5 of article 30.5 of this title, or a board of cooperative services created and operating pursuant to article 5 of this title that operates one or more public schools.

(d) "Psychomotor skills development" means the use of hands-on practice that supports cognitive learning.

(e) "State board" means the state board of education created and existing pursuant to section 1 of article IX of the state constitution.

(2) On and after September 1, 2014, each local education provider may apply for a grant or grants to provide instruction to students in any of grades nine through twelve and school staff in any of grades nine through twelve in cardiopulmonary resuscitation and the use of an automated external defibrillator. The instruction funded pursuant to this section must include a nationally recognized, psychomotor-skills-based instructional program that reflects current, national, evidence-based, emergency cardiovascular care guidelines for cardiopulmonary resuscitation and the use of an automated external defibrillator. The department shall administer the grant program pursuant to state board rules adopted pursuant to subsection (3) of this section.

(3) The state board shall promulgate rules concerning the grants awarded pursuant to this section, which rules must include, at a minimum:

(a) The process by which a local education provider may apply for and receive grant moneys pursuant to this section, including application requirements and deadlines;

(b) The number and amount of each grant and whether grants moneys will be awarded in the order applications are received or through some other method;

(c) The process for achieving a balanced distribution of grant moneys to applicants including rural, urban, and suburban local education providers; and

(d) Procedures for monitoring a local education provider's compliance with the provisions of this section and specifically that moneys awarded pursuant to this section are used for reasonable costs associated with psychomotor-skills-based cardiopulmonary resuscitation training and training on the use of automated external defibrillators, including but not limited to training materials and the temporary employment of cardiopulmonary resuscitation instructors or other trainers qualified to teach skills-based cardiopulmonary resuscitation training.

(4) Notwithstanding any other provision of this section to the contrary, the department shall not award any grants pursuant to this section unless the department determines that there are sufficient moneys in the fund to implement the program.

(5)(a) There is created in the state treasury the school cardiopulmonary resuscitation and automated external defibrillator training fund. The fund consists of:

(I) Two hundred fifty thousand dollars, which the state treasurer shall transfer from the general fund to the fund on August 6, 2014;

(II) Any other moneys that the general assembly appropriates to it; and

(III) Any gifts, grants, or donations credited to the fund pursuant to paragraph (b) of this subsection (5).

(b) The department may seek, accept, and expend gifts, grants, or donations from private or public sources for the purposes of this section; except that the department may not accept a gift, grant, or donation that is subject to conditions that are inconsistent with this section or any other law of the state. The department shall transmit all private and public moneys received through gifts, grants, or donations to the state treasurer, who shall credit the same to the fund. Nothing in this section requires the department to solicit moneys for purposes of implementing this section.

(c) The moneys in the fund are subject to annual appropriation by the general assembly to the department for the purpose of awarding grants allowed by this section and for the department's reasonable and necessary administrative expenses associated with implementation of this section. The department's administrative expenses for a fiscal year shall not exceed two percent of the money transferred or appropriated to the fund in the fiscal year.

(d) The state treasurer may invest any moneys in the fund not expended for the purpose of this section as provided by law. The state treasurer shall credit all interest and income derived from the investment and deposit of moneys in the fund to the fund. Any unexpended and unencumbered moneys remaining in the fund at the end of a fiscal year shall not be credited or transferred to the general fund or another fund.

As used in this article 53, unless the context otherwise requires:

(1) "Automated external defibrillator" or "AED" means an automated external defibrillator approved for sale by the federal food and drug administration.

(2) "Person" means an individual, corporation, partnership, limited liability company, association, trust, unincorporated organization or other legal entity or organization, or a government or governmental body.

(3) "Public place" means an enclosed indoor or outdoor area capable of holding one hundred or more people and to which the public is invited or in which the public is permitted but does not include a private residence.

(4) "Public school" means a school of a school district, a district charter school, an institute charter school, a facility school, or a school operated by a board of cooperative services.

(1) Any public school or person who owns, operates, or manages a public place is encouraged to place functional AEDs in sufficient quantities to ensure reasonable availability for use during perceived sudden cardiac arrest emergencies.

(2) Any individual is permitted to retrieve or use an AED.

(3)(a) A public school or public place shall accept a donation of an AED that meets standards established by the federal food and drug administration and is in compliance with the manufacturer's maintenance schedule. A public school or public place shall also accept gifts, grants, and donations, including in-kind donations, designated for obtaining an AED, and for inspection, maintenance, and training in the use of an AED.

(b) If a public school or public place accepts a donated AED pursuant to subsection (3)(a) of this section but the public school or public place does not want to accept responsibility for AED training or installation or for ensuring the AED is in compliance with the manufacturer's maintenance schedule, the public school or public place is not required to accept the AED unless the donating party agrees to be responsible for AED training, installation, and maintenance. The public school or public place shall decide who will be trained, the frequency of training, and when the AED training and installation will take place. If the donating party has accepted responsibility for the maintenance of the AED but can no longer provide maintenance, the public school or public place may either accept responsibility for the maintenance of the AED or remove the AED from the public school or public place.

(c) An AED acquired by a public school must be appropriate for use on children and adults.

(4) On or before September 1, 2019, the department of public health and environment shall award a fifteen thousand dollar contract to a nonprofit organization for the purpose of acquiring and distributing AEDs to public places.

(1) "Department" means the department of public health and environment.

(2) "Office" means the office of cardiac arrest management created in section 25-53-202.

(3) "Public access defibrillator" means an automated external defibrillator approved for sale by the federal food and drug administration and available for use by the general public.

(4) "Sudden cardiac arrest" means the sudden and unexpected cessation of cardiac mechanical activity.

(1) There is hereby created in the department the office of cardiac arrest management. The purpose of the office is to:

(a) Promote the use of public access defibrillators and the use of registries to let the public know where a public access defibrillator can be found and used when an individual is suffering from sudden cardiac arrest; and

(b) Coordinate the collection of sudden cardiac arrest data from hospitals and emergency medical services.

(2) The office shall:

(a) Coordinate the collection of sudden cardiac arrest data into a data analysis system specified by the department, including outcome data from hospitals that receive cardiac patients transported by emergency medical services;

(b) Implement an outreach campaign to:

(I) Raise awareness regarding sudden cardiac arrest and the skills necessary to save lives, including the importance of compression cardiopulmonary resuscitation;

(II) Raise awareness regarding the use of public access defibrillators;

(III) Demonstrate how to call for help and emergency medical services; and

(IV) Encourage all residents of Colorado to engage in basic life-saving actions;

(c) Maintain a list of training and education programs offered in the state that:

(I) Teach life-saving skills, including cardiopulmonary resuscitation and the use of a defibrillator; and

(II) Comply with the guidelines published by the American Heart Association;

(d) Employ a statewide cardiac arrest data coordinator and other personnel as necessary to accomplish the purposes of this section; and

(e) Coordinate the submission of data, including the global positioning system location of public access defibrillators, to an automated external defibrillator registry designated by the department.

(3) The office may:

(a) Acquire, analyze, and oversee cardiac arrest data;

(b) Release reports generated from the data; and

(c) Share the data with:

(I) Emergency medical services providers, dispatch centers, hospitals, and other entities as appropriate to assist with emergency response capabilities;

(II) Appropriate entities as requested for research purposes;

(III) Designated state and national cardiac arrest registries; and

(IV) Designated state and national automated external defibrillator registries.

(4) (a) For state fiscal year 2022-23, and for each state fiscal year thereafter, the general assembly shall appropriate two hundred thousand dollars from the general fund to the department for allocation to the office for the purposes of this section.

(b) The department may seek, accept, and expend gifts, grants, and donations for the purposes of this section.

(5) The state board of health may promulgate rules to implement this section.

M. Office Facilities and Equipment for Provision of Minimal Sedation, Moderate Sedation, Deep Sedation and/or General Anesthesia

1. Any dentist whose practice includes the administration of minimal sedation by any anesthesia provider must provide the following office facilities and equipment, which are required to be functional at all times:

a. Emergency equipment and facilities, including:

i. An appropriate size bag-valve-mask apparatus or equivalent with an oxygen hook-up;

ii. Oral and nasopharyngeal airways;

iii. Appropriate emergency medications; and

iv. An external defibrillator - manual or automatic.

b. Equipment to monitor vital signs and oxygenation/ventilation, including:

i. A continuous pulse oximeter; and

ii. A blood pressure cuff of appropriate size and stethoscope, or equivalent blood pressure monitoring devices.

c. Oxygen, suction, and a pulse oximeter must be immediately available during the recovery period.

2. Any dentist whose practice includes the administration of moderate sedation by any anesthesia provider must provide the following office facilities and equipment, which are required to be functional at all times:

a. Emergency equipment and facilities, including:

i. An appropriate size bag-valve-mask apparatus or equivalent with an oxygen hook-up;

ii. Oral and nasopharyngeal airways;

iii. Appropriate emergency medications; and

iv. An external defibrillator - manual or automatic.

b. Equipment to monitor vital signs and oxygenation/ventilation, including:

i. A continuous pulse oximeter; and

ii. A blood pressure cuff of appropriate size and stethoscope, or equivalent blood pressure monitoring devices.

c. Oxygen, suction, and a pulse oximeter must be immediately available during the recovery period.

d. Back-up suction equipment.

e. Back-up lighting system.

f. Parenteral access or the ability to gain parenteral access, if clinically indicated.

g. Electrocardiograph, if clinically indicated.

h. End-tidal carbon dioxide monitor (capnography) by July 1, 2016.

3. Any dentist whose practice includes the administration of deep sedation and/or general anesthesia by any anesthesia provider must provide the following office facilities and equipment, which are required to be functional at all times:

a. Emergency equipment and facilities, including:

i. An appropriate size bag-valve-mask apparatus or equivalent with an oxygen hook-up;

ii. Oral and nasopharyngeal airways;

iii. Appropriate emergency medications; and

iv. An external defibrillator - manual or automatic.

b. Equipment to monitor vital signs and oxygenation/ventilation, including:

i. A continuous pulse oximeter; and

ii. A blood pressure cuff of appropriate size and stethoscope, or equivalent blood pressure monitoring devices.

c. Oxygen, suction, and a pulse oximeter must be immediately available during the recovery period.

d. Back-up suction equipment.

e. Back-up lighting system.

f. Parenteral access or the ability to gain parenteral access, if clinically indicated.

g. Electrocardiograph.

h. End-tidal carbon dioxide monitor (capnography) by July 1, 2016.

i. Additional emergency equipment and facilities, including:

i. Endotracheal tubes suitable for patients being treated;

ii. A laryngoscope with reserve batteries and bulbs,

iii. Endotracheal tube forceps (i.e. magill); and

iv. At least one additional airway device.