Regulations on defibrillators in Múrcia

Decree of the Murcia Community on cardioprotection

Murcia legislation on defibrillators and cardioprotection

Murcia defibrillators regulations


Decree No. 349/2007, of November 9, which regulates the use of external semi-automatic defibrillators by non-medical personnel in the Autonomous Community of the Region of Murcia.

The Constitution, in article 43, recognizes the right of all citizens to the protection of health and the competence of public powers to organize and protect public health, through preventive measures and the services and services necessary.

The Statute of Autonomy of the Region of Murcia, approved by Organic Law 4/1982, of June 9, attributes to the Autonomous Community of the Region of Murcia, in article 11, paragraph one, the powers of legislative development and execution of Health and Hygiene matters, pharmaceutical organization and hospital coordination in general, including Social Security, without prejudice to the provisions of number 16 of the article. 149.1 of the Constitution in all its seus vessants.

Law 14/1986, of April 25, General de Sanitat, in articles 1.1 and 6.4, establishes the general regulation of all actions that allow the right to health protection to be effective and guides the actions of public administrations sanitàries to guarantee sanitary assistance in all cases of loss of health.

Així mateix, article 18.16 imposes on public administrations the functions of control and improvement of the quality of health care at all levels. Chapter V establishes the possibility of limiting public and private activities that may have negative consequences for health. Així, article 25 provides that:

1. The requirement of sanitary authorizations, including the obligation to submit to registration for sanitary reasons to companies or products, are established by regulations, present on the basis of the one provided by this Law.

  1. "They have to establish, així mateix, prohibitions and minimum requirements for people and the transit of children, which suppose a risk or danger for health." For its part, Law 4/1994, of July 26, of Health of the Region of Murcia, determines in article 2, with its main informants, among others, the integral conception of health, the participation community and the promotion of individual and social interest in health and the health system, determining in the final provision according to the authority to the Governing Council to dictate all the provisions that it considers necessary for the execution and deployment of this Llei.

In accordance with all of this, through this Decree it is necessary to develop the powers attributed to this Autonomous Community in accordance with the provisions established both in the basic state regulations and in the autonomous norms of its own, in order to advance in those actions that allow the effort to protect health to be effective and guarantee health care in all cases of health loss.

Deaths of cardiac origin continue to be a major health problem. The incidence has decreased slightly, despite the reduction in mortality in cardiovascular diseases in the current population. The reported death is caused unexpectedly, without foreseeable symptoms.

On some occasions there are factors that allow them to be identified as the risk population, on other occasions they do not, and unfortunately only a small amount per cent survives without consequences. More than 85% of all reported deaths are of cardiac origin and more than 90% of cases are caused outside of the hospital.

In 85% of people who experience out-of-hospital cardiac arrest, that is to say, died, the main cause is a cardiac rhythm disorder, abnormal ventricular fibrillation.

Currently, Spain produces about 60.000 infarcts and 26.000 deaths of cardiac origin, the majority of which correspond to the episodic appearance of malignant ventricular arrhythmia (MVA), the only and effective treatment of which this is the case. Immediate application and as soon as possible of electrical defibrillation.

The probability of survival decreases by 10% for each minute elapsed without application of defibrillation, and within two minutes these possibilities reach zero.

Defibrillation is an electrical tract that, applied in the first few minutes, constitutes the most effective measure to restore spontaneous circulation in cases of sudden death. This technique consists of connecting the patient to a device (Semi-Automatic Defibrillator), capable of analyzing the victim's heart rate and requesting the operator to deliver an electric shock if indicated.

The effectiveness lies in installing these devices in very close areas (airports, shopping centers and cities, etc.) where cardiac arrests can potentially occur, so that the time passes correct for the purposes of the device and the personnel authorized to do so. its effects on the victim are less than if the traditional out-of-hospital medical emergency system is activated.

Currently, these are low-cost, high-reliability, low-maintenance, easy-to-use and highly secure equipment that can be used by non-medical personnel, with curt and sensitive training, while allowing the members of the service to be integrated into the chain of survival. non-health emergencies, such as police, firefighters, security personnel, and also to implement community access programs to defibrillation.

The improvement of semi-automatic defibrillators has simplified their use in the recognition of cardiac rhythm disorders and their electrical tract, eliminating the complications of training for their use. The introduction of these semi-automatic defibrillators has assumed that the concept “Public access to defibrillation” is generated, based on a deductive rationale: “If early defibrillation improves the survival of the death caused by cardiac origin , the increase in availability and access to defibrillators allows for faster defibrillation and, therefore, a better prognosis of the six consequences.

Cal doncs regulate the use of external semi-automatic defibrillators, fix the training requirements and the procedure for accreditation of non-medical personnel who can provide the use of a semi-automatic external defibrillator device, together with the accreditation of the entities who can provide this training and evaluate the training of the students. For these reasons, the impact of the use of these devices on the health of people is necessary, among other measures, the creation of records in which records are recorded, before the start of operation, entities, companies, establishments and services that provide semi-automatic external defibrillators to attend to cardiorespiratory arrests that may occur in the workplace, facilitating those essential details to guarantee that the development of lactivitat is dugui a terme amb subjecció To the conditions established in this Decree, the persons accredited for the use of the materials, together with the training entities.

However, these records must allow for monitoring and control of the correct use of these devices. In attention to the competencies in matters of health, you refer to article 11.1 of the Statute of Autonomy, and pursuant to what is provided by Law 6/2004, of December 28, of the Statute of the President and of the Consell de Government of the Region of Murcia, at the request of the Minister of Health, agreed with the Legal Council of the Region of Murcia and with the prior deliberation of the Government Council in a meeting held on November 9, 2007,


Article 1.

– Object.

The purpose of this Decree is to regulate the use of semi-automatic external defibrillators by non-medical personnel, to establish the training program and the accreditation procedure for non-medical personnel who can provide these services to the territory. of the Autonomous Community of Murcia, together with the form of accreditation of the centers that intend to teach the training program and evaluate the training of non-medical personnel for the use of semi-automatic external defibrillators.

Article 2.

– Definition.

For the purposes of this Regulation, it is intended for semi-automatic external defibrillator that technical equipment, approved for use in accordance with current legislation, capable of analyzing the cardiac rhythm, identifying the fatal rhythms related to defibrillation and administer an electrical shock with the aim of restoring the viable rhythm, with high levels of security.

Article 3.

– Use of external semi-automatic defibrillators.

  1. Semi-automatic external defibrillators may only be used by persons authorized to do so in the manner provided for in this regulation.
  2. The use of the semi-automatic external defibrillator device implies in all cases the obligation to immediately contact a medical emergency service in order to guarantee the continuity of care and medical control over the affected person.

Article 4.

– Communication of installation of external semi-automatic defibrillators.

  1. The organizations, institutions and companies, public or private, or persons who wish to establish an external semi-automatic defibrillator in their private home must notify the General Directorate of Public Health including the information and the following documents:
  2. a) Name and DNI or NIF of the natural or legal person who owns the lentitat, company, establishment or service that has the defibrillator. In the case of legal persons, the name of those who hold legal representation and documentation proving this condition.
  3. b) Brand, model and serial number of the defibrillator. Accredited certificate from the manufacturer that complies with the CE marking.
  4. c) Description of the specific physical space where the defibrillator will be located.
  5. d) Name and ID of the person accredited by the Department of Health, in accordance with what is provided for in this Decree, for the use of the defibrillator and documentation accrediting the express acceptance of this function signed by the person that s'hagi designat com a accredited.
  6. e) Civil liability insurance policy for any damages that may arise from the use of the defibrillator, provided that it is the responsibility of public organizations or institutions or private homes.
  7. f) In the case of private homes, a doctor's report will also be provided in which it is easy to record the identification of the patient who is the beneficiary of the possible use, together with the underlying pathology that, both criteria of evidence, with a specific treatment for electrical defibrillation.
  8. Any modification in the details attached to the previous documentation must be communicated to the General Directorate of Public Health within one month of it being produced and, especially, the desire to suspend the use of the defibrillator. What is tracti?

Article 5.

– Installation and maintenance of defibrillators.

The installation and maintenance of the external semi-automatic defibrillators will take time to complete, except for the following standards:

  1. a) Organizations, institutions, public or private companies must place, in a visible area and facing the public, a sign indicating the existence and location of an external semi-automatic defibrillator.
  2. b) After each use of the defibrillator, the person responsible will submit a report written by the person who will use it and the Documentary Registry that the device provides to the corresponding service of the Department of Health, which will be incorporated into the planned Registry. to article 9, paragraph b) of this Decree.
  3. c) The persons, organizations, institutions and public or private companies that install an external semi-automatic defibrillator in their home or center will be responsible for guaranteeing the maintenance and conservation, in accordance with the instructions of the manufacturer of the device. l'equip, així com to maintain in force. The civil liability policy, which applies to the latter, is excepted according to what is provided in the previous article.

Article 6.

– Accreditation for the use of external semi-automatic defibrillators.

  1. The Department of Health will accredit people who have passed the initial and continuing training courses in basic cardiopulmonary resuscitation and semi-automatic defibrillation, provided for in this Regulation, for the use of semi-automatic external defibrillators. However, the public or private entities authorized by the Ministry of Health to teach the training course reflect a relationship between the people who have passed the course.
  2. This accreditation will be valid for an annual period and will have time to renew after expiration while passing the continuing training provided for in the annex of this Regulation. 3. Failure to pass or not participate in this continuing education course will contribute towards the expiration of credit.

Article 7.

– Training program.

  1. The initial training program provided for in this Decree aims to ensure that non-medical personnel obtain the knowledge and qualifications necessary to be able to use semi-automatic external defibrillators. The continuing training, for the first time, aims to recycle and guarantee the knowledge obtained in the initial course for the use of semi-automatic external defibrillators.
  2. The Basic Program for initial and continued training in semi-automatic external defibrillator devices for non-medical personnel is the one established by the Decree.

Article 8.

– Training and assessment centers.

  1. Only public or private entities accredited by the Department of Health may provide the training course, which will have the duration and the contingencies provided for in the annex of this Regulation.
  2. Public or private entities or companies interested in providing the training referred to in this Decree have to request tender from the Ministry of Health for the corresponding accreditation.

The application will be accompanied by a report that contains the justification of the completion of the following requirements:

  1. a) Provide a minimum amount of pedagogical material to each training center that will consist, however, for each group of students in a simulation mannequin that will allow the practices and evaluation of basic life support, including the release of the via air, artificial ventilation and external cardiac massage, together with the use of the semi-automatic external defibrillator; a mask for ventilation; an external semi-automatic defibrillator of approved degudament training and a set of oropharyngeal cannules of various sizes.
  2. b) Arrange a teaching team integrated by monitors and instructors. For this purpose, people trained by scientific societies to reconegut prestige, together with medical professionals, will be reunited with instructors and monitors.
  3. Once the application for accreditation has been submitted together with the documentation referring to the previous section and has favorably evaluated the program and the proposed evaluation system, the General Directorate of Public Health will issue an express Resolution of accreditation within three months. transcorregut aquest temps sense que s'hagi produït pronouncement, s'understandrà esteemed the request.
  4. The accreditation of the training centers is valid for a period of two years, and must be renewed at this term through compliance with the requirements provided for in the previous sections. The renewal period will ultimately determine the expiration of the credit for the delivery of the training and recycling courses to which this Regulation refers.

Article 9.

– Administrative records.

The Department of Health, in relation to the activities regulated by this Decree, will maintain the following records:

  1. a) Register of persons accredited for the use of semi-automatic external defibrillators devices, which will contain personal identification data, issuance dates of accreditation certificates and renewal dates of materials.
  2. b) Register entities with semi-automatic external defibrillators.
  3. c) Register of accredited training entities.

Article 10.

– Inspection and Control.

In order to verify the compliance of this Decree, the Department of Health, through its corresponding technical services, will carry out the inspection actions and controls necessary with respect to the establishments and authorized persons and subject to the scope of application of this Decree.

Additional provision.

Creation of records.

Within three months from the entry into force of this Decree, the Department of Health will create the records referred to in Article 9.

The General Directorate of Public Health will be the organization in charge of these Registries, adopting the technical, organizational and management measures necessary to guarantee the confidentiality, security and integrity of data, in accordance with the one that establishes the current regulations regarding protection of personal data.

Transitional provisions.


Courses in other autonomous communities.

For the purposes of articles 6 and 7, the accreditations of having carried out the training courses in other autonomous communities in accordance with the specific regulations or regulations, or those imparted to the Autonomous Community of the Region of Murcia also prior to the entry into force of this Regulation, provided that the duration and the contingencies include the minimum established by the regulation and it is possible to demonstrate its equivalence to the General Directorate of Public Health, without prejudice to the renewal of the Regulation. agreed with the one that provides article 6.


Terminated dadaptació.

Institutions, centers, entities or persons that have external semi-automatic defibrillators prior to the entry into force of this Decree will have a maximum term of six months to complete the one provided for in article 4 d. 'this Decree.

Final provision.

Entry into force

This Decree will come into force on the second day of publication in the Official Bulletin of the Region of Murcia. To Múrcia, November 9, 2007.

—The President, Ramón Luis Valcárcel Siso.

—The Minister of Health, María Ángeles Palacios Sánchez.

Annex Basic initial and continuing training program for the use of semi-automatic external defibrillators for non-medical personnel.

  1. A) INITIAL TRAINING The initial training course in Basic Cardiopulmonary Resuscitation (CPR) and Use of the Semiautomatic External Defibrillator will be based on the current recommendations prepared by the International Scientific Community for this purpose manuals and audiovisual material prepared in accordance will be used. both these recommendations.

A.1) BASIC CARDIOPULMONARY RESUSCITATION Objective: to train the student for the initial action with basic mitjans in cases of cardiorespiratory arrest. Duration: 8 hours. Theoretical module: Introduction to the course: 15 minutes. Access to the emergency system: 15 minutes. Concept of Chain of Survival: 30 minutes Basic vital support: 60 minutes. Practical module: Practice of basic vital support maneuvers sense equipment: mouth-to-mouth ventilation, cardiac massage with 1 and 2 resuscitators (2 hours).

Basic life support maneuver practices instrumentation: mask ventilation, oropharyngeal cannules (2 hours) Airway clearance (1 hour) Basic life support assessment (1 hour)

A.2) EXTERNAL SEMIAUTOMATIC DEFIBRILLATION Objective: train students in the use of semi-automatic external defibrillators in cases of cardiorespiratory arrest. Duration: 4 hours. Theoretical module: Semi-automatic external defibrillator: operation and maintenance: 15 minutes. Sequence of action according to the recommendations of the European Resuscitation Council or the American Heart Association: 1 hour Data collection according to the Utstein Method: 15 minutes. Practical module: External defibrillation practices. Safety and maintenance standards: 15 minutes. Integrated practice simulation with different possible scenarios: 2 hours. Evaluation of external semi-automatic defibrillation: 15 minutes.

  1. B) CONTINUED TRAINING The continuing training course will also be based on the current recommendations prepared by the International Scientific Community for this purpose manuals and audiovisual material prepared in accordance with these recommendations will be used. This course will be intended for all those people who have accreditation and prior training in basic CPR and use of semi-automatic external defibrillators.

Objective: to recycle and secure the connections obtained in the initial course for the use of semi-automatic external defibrillators. Duration: 4 hours. Theoretical module: Theoretical reminder of basic vital support: 30 minutes Practical module: Basic vital support practices with equipment and sense: 90 minutes Global evaluation of the course.


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