THE SCHOOL DISTRICT OF PALM BEACH COUNTY, FLORIDA

Transcription

1 AUTOMATIC EXTERNAL DEFIBRILLATORS (AEDs) SCHOOL-BASED PROGRAM THE SCHOOL DISTRICT OF PALM BEACH COUNTY, FLORIDA

2 TABLE OF CONTENTS Overview 3 What is an Automated External Defibrillator (AED)? 3 Benefits of AEDs in Schools 3 Legal Aspects of AED School-Based Program 4 AED School-Based Program Support Network 4 Implementation of AED Program-District Responsibilities 5 Policy and Procedure for AED Use in Schools 5 Placement and Maintenance of AED 5 Medical Emergency Response Plan 6 Quality Improvement 8 2

3 Overview Defibrillation, the delivery of an electric shock to the heart to treat ventricular fibrillation, has moved from being available only in the hospital and emergency response areas to implementation by the trained layperson. This is done through public access defibrillation programming. Research has repeatedly shown that shortening the time between the onset of ventricular fibrillation and defibrillation increases survival of victims. Automatic external defibrillators (AEDs) made public access defibrillation possible with the devices allowing trained lay people to safely and effectively defibrillate the victim of ventricular fibrillation. The goal of public access defibrillation is to have AEDs readily available for use by laypersons trained in both cardiopulmonary resuscitation (CPR) and AED use. The Centers of Disease Control estimates that 1 in every 200,000 patients younger than 25 years old will die of Sudden Cardiac Arrest (SCA) in the United States yearly. Although data reports are from many varied sources, there is some evidence that SCA in adolescents and young adults is increasing. Cardiac disorders, principally functional/structural and electrical causes are primary factors contributing to SCA in youth (Pediatrics 2012;129:e1094-e1102). What is an Automated External Defibrillator (AED)? Advancements in medical technology make it possible to provide immediate access to defibrillation through devices known as AEDs. This technology significantly increases the odds of surviving cardiac arrest. An AED is a portable, medical device that effectively restarts a heart that has stopped beating. It automatically analyzes heart rhythms and delivers an electric current to the heart if the heart is in ventricular fibrillation to restore the heart back to its normal rhythm. Benefits of AEDs in Schools Available to use in the event of sudden cardiac arrest; Heightened awareness of the need to learn CPR skills among faculty, students and coaches; and Available for use with adults that work at or visit schools. Legal Aspects of AED School-Based Program What is the Legal Liability of the AED Program? The following Florida statutes and School Board policy relates to the use of AEDs: 3

4 The School Board of Palm Beach County has adopted School Board Policy 5.323, titled Automated External Defibrillators. o Policy addresses: Definitions; Staff responsibilities; AED Implementation; and Training, purchase, placement, and maintenance. The policy states in 4.c. Additionally, as acquirers of AED s the School Board and its employees and agents shall be immune from liability as provided by Fla. Stat (3) and as further provided by Fla. Stat Good Samaritan Act, Fla. Stat , which would also apply. o It states in part... Any person, who gratuitously and in good faith renders emergency care... in direct response to emergency situations... without objection of the injured victim.. shall not be held liable for any civil damages as a result of such care or treatment... where the person acts as an ordinary reasonably prudent person would have acted under the same or similar circumstances. Florida became the first state in 1997 to adopt a public access defibrillation law that required persons who have access to or use an AED to obtain appropriate training and demonstrate proficiency in the use of AEDs. AED School Based Program Support Network 1. District Safety Manager Linda King - (561) or PX 48245, linda.king@palmbeachschools.org 2. District Safety Technicians Troy Wilkinson (561) or PX , Troy.Wilkinson@palmbeachschools.org David Daley (561) david.daley@palmbeachschools.org or PX , Fred Cahill (561) fred.cahill@palmbeachschools.org or PX 47560, Tom Clark (561) thomas.clark@palmbeachschools.org or PX 47588, 3. District Specialist Cathy Burns, cathy.burns@palmbeachschools.org 4

5 Implementation of AED Program District Responsibilities Schools The following steps must be followed by the school prior to placement of AEDs: o Identify AED Site Coordinator and all other employees who are trained in the use of the AED. Ensure designated AED Site Coordinator take the online course, maintain and update all school AEDs in the online tracking system. Coordinates training and updates; Provides CPR/AED certification for AED Site Coordinator Risk and Benefits Management Purchase and distribution of AED s and replacement parts; Inspection of Readiness Checklist and Inventory; Maintenance of database of equipment and AED coordinators; and Placement of equipment on school campus. Purchasing Department Acquisition of equipment and supplies; and Coordination of the bid process Policy and Procedure for AED Use School Board Policy AUTOMATED EXTERNAL DEFIBRILLATORS Placement and Maintenance of AEDs Please refer to the following resources for guidance on the placement and maintenance of AEDs in the school setting. The forms for ordering replacement parts for the AEDs are included in the on-line training course for site coordinators or can be obtained by contacting one of the Safety Technicians or the Specialist. 5

6 AUTOMATED EXTERNAL DEFIBRILLATOR (AED) EMERGENCY RESPONSE PLAN Preparedness Provide First Aid/CPR/AED training for the AED site coordinator and all members of the AED response team. Additional training is required for personnel who may assist in the use of an AED during a critical incident, i.e. health room designees (2), coaches, assistant principals, principals. Maintain and update the AED school manual provided to all AED site coordinators. o Manual identifies district management of AED program o Manual includes the AED readiness inventory and checklist to be checked by AED site coordinator and/or AED response team member on a monthly basis to ensure the unit is in working order. Place AED in accessible area with clear access that is well marked. Replace expired electrodes and batteries within 24 hours of receipt of replacement parts. Response Assess the situation as trained in the CPR/AED class. Determine unresponsiveness and call 911 or 9911 to contact fire-rescue and, if necessary, police. Call main office and school nurse if available and alert them to emergency and location of unconscious person. Main office will direct the Emergency Medical Service (EMS) to the exact location within the school and assign someone to retrieve AED and meet responding volunteer to take AED to the emergency scene. Main office will notify AED site coordinator, AED response team members within school to respond (using communication system previously set up for this). CPR-trained individuals will assess the emergency and, if needed, begin CPR until the AED has arrived: o New American Heart Association CPR guidelines beginning 2011 utilize the CAB process Tap and Shout if no response start Compressions as someone is calling 911 and getting the AED After compressions Airway tilt head Breath give 2 Breaths just enough to raise chest Turn On AED Apply electrode pads (according to diagram on back of electrode pads) to victim s bare chest: o Peel electrode pads, one at a time, from the backing or liner. o Shave or clip chest hair if so excessive it prevents a good seal between electrode pads and skin. o Wipe chest clean and dry if victim s chest is dirty or wet. o Press electrode pads firmly to skin. o Note: If victim is less than eight years old or less than 55 lbs., remove preconnected adult electrodes, connect the infant/child electrodes to the AED and 6

7 proceed with above 4 steps. If in doubt, defibrillate with pre-connected electrodes. Stand clear of victim while machine evaluates victim s heart rhythm. o Clear area, making sure no one is touching the victim; o AED will analyze the victim s heart rhythm and deliver shock; o After the shock is delivered, the device will prompt to check pulse (or breathing and movement) and if absent, start CPR; o If pulse or signs of circulation such as normal breathing and movement are absent, perform CPR for one minute; o AED will countdown one minute of CPR and evaluate victim s heart rhythm when CPR is over; o If pulse or signs of circulation are present, check for normal breathing, place them on their side, in the recovery position and monitor closely; and o Continue cycles of heart rhythm evaluations, shocks (if advised by the AED) and CPR until EMS arrives. Do not use portable radios or cell phones within 4 feet of victim while AED is evaluating heart rhythm. Leave AED attached to victim until EMS arrives and disconnects AED. If the AED site coordinator or AED response team member is present, they are responsible for initiating the AED use based upon standing orders (only on victims who are not breathing and have no signs of circulation). Have an AED response team member remain with the victim to assist EMS, monitor and assess the school environment, and take charge of post-event procedures. After-School events, including athletic events, should follow the above procedures with these additions: o Public or cellular phone, dial 911; o Alert the supervising staff member and/or athletic staff, of the emergency and inform the athletic director/manager if able. o Assign a designee to retrieve the AED; and o If CPR/AED trained, the supervising staff/athletic trainer will initiate CPR and AED procedures until EMS arrives. Recovery The AED site coordinator and/or AED response team member will document the event using the school district accident form and will forward a copy of the complete form to the AED Program Coordinator in Risk Management as identified in the AED School Manual. o The AED Program Coordinator will notify the Specialist to discuss how procedures may be improved. o The school will replenish supplies needed to return the AED to service by contacting the AED device sales representative (refer to manual). Notify the school s nurse if she/he was not a responder to complete follow-up and case management of victim. The AED will be wiped clean according to the owner manual directions. Electrode pads must be replaced and reconnected to the AED. Contents of the attached resuscitation kit must be replaced if used. 7

8 The principal will determine debriefing needs of staff and students to help handle their emotions after a rescue effort. School-Based AED Program Quality Improvement By means of Continuous review of incidents by the AED Program Coordinator, Health Services Specialist, and vendor of the AED unit in schools. (Each time an AED is utilized) By means of Skill drills and equipment readiness checks By means of Online staff training By means of Equipment maintenance / upkeep AED Maintenance and Tracking Program Effective use and function of AED units in our schools depends upon a vigilant and responsible AED site coordinator who maintains the AEDs for his/her school. Working together with the Risk Management department, all AEDs in our schools can be effectively maintained for proper working order through our online tracking system. The AED tracking system is located at the school district website: Site Coordinator Login ID - Pass Word Use the same sign on information that you use to check your district . Website Pass Word - a1e2d3coor This online program requires the AED site coordinator to input essential information about the AEDs to make sure that their electrodes and batteries are replaced when needed. Detailed instructions about the online tracking program are available through the AED site coordinator online training course. 8