††††††††††† E.† Risk Management
††††††††††††††††††††††† 5.† School-Based Public Access Defibrillation Program (AED)
Policy and Procedures
Each year approximately 250,000 people die from sudden cardiac arrest (SCA).† The chance of survival decreases an estimated 10% each minute without defibrillation even when prompt bystander Cardiopulmonary Resuscitation (CPR) is initiated.† Use of an Automated External Defibrillator (AED) is intended to maximize the chance of survival based upon the steps taken during the critical minutes before emergency medical services (EMS) providers arrive and assume responsibility for the care of the patient.† The following policy and procedures are designed to direct trained responders in the Narragansett School System to deliver early defibrillation to victims of sudden cardiac arrest.
The purpose of this policy is to define and establish standard operating guidelines that are required by the Rhode Island Department of Public Health, in order for the Narragansett School System to acquire, maintain and utilize Automatic External Defibrillators (AED).† The policy is intended to greatly increase the chance of survival of a sudden cardiac arrest prior to the arrival of the local EMS.† This policy does not create an obligation to use the AEDís nor to create an expectation that either an AED or trained employee will be present at every event.† This policy will identify the Medical Director, the Program Coordinator, Site Leaders, and the School Physician.†
Individuals Responsible for the Narragansett Public Schools AED Program
AED Program Medical Director††††††††††††††††††††††† Dr. William Sabina (South County Hospital)
Program Coordinator††††††††††††††††††††††††††††††††††††††† Operations
Site Leader(s)†††††††††††††††††††††††††††††††††††††††††††††††††† Building School Nurse Teachers/
††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† Building Principals
School Physician†††††††††††††††††††††††††††††††††††††††††††††† Dr. Robert Maltz (consultant role only)
AED Program Medical Director will:
∑ Oversee all medical aspects of the program
∑ Ensures compliance with appropriate regulatory requirements
∑ Ensure proper skills training and maintenance for AED responders
∑ Establish and review procedures for AED use
∑ Establish a quality review and improvement program, including post-drill and post debriefing
∑ Establish and maintain a relationship with local EMS
Program Coordinator will:
∑ Coordinate and document initial AED training, annual refresher and biennial retraining and any additional training on an ad-hoc basis to designated AED trained staff
∑ Assist with the development and implementation of AED program
∑ Act as liaison among the AED program participants
∑ Coordinate and oversee non-medical aspects of the program
∑ Coordinate documentation (relating to training, maintenance, use, and post-incident data collection
∑ Coordinate training of AED certified staff
∑ Maintain master list of all AED certified staff and training records
∑ Act as a resource to the Medical Director and Site Leaders
Site Leaders will:
∑ Be responsible for the day-to-day accountabilityof the AED Program during the contracted school year
∑ Check AED to the Program Coordinator
∑ Coordinate and document site-specific drills and refresher training
∑ Notify the Program Coordinator if a unit is out of service
∑ Retains copy of usage report for documentation
All Building Medical Response Team Members are required to have current documentation of successful completion of a course of basic life support (BLS) that includes cardiopulmonary resuscitation and the use of AEDís according to standards and guidelines of the American Heart Association.
The Site Leaders will be responsible for coordination and documenting initial AED training and annual refresher and biennial training for Building Medical Response Team Members/AED responders.
All students as part of the Narragansett School System Comprehensive School Health Curriculum will receive CPR/AED training using an American Heart Association program.
On site drills will be conducted at least once during the school calendar year.† Drills will include a review of site-specific emergency communication and response plans as well as use of specific AED devices.† The on-site training will be coordinated and documented by the School Nurse/Teacher, with the assistance of the EMS liaison.
The location of the AEDís will be determined with the cooperation of the American Heart Association, the Medical Director, the AED manufacturer, and the School Nurse/Teachers.
Maintenance of the AEDís shall be the responsibility of the Narragansett School Department.† See the AED manufacturerís Operating Instructions manual for detailed maintenance information and instructions.† The School Nurse/Teacher and/or designee responsible for the AED will perform and document, during the school year, as follows:
Daily and after each use:
∑ Check readiness display and confirm no battery indicator or service indicator displayed
∑ Visually inspect the AED: Proper location, clean, no tampering
Weekly and after each use:
∑ Inspect AED case, connectors, and battery according to the Operatorís Checklist
∑ Check station against inventory, and restock as needed
After each use:
∑ Inspect exterior for dirt and contamination, clean if needed (see Operating Instructions)
Complete AED incident report
If the unit needs immediate service or supplies, remove from service and notify the Program Leader immediately.† If the unit is still operational but requires service or supplies will expire soon, the School Nurse/Teacher should notify the Program Leader immediately.
Use of AED
Emergency Action Instructions:† AEDs are located in various, approved locations around each school building.† Each School Nurse/Teacher and building principal should review the locations will all staff members at the beginning of each school year during orientation.†
When the Health Office and/or Main Office receives a call with a Medical Emergency the
emergency action instructions
NOTE:† DO NOT USE AED ON A VICTIM LESS THAN 8 YEARS OLD OR 55 POUNDS.
DO NOT START CPR OR INITIATE DEFIBRILLATION IF:
o Person has a pulse
o There is a valid DNR
o on the person in compliance with Rhode Department of Public Health/DNR protocols
∑ Power on AED
∑ Attach AED electrodes to victims bare chest
∑ Allow AED to analyze
∑ clear victim during analysis
∑ If advised to shock
* clear victim
* press shock button
∑ Continue to follow AED prompts until EMS services arrives
∑ If defibrillation is unsuccessful, the School Nurse/Teacher AED responder shall continue 5 minutes of CPR, the follow same steps above
Early Advanced Care
∑ EMS takes charge of victim upon arrival
∑ Provide victim information to EMS: name, age, know medical problems (or copy of emergency card), details of incident, victim condition and aid provided (including number of shocks administered).
∑ When EMS arrives, the defibrillator pads/electrodes shall remain in place on the victim and the defibrillator will remain at the school where information regarding the cardiac event will be downloaded by the School Nurse/Teacher or EMS.
∑ School Nurse/Teacher notifies the Program Coordinator, who notifies the Medical Director
∑ School Nurse/Teacher completes incident report and forwards copy to the Program Coordinator.† The Program Leader will retain one copy of the report and forward one copy to the Medical Director and Central Office.
∑ Before AED is entered back into service, the School Nurse/Teacher will inspect, clean if needed and re-stock AED station (according to maintenance procedure)
∑ As appropriate, the Medical Director/ EMS will conduct a post incident review (including quality improvement) and debrief program staff and those involved in the incident.
1 Reading:††††† February 15, 2006†††††††††††††††††††††††††††††††††††††††††††††††††† Narragansett School System
:††††††††† March 15, 2006†††††††††††††††††††††† Narragansett,