††††††††††† 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 AED program 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††††††††††††††††††††††††††††††††††††††† Director of Business Operations


Site Leader(s)†††††††††††††††††††††††††††††††††††††††††††††††††† Building School Nurse Teachers/

††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† Building Principals/Athletic Directors


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 and maintain records of 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 such as arranging for equipment maintenance

        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 AED program Medical Director and Site Leaders


Site Leaders will:

        Be responsible for maintaining building level lists of the Building Medical Response Team

        Be responsible for the day-to-day accountabilityof the AED Program during the contracted school year

        In the case of the Athletic Department the Athletic Directors will be responsible for the dissemination and monitoring of the AEDís under his/her care as well as monitoring the certification of all coaches

        Check AED (by site leader/or designee) and report problems 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

Responsible for Immediate post- incident debriefing


Training - Annual training and re-certification in Basic Life Support (BLS) according to currently accepted guidelines as provided by either the American Heart Association or the American Red Cross will be offered for all School Nurse Teachers, Building Medical Response Team Members, and Narragansett School System school personnel.


All School Nurse/Teachers are required to maintain annual CPR/AED certification by either the American Heart Association or the American Red Cross.


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 coaches must be CPR/AED trained as a condition of employment.


All students as part of the Narragansett School System Comprehensive School Health Curriculum will receive CPR/AED training using an American Heart Association or American Red Cross 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 initial location of the AEDís will be determined with the cooperation of the American Heart Association, the AED program 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 procedures as outlined in the Narragansett School Systemís Standing Orders will be utilized.


Approved emergency action instructions will be included within each AED box and will be reviewed annually by the School Nurse Teachers, building administrators and all staff members at the start of each school year during orientation.:


Evaluation of incident response/review of protocols will take place annually and after any use of the AED.Ask the caller the nature of the emergency.


A written report of any incident will be provided to the School Medical Director and the AED Medical Director.





o       Person has a pulse

o       There is a valid Do Not Resuscitate order (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, then follow same steps above


Early Advanced Care

        EMS takes charge of victim upon arrival

        Provide victim information to EMS: name, age, known 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.


Post Evaluation

        School Nurse/Teacher notifies the Program Coordinator, who notifies the AED program 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 AED program 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 AED program Medical Director/ EMS will conduct a post incident review (including quality improvement) and debrief program staff and those involved in the incident.


Each principal, in accordance with this policy, will cause a brief synopsis of this policy and the disciplinary actions that will be taken in each school for the misuse, compromising of equipment, false alarms caused by tampering with the cases, or in general mistreatment of the AED equipment, to be placed in each schoolís respective handbook.



1st Reading:††††† February 15, 2006†††††††††††††††††††††††††††††††††††††††††††††††††† Narragansett School System

Adopted:††††††††† March 15, 2006†††††††††††††††††††††† ††††††††††††††††††††††††††††††† Narragansett, Rhode Island