AEDs IN PUBLIC SCHOOLS GUIDELINES FOR IMPLEMENTATION

HONDO SCHNEIDER

ATHLETIC TRAINER

MIDLAND SENIOR HIGH SCHOOL &

ATHLETIC TRAINER REPRESENTATIVE

U.I.L. MEDICAL ADVISORY COMMITTEE

MIDLAND, TEXAS

OBJECTIVES:

1. TO PROVIDE THE BASIC INFORMATION TO IMPLEMENT AN AED PROGRAM WITHIN YOUR SCHOOL SYSTEM

2. TO PROVIDE THE INFORMATION REQUIRED IN AN EMERGENCY ACTION PLAN

TABLE OF CONTENTS• Purpose• Goal• Policy• Administrative Oversight• Program Coordinator• Medical Oversight• Campus Coordinator• EMS Coordination• AED Placement• Maintenance• Responder Training• Emergency Action Plan• AED Protocol• Post Event Procedures

PROGRAM PURPOSE

• Specifically state the purpose of the AED program in your implementation manual.

• To provide an action plan and guidelines specific to your district’s AED implementation program

EXAMPLE OF PURPOSE

• To provide an action plan & guidelines for responding to sudden cardiac arrest (SCA) and the possible intervention with an automated external defibrillator (AED).

PROGRAM GOAL

State the goal of your AED program.

“The goal of your program is to increase the rate of survival of anyone who has suffered from sudden cardiac arrest.”

3 minutes is optimal and 5 minutes is acceptable.

For every minute without CPR and defibrillation, the odds of survival decrease 7-10%.

DISTRICT AED POLICY

Your policy should minimally include:

• Where the AED’s will be placed• Who is required to be trained• Who will provide the training• Who will incur the cost of training• That each venue will have an EAP• Who will be financially responsible for maintenance• When will an AED be utilized• The components of each AED unit• The AED and ready kit shall be brought to all major medical

emergencies

ADMINISTRATIVE OVERSIGHT

Each school district should designate an individual within their district to supervise the AED program.

This person should be an assistant superintendent or someone in an administrative capacity, i.e. director of safety, director of health services, etc.

In a small school district it may be the superintendent or the athletic director/head football coach.

PROGRAM COORDINATORThe program coordinator is someone employed by your district who can and

will be responsible for the intricate aspects of the program.

They will communicate with the administration concerning all aspects of the program.

Their responsibilities may include:• Coordination of training for responders• Selection of employees for AED training• Coordination of equipment and accessory maintenance• Annual review and/or revision of guidelines as required• Monitor the effectiveness of the program• Communicate with the Medical Oversight Director on all issues related to

the medical emergency response program, including post-event documentation

• Maintain and keep on file the district’s AED records

MEDICAL OVERSIGHT

Each district should have an physician designated as their medical oversight director.

The USFDA has cleared AEDs for use with a physician’s prescription.

Responsibilities may include, but are not limited to:

• Provide medical leadership

• Serve as a spokesperson for the program

• Assist in reviewing local and state regulations

• Assist in coordination with the local EMS system

• Assist in development of program procedures and guidelines

• Approve standing orders for AED use

PHYSICIANS AUTHORIZATION(Example)

AED STANDING ORDER PRESCRIPTION FOR USE

Date of issuance:_____________________Date of expiration:____________________

This document authorizes trained employees of Midland Independent School District (MISD) to utilize an Automated External Defibrillator (AED), in conjunction with CPR, to assist in resuscitation of a victim who has collapsed and is unconscious, pulse less, apneic or experiencing agonal respiration. Individuals within MISD who are designated and permitted to operate an AED must be trained in accordance with state and local regulations. Personnel trained to respond to a cardiac arrest with an AED device must follow the manufacturer’s operating procedure when in use.

Signature of School Physician Consultant Date

CAMPUS COORDINATOR‘Could be the campus nurse, athletic trainer, or an athletic administrator

The campus coordinator should be someone designated by the program coordinator in conjunction with the campus administrator who will be responsible for the logistics of each campus AED program.

The campus coordinators responsibilities should include:

• Be responsible for all maintenance records for each AED on their campus• Annually forward to the program coordinator all AED records for their

campus• Be responsible for campus compliance with the district’s AED policy• Maintain a current record of all AED trained providers for their campus• Assist in scheduling training for all new employees as well as current

employees as required• Disseminate the location (s) of AED (s) to all campus employees• The campus coordinator should report directly to the program coordinator

EMS COORDINATION

Notification of the local EMS is required by Texas Law.

HB 580 from the 76th Legislature, Section 779.005 states that: When a person or entity acquires an automated external defibrillator, the person or entity shall notify the local EMS provider of the existence, location, and type of AED.

The location of AEDs to the EMS is imperative in the event of EMS activation. The dispatcher may be able to inform the 911 caller the location of an AED in the event the person making the call does not know.

PLACEMENT OF AEDsThe program coordinator and campus coordinator should conduct a

facility review to determine the ideal location for each AED.

Many AED sales representatives will assist with this process.

Ideally, each athletic trainer should have a personal AED to accompany them at every event.

Effective AED programs utilize a 3 minute response time as a guideline in determining the placement of their units.

Determine if the AED will be secured or unsecured, i.e. wall mount cabinet, nurses office, etc.

Ideally, an AED should not be in a secured location.

MAINTENANCE PROGRAM

Dailey, monthly, and annual checks are required for AED units.

All AED units have their own specific maintenance requirements.

HB 580, Section 779.003 requires that all units are maintained and tested according to the manufacturers requirements.

Each campus coordinator should have a copy of the manufacturers maintenance procedure.

At the end of each school year the following should be performed:• Forward monthly checklist to program coordinator• Forward training records to program coordinator• Forward annual checklist to program coordinator

Midland Independent School District

Monthly Maintenance Checklist for

Cardiac Science Powerheart G3 Automated External Defibrillators Initial boxes as items are checked off

Return completed form to Program Coordinator Month Step 1

Open Lid

Step 2 Status indicator should turn red

Step 3 Status indicator should turn back to green within 5 seconds

Step 4 Check expiration dates on pads

Step 5 Listen for voice prompts

Step 6 Close lid and confirm green status indicator

Print date

Print name

January February March April May June July August September October November December

Daily Maintenance: Verify that the Status indicator is green. Unit Serial Number:______________ Location:_________________

RESPONDER TRAININGWho will be trained?

Every person designated by the UIL as an extracurricular sponsor whom is required to be trained in first aid/CPR.Any other person designated by the program coordinator.

Who will provide the training?AHA, American Red Cross, etc. TSDHS approved provider.Most large districts will have their own certified first aid/CPR/AED trainers.

Who will pay for the training?The school district should be responsible for all costs incurred.

Responders should be trained on units similar to those procured by their employer.

EMERGENCY ACTION PLANEvery campus should have an EAP specific to their individual need, i.e.

gymnasiums, football fields, baseball fields, etc.EAP should be venue specific.

An EAP should include, but is not limited to:• Who will provide emergency care?• Who and how will EMS be activated?• Who will monitor non-injured students/team members during the

emergency?• How will the parent or guardian be notified?• Is there an adequate communication system in place?• Is the student’s emergency contact information readily available?• DIRECTIONS TO THE SPECIFIC LOCATION• Who will accompany the injured athlete to the hospital?

SAMPLE VENUE SPECIFIC EMERGENCY PROTOCOL

• ______________________Sports Medicine Emergency Protocol• Call 911 to activate the EMS system• Instruct EMS personnel to “report to_____and meet_______at__________as we

have an injured person in need of emergency medical treatment.”

• i.e. _______football practice field located at _________, enter through the _______gate by cross street________.

• 3. Provide the necessary information to EMS personnel:• Name, address, telephone number of caller• Number of victims; condition of victims• First-aid treatment initiated• Specific directions as needed to locate the scene• Any other information requested by the dispatcher• Provide appropriate emergency care until arrival of EMS personnel, assist as needed• Notes:

– A staff member should accompany any student-athlete or district personnel to hospital

– Parents, guardians, or next of kin should be notified immediately– Inform administration– Have medical history available– Complete appropriate documentation

AED PROTOCOL

The district should provide a protocol specific to the AED units their district has purchased to each employee designated as an AED responder.

POST EVENT PROCEDURES

Post event documentation should be performed within 48 hours of an incident.

The program coordinator should meet with the personnel involved and complete the required documentation.

At this time the following should be evaluated:• Evaluate response time• Discuss strategies for improvement• Follow-up on victim• Provide emotional support for personnel involved• Equipment check and replenish supplies• Return AED to it’s designated location

Incident Details

Victim Name:______________________________________________ Victim DOB:___/___/___Victim Age: ___/___/___Victim Sex: ____ Incident Date:___/___/___ Incident Time:______ Incident Location: ___________________________________________ Event History

Victim activity prior to event:______________________________________ Victim complaints prior to event:____________________________________ Was the event witnessed?..............No Yes, at ______time by _______________ Was CPR started?............................No Yes, at ______time by _______________ Assessment and Treatment

Were ABC’s assessed?....................No Yes, at ______time by _______________ Was CPR initiated?..........................No Yes, at ______time by _______________ Was shock #1 delivered?.............. No Yes, at ______time by _______________ Was shock #2 delivered?.............. No Yes, at ______time by _______________ Was shock #3 delivered?.............. No Yes, at ______time by _______________ Was ROSC achieved?...................... No Yes, at ______time by _______________ Was respiration regained?............. No Yes, at ______time by _______________ Was consciousness regained?........ No Yes, at ______time by _______________ Was patient transferred to EMS?.... No Yes, at ______time by _______________ Report Completed: ____________________________________Date_____

CONTACT INFORMATION

• Texas State Athletic Trainer’s Association• www.TSATA.com• National Athletic Trainer’s Association• www.NATA.com• University Interscholastic League• www.uil.utexas.edu/athletics

• Hondo’s E-Mail: wschneid@esc18.net