Ohio Schools Automated External Defibrillation Program. Student Activity Center

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1 Student Activity Center I. PURPOSE The practices and procedures described in this document comprise a program through which Vandalia Butler High School may administer its automated external defibrillator program. This may serve as a template for your school's implementation plan. This program conforms to standards set forth by the American Heart Association (AHA) and will follow the requirements of Ohio Revised Code, Section It is the goal of this school to minimize the risk associated with Sudden Cardiac Arrest (SCA) among its employees, students and visitors. This program should be followed by all personnel. A copy of this program is to be made available to every employee upon hiring, and a copy will be supplied to any employee upon request. This program will be reviewed annually, and updated whenever new or modified tasks or procedures are implemented. A copy of this program has been provided to the local EMS agency listed below: Name: Vandalia City Fire Department Address: 257 N. Dixie Dr. Vandalia, OH Phone #: II. DEFINITIONS a. Sudden Cardiac Arrest. A condition that occurs when the electrical impulses of the human heart malfunction causing a disturbance in the heart's electrical rhythm called ventricular fibrillation (VF). This erratic and ineffective electrical heart rhythm causes complete cessation of the heart's normal function of pumping blood resulting in sudden death. The most effective treatment for this condition is the administration of an electrical current to the heart by a defibrillator or (AED), delivered within a short time of the onset of the VF. b. Automated External Defibrillator (AED). A device used to treat a patient with a cardiac arrest whose heart is beating erratically (fibrillating). The AED will analyze the hearts rhythm and advise the operator if a shockable rhythm is detected. If a shockable rhythm is detected, the AED will charge to the appropriate energy level and advise the operator to deliver a shock. c. AED Site Coordinator. (e.g. a school nurse, health care coordinator, athletic director). This is the person designated by the school that conducts the day-to-day duties associated with the AED program and serves as the medical director's point of contact for the AED program. 1

2 d. AED Medical Director. A designated licensed physician providing medical oversight to the program, who is responsible for medical control, development, implementation, and establishing response procedures and a quality improvement plan. e. Medical Response Team. This is a group of trained rescuers who provide basic life support (CPR and first aid) and apply AEDs during medical emergencies. f. Trained Rescuer. A person designated to respond to medical emergencies and possesses proper training in CPR, first aid, and AED use within the confines of the AED program including defibrillation of the victim. III. RESPONSIBILITIES a. Medical Director. The oversight physician providing medical direction to this program is: Dr. Terry Gordon Akron General Medical Center Akron, OH Hotline in case of event/aed use: Medical direction will include the following: Providing medical direction for use of AEDs. Writing a prescription for AEDs. Reviewing and approving guidelines for emergency procedures related to use of AEDs and CPR. Evaluation of post event review forms and digital file downloads from AED. b. AED Site Coordinator. The AED site coordinator is: Name: Barb Long Room #: Clinic Telephone:#: address: Barb.Long@vandalia-butler.k12.oh.us The AED site coordinator is responsible for the following: Coordinating equipment and accessory maintenance. Maintaining on file a specification/technical information sheet for each approved AED model assigned or donated to the school. Revision of this procedure as required. Monitoring the effectiveness of the system. Communication with the medical director on issues related to the medical emergency response program including post event reviews. 2

3 Check AED and supplies on a routine basis (weekly) according to the Operating Instructions checklist. Organizing all initial and refresher training programs. Conducting post incident debriefing sessions for any employees involved in AEDs use incidents. c. Medical Response Team and Trained Rescuers 1. AED trained rescuer responsibilities. Activating internal emergency response system and providing prompt basic life support including AED and first aid according to training and experience. Understanding and complying with the requirements of this policy. The trained rescuers for: Student Activity Center are: Name: Shannon White Room #: Main Office address: Shannon.White@vandalia-butler.k12.oh.us Name: Brandon Hartley Room #: Main Office address: Brandon.Hartley@vandalia-butler.k12.oh.us Name: Kelly Stevens Room #: 24 address: Kelly.Stevens@vandalia-butler.k12.oh.us Name: Barb Long Room #: Clinic address: Barb.Long@vandalia-butler.k12.oh.us Name: Brian Tregoning Room #: 5 address: Brian.Tregoning@vandalia-butler.k12.oh.us 3

4 2. Volunteer rescuer responsibilities: Anyone can at their discretion provide voluntary assistance to victims of medical emergencies. The extent to which these individuals respond shall be appropriate to their training and experience. These responders are encouraged to contribute to emergency response only to the extent they are comfortable. The emergency medical response of these individuals may include CPR, AED or medical first aid. 3. School office responsibilities: Receiving emergency medical calls from internal locations. Utilizing an established checklist to assess emergency and determine appropriate level of response. Contacting the external community response team (EMS) if required. Deploying AED-trained employees to emergency locations. Assigning someone to meet responding EMS aid vehicle and direct EMS personnel to the site of the medical emergency. IV. APPLICABLE DOCUMENTS State AED Guidelines. Medical emergency action plan. State immunity from liability exclusion. AED procedure. V. EQUIPMENT The LIFEPAK Automated External Defibrillators (AEDs) have been approved for this program. The AED conforms to the standards set forth by the State of Ohio. The AED and first aid emergency care kit will be brought to all medical emergencies. VI. AED LOCATION The AED is to be located in an unrestricted, public area within the school building. This location will allow quick access for first responders in the event of a cardiac arrest. The AED is located: Lobby wall just outside main gym. During school hours, the AED will be at this designated location. This location shall be specific to each school, but should allow the device to be easily seen by staff, students and visitors alike. After school hours, the AED may be moved from its designated location by an AED-trained rescuer (for example athletic trainer) to support athletic department activities on a voluntary basis. A trained volunteer would have to be available and willing to support this effort during 4

5 non-school hours. A visible sign must be left in the place of the AED, with the phone number of the athletic trainer, clearly indicating he/she has possession of the AED. It is the responsibility of that individual to return the AED to its proper place by the beginning of the next school day. VII. ADDITIONAL RESUSCITATION EQUIPMENT Each AED will have one set of the adult defibrillation electrodes connected to the device and one spare set of adult electrodes. In addition, two sets of Infant/Child electrodes will accompany the AED. One resuscitation kit will be connected to the handle of the AED. This kit contains two pair latex -3 gloves, one razor, one set of trauma shears, and one face mask barrier device. VIII. EQUIPMENT MAINTENANCE All equipment and accessories necessary for support of medical emergency response shall be maintained in the state of readiness. Specific maintenance requirements include: 1. The main school office shall be informed of changes in availability of emergency medical response equipment. If equipment is withdrawn from service, the main school office shall be informed and then notified when the equipment is returned to service. 2. The main school office shall be responsible for informing response teams of changes to availability of emergency medical equipment. 3. The AED site coordinator or designee shall be responsible for having routine equipment maintenance performed. All maintenance tasks shall be performed according to the equipment maintenance procedures as outlined in the operating instructions. 4. Following use of emergency response equipment, all equipment shall be cleaned and/or decontaminated as required. If contamination includes body fluids, the equipment shall be disinfected according to procedures outlined in the emergency response plan. ROUTINE MAINTENANCE 1. The AED will perform a self-diagnostic test every 24 hours that includes a check of battery strength and an evaluation of the internal components. 2. If the OK icon is NOT present on the readiness display, contact the AED site coordinator or designee immediately. a. If the battery icon is visible, the battery needs to be replaced. You may continue to use the AED if needed. b. If the wrench icon is visible, the AED needs service. You may attempt to use the AED if needed. 5

6 c. If the message CALL SERVICE appears, the AED is not usable. Continue to provide CPR until another AED is brought to the victim or EMS arrives to take over care. d. If the expiration date on the electrode is near, notify the AED site program coordinator or designee immediately. IX. TRAINING REQUIREMENTS (TRAINED RESCUERS) Any employee (trained rescuer) who is expected to provide emergency care to a victim of sudden cardiac arrest or other medical emergency will be trained in basic first aid, CPR and AED use for adults, children and infants. This training will conform to the American Heart Association (AHA) standards; the textbook utilized will be the American Heart Association's Heartsaver AED. This will be provided free of cost to five individuals. Training will also include information on observing universal precautions against blood-borne pathogens when treating sudden cardiac arrest or accident victims. The AED site coordinator will maintain all training records. Volunteer Responders: These responders will possess various amounts of training in emergency medical response. Volunteer responders can assist in emergencies but must only participate to the extent allowed by their training and experience. Volunteer responders may have training adequate to administer first aid, CPR and the use of AEDs deployed throughout the school's campus. It is encouraged that as many people as possible within the school be trained in the use of AEDs; however, only the cost of the training of the initial five rescuers will be covered by this initiative. X. REFRESHER TRAINING 1. Trained rescuers must renew first aid, CPR and AED training every two years. 2. AED-trained rescuers shall refresh their first aid, CPR and AED training using computer-based training. Each AED-trained employee will have access to AED CHALLENGE interactive training software. It is suggested that every six months, each trained rescuer will perform a three-scenario test that will be reviewed by the AED site coordinator or designee. 6

7 XI. INDICATIONS FOR AED USE The AED should be used on any person who displays ALL the symptoms of a cardiac arrest. The AED will be placed only after the following symptoms are confirmed. Victim is unresponsive. Victim is not breathing or is breathing ineffectively. Victim has no signs of circulation such as pulse, coughing or movement (occasionally seizure-like activity may be the result of a cardiac arrest). NOTE: For the treatment of children under 8 years old or up to 25 kg (55 pounds) use AED with Infant/Child Reduced Energy Defibrillation Electrodes. Infant/Child electrodes will be available with each AED. IMPORTANT CONSIDERATIONS: Nitroglycerin patch on chest (remove nitroglycerin patch carefully, then apply AED pads). Use caution if the victim has other transdermal patches. Implanted pacemaker or defibrillator, which may interfere with the rhythm analysis. Do not place electrodes directly over pacemaker or defibrillator. AED USE DURING SCHOOL HOURS 1. Assess scene safety. Rescuers are volunteers and are not expected to place themselves at risk in order to provide aid to others. Instead, the scene or environment around the victim must be made safe prior to attempts to assist. Some examples are: Electrical dangers. (Downed power lines, electrical cords, etc.) Chemicals. (Hazardous gases, liquids or solids, smoke, etc.) Harmful people. (Anyone who could potentially harm you.) Traffic. (Make sure you are not in the path of traffic.) Fire or flammable gases, such as medical oxygen, cooking, gas, etc. 2. Determine unresponsiveness. 3. Activate system. a. At any public telephone or cellular phone, dial or local emergency number. b. Call main office and alert them to emergency and location of unconscious person. c. Main office staff will assign someone to retrieve AED and meet responding volunteer at emergency scene. d. The office staff will assign someone to wait at the facility entry to direct the emergency medical service (EMS) to the victim's location. 4. CPR-trained individuals will assess the emergency and, if needed, begin CPR until the AED has arrived. a. Open airway (A). b. Check for breathing (B). If victim is not breathing normally or breathing ineffectively, give two slow breaths. Observe universal precautions using gloves 7

8 and ventilation mask. If breathing, place in the recovery position and monitor breathing closely. c. Check for signs of circulation, such as pulse, coughing or movement (C). d. If there are no signs of circulation and the AED is not available immediately, begin chest compressions and breathing (CPR) until AED arrives. Apply AED immediately. 5. Turn on AED. 6. Apply electrode pads. a. Shave chest hair if it is so excessive it prevents a good adherence. b. Wipe chest clean and dry if victim s chest is dirty or wet. c. Peel electrode pads one at a time from the backing or liner. d. Attach electrode pads firmly to skin. NOTE: If the victim is under 8 years old or up to 25 kg (55 pounds), connect the Infant/Child Reduced Energy Defibrillation Electrodes to the AED. Remove preconnected adult defibrillation electrodes and proceed with steps a, c, and d. Do not delay therapy to determine precise age and weight of child. If in doubt, defibrillate with the preconnected defibrillation electrodes. 7. Follow the voice prompts of the AED. 8. Refrain from using portable radios or cell phones within 4 feet of the victim while the AED is evaluating heart rhythm Shock Advised: 1. Clear area, making sure no one is touching the victim. 2. Push SHOCK button when prompted. 3. Device will analyze the victim's heart rhythm and shock up to three times. 4. After three shocks, the device will prompt to check pulse or for breathing and movement and if absent, start CPR. 5, If pulse or signs of circulation such as normal breathing and movement are absent, perform CPR for one minute. 6. The device will count down one minute of CPR and will automatically evaluate the victim's heart rhythm when CPR's time is over. No Shock Advised: 1. The device will prompt to check pulse (or breathing and movement) and if absent, start CPR. 8

9 2. If pulse or signs of circulation such as normal breathing or movement are absent, perform CPR for one minute. 3. If pulse or signs of circulation are present, check for normal breathing. 4. If victim is not breathing normally, give rescue breaths at a rate of 12 per minute. 5. AED will automatically evaluate the victim's heart rhythm after one minute. 6. Continue cycles of heart rhythm evaluation, shocks (if advised) and CPR until professional help arrives. 7. Leave AED attached to victim until EMS arrives. 8. If victim regains signs of circulation such as breathing and movement, place the victim on his or her side in the recovery position. 9. Turn over care of victim to EMS personnel, once they have arrived, following the instructions of the EMS personnel for further actions. AED USE AFTER SCHOOL HOURS 1. Athletic trainer-covered events. a. Determine unresponsiveness. b. Activate system. Dial or local emergency number. Alert athletic staff of emergency by sending a runner to inform athletic trainer, athletic director or field/gym manager. c. If present, the athletic trainer or designee will retrieve the AED. d. If CPR and/or AED-trained individual is available, CPR and AED procedure should be initiated until EMS arrives. e. Follow procedures outlined above. (See AED USE DURING SCHOOL HOURS Sections 4a, 4b, 4c and 4d). 2. Other school events. (If the AED is available.) a. Determine unresponsiveness. b. Through public or cellular telephone dial or local emergency number. Alert the supervising staff member of the emergency. c. If CPR and AED trained, the supervising staff will retrieve the AED. CPR and AED procedures should be initiated until EMS arrives. d. Follow procedures as outlined above. (See "AED USE DURING SCHOOL HOURS" sections 4a, 4b, 4c and 4d). 9

10 XII. POST EVENT REVIEW a. Internal Post Event Documentation: It is important to document each use of the medical emergency response system. The following forms shall be sent to the AED coordinator or designee within 24 hours of a medical event: An accident form shall be completed by a responding rescuer for each accident requiring first aid of any type. The AED-trained rescuer or volunteer responder shall complete a medical event form (9-1-1 form) whenever an AED is used. b. External Post Event Documentation: A copy of AED use information shall be presented within 48 hours of the emergency to the following: Medical director of the AED program. Local EMS. At a minimum, event information supplied shall include any recorded data and all electronic files captured by the AED. For each deployment of the rescue team and/or the AED is used, a review shall be conducted to learn from the experience. The AED site coordinator or designee shall conduct or document the post event review. All key participants in the event shall participate in the review. Included in the review shall be the identifications of actions that went well and the collection of opportunities for improvement. This information shall be forwarded to the medical director for review along with all rescue data recorded by the AED. XIII. AFTER USE 1. The AED will be wiped clean according to policy. 2. Electrode pads must be replaced and reconnected to the device. (Electrode pads and CHARGE-PAK charging units must be replaced in the LIFEPAK AED). 3. Contents of attached resuscitation kits must be replaced if used. 4. Critical event stress debriefing will be conducted by the site coordinator. XIV. ANNUAL SYSTEM ASSESSMENT Once each calendar year, the AED site coordinator or designee shall conduct and document a system readiness review. This review shall include the following elements: Training records. 10

11 Equipment operation and maintenance records. Name of school site coordinator (print or type): Roger Bowen Address: 600 S. Dixie Dr. Vandalia, OH School: Student Activity Center County: Montgomery Telephone: Signature of school coordinator: Note: LIFEPAK AEDs are prescription devices. AED users should be trained in CPR and the use of the AED. Although not everyone can be saved from sudden cardiac arrest, studies show that survival rates can be dramatically improved with early defibrillation. LIFEPAK is a registered trademark of Medtronic Emergency Response Systems, Inc. CHARGE-PAK is a trademark of Medtronic Emergency Response Systems, Inc. AED Challenge is a trademark of Insight Instructional Media, LLC. American Heart Association is a registered trademark of the American Heart Association, Inc. 11