AED/DEFIBRILLATOR MEDICAL AUTHORIZATION The Food & Drug Administration considers defibrillators to be prescription devices pursuant to 21 CFR 801.109 and medical authorization is required. Most states provide immunity from civil liability to the physician prescribing an AED. State legislation can be accessed through your state s website, medical board or at http://www.aedhelp.com This serves as Medical Authorization for External Defibrillators and Automated External Defibrillator(s) (AEDs) as indicated below: 1. Medical Authorization for Public School Setting with Multiple Locations. See attached list. 2. Name of Recipient of AED(s): Socorro Independent School District. 3. See attached address list for locations where AEDs will be located. If more locations are provided under this Medical Authorization, please attach a separate piece of paper listing the required contact information for each location. List any restrictions to this Medical Authorization, if applicable: None Authorizing Physician: Dr. Gilbert Handal, MD Texas Tech University Health Sciences Center Department of Pediatrics 4800 Alberta El Paso, TX 79905 (915) 545-6787 (915) 545-6976 Fax Physician s Signature Date Return Form to: HeartSafe America, Inc. 13731 Omega Rd. Dallas, TX 75244 Update HeartSafe America, Inc. with any changes to this Medical Authorization Phone: 972-248-9477 Fax: 775-366-0878
SOCORRO INDEPENDENT SCHOOL DISTRICT Public Access Defibrillation Program 1. An Automated External Defibrillator (AED) will be maintained on the premises of See Attached Listing. 2. The AED shall be used in emergency situations warranting its use by individuals specifically trained in use of the device. PROCEDURE: Location, maintenance and testing of AED(s): 1. One (or more) AED(s) will be located at See Attached Listing. The type of device, intended use area, plan for maintenance and testing and location of the device on the premises shall be confirmed annually in writing to : El Paso Fire Department Training Academy 6800 Delta El Paso, TX 79905 (915) 775-7325 Dr. Gilbert Handal, MD Texas Tech University Health Sciences Center Department of Pediatrics 4800 Alberta El Paso, TX 79905 (915) 545-6787 (915) 545-6976 Fax Life Ambulance Service, Inc. Rachel Harracksingh Vice-president 5720 Trowbridge El Paso, TX 79925 (915) 877-3155 2. Maintenance and inspection will be conducted as required by the manufacturer: Documentation of the AED maintenance and inspection is maintained for a period of 5 years. Nurses are responsible for documentation of the AED(s) located on their campus. Documentation shall include a record of the date and type of maintenance/inspection, and the signature of the person performing the maintenance/inspection. A copy of this documentation will be kept on file for five years. Use of the AED 1. Determine unresponsiveness of victim and activate Emergency Response Plan. If adult victim is unresponsive, call 9-1-1 and get AED (If child victim, ages 1-8 years old or less than 55 pounds, is unresponsive, start CPR as needed for 2 minutes, then get AED). Assess the victim: airway, breathing, and circulation. Initiate CPR, if required, while the AED is brought to the victim s side. The public address system or campus radio system will be used to activate campus/facility Emergency Response Team and indicate location of victim. Designate an individual to wait at facility entrance to direct the EMS to victim s location. 2. Upon arrival of the AED, place near head of victim, close to AED operator.
3. Prepare to use the AED. Turn the power ON. Bare and prepare chest for AED use (Provide privacy when possible). Attach the electrode pads to the victim. Stop CPR while the device analyzes the heart rhythm. Clear before analyzing. Follow the machine prompts for further action. If a shock is indicated, be sure all rescuers are CLEAR of the victim before shock is administered. Follow the AED s voice and/or screen prompts. 4. Upon arrival, EMS shall take charge of victim. Provide victim information: name, age, known medical problems, time of incident. Provide information as to current condition and number of shocks administered. After use of AED 1. The program Medical Director shall be notified of AED use. The School Nurse/Facility AED Coordinator will retrieve rescue data from unit and notify: Program Medical Director Health Services Department Risk Management The School Nurse/Facility AED Coordinator will complete any follow-up reports as requested. The School Nurse/Facility AED Coordinator will contact Health Services Department to schedule a quality review. 2. A debriefing session will be held as soon as possible for all initial responders. Contact: Health Services Coordinators at 937-4044 or 937-0057. 3. The AED will be checked and put back into readiness state. Replace AED electrodes by connecting to the AED. Check expiration date on the electrodes. Restock pocket mask and other supplies used. Place one of the electrode expiration date stickers on the outside of the AED so it can be viewed without opening the lid. Close lid of AED and view the status indicator for flashing GREEN light. Clean AED if needed according to manufacturer recommendations. Document readiness of AED unit. AED Inventory 1. Readiness status will be assured by daily visual checks of the flashing GREEN light. 2. Readiness status will be documented monthly. 3. Readiness status will be assured following any AED use.
CALL 911 IMMEDIATELY, THEN ASSESS FOR AED USE START CPR IF NEEDED UNTIL AED ARRIVES CONTINUE UNTIL READY TO USE /ANALYZE Indications for AED Use Procedure The AED should be used on a patient who: Is unconscious Is not breathing Has no signs of circulation Is 8 years old or > 55+ lbs (When equipped with infant/child defibrillation key, AED may be used for all victims ages 1-8 years old or <55 pounds) Assess the scene safety. Is the scene free of hazards? Rescuer makes sure there are no hazards to them. Some examples are: Electrical Dangers (downed power lines, electrical cords, etc.) Chemical (hazardous gases, liquids or solids, smoke) Harmful People (anyone who could potentially harm you) Traffic (make sure you are not in the path of traffic) Fire, flammable gases such medical oxygen, cooking gas, etc. Determine if patient: Is unconscious Is not breathing Has no signs of circulation 8 years old or > 55+ lbs (When equipped with infant/child defibrillation key, AED may be used for all victims ages 1-8 years old or <55 pounds)
Turn the AED on. 1. Push the button or open the lid. Follow the visual and audible prompts. 2. Attach Pads 3. Allow the AED to check the heart rhythm. Make sure no one touches the victim. 4. Push the SHOCK button if the AED tells you to do so. Make sure no one touches the victim. If a shock is delivered, start the steps of CPR right after shock delivery.
Post Incident Procedure These steps should be completed as soon after the incident as possible: Replace AED electrodes by connecting to the AED. Check expiration date on the electrodes. Restock pocket mask and other supplies used. Place one of the electrode expiration date stickers on the outside of the AED so it can be viewed without opening the lid. Close lid of AED and view the status indicator for the flashing GREEN light. Clean AED if needed according to manufacturer recommendations. Nurse will retrieve rescue data and forward to Oversight Physician.