Automated External Defibrillators AED in Schools Randall S

Automated External Defibrillators (AED) in Schools Randall S. Fischer, B. A. , EMT-P Operations Director, Ringdahl EMS Program Coordinator, EMSC

A Collaborative program of Children’s Hospitals and Clinics Emergency Medical Services Regulatory Board University of Minnesota Medical School o o o Claudia Hines, RN, Manager Randy Fischer, NREMT-P, Program Coordinator Jennifer Piccolo-Fisher, Office Coordinator Lee Pyles, MD, Co-Medical Director, U of M Jeff Schiff, MD, Co-Medical Director, Children’s Hospitals & Clinics Mary Ann Mc. Neil, Director, U of M Depart. of Emergency Medicine R. Fischer-2005

How Common is Sudden Cardiac Arrest? • One of the leading causes of death in U. S. • At least 250, 000 suffer SCA each year • Median age of victim is 65 years, but it affects people of all ages, even teenagers. R. Fischer-2005

What is Sudden Cardiac Arrest (SCA)? Electrical system in the heart malfunctions Heart unexpectedly and abruptly stops beating Not the same as a heart attack. Usually caused by an abnormal heart rhythm called Ventricular Fibrillation Results in death if not treated immediately. R. Fischer-2005

SCA: a public health crisis R. Fischer-2005

Why is early defibrillation so important? • Chance of survival from SCA diminish 7 -10% with every minute after collapse R. Fischer-2005

Why is Public Access Defibrillation so Important? 9 -1 -1 Called Dispatched Victim Collapse 0 1 st Responder Paramedics On-Scene st Responder 1 Applies AED 5 10 15 Transport To Hospital 20 Public AED Applied 75% Chance of Survival R. Fischer-2005

Why is Public Access Defibrillation so Important? According to the May 3, 2004 issue of Aviation Week & Space Technology, American Airlines has used an AED on its aircraft 89 times in the last 7 years and saved 50 lives (a 56% survival rate). R. Fischer-2005

Why put AED’s in schools? • SCA in adolescents is a growing concern • Some seemingly healthy physically fit children collapse without warning. • Knowing CPR, First Aid and AED operation is critical. • Schools are community gathering points • Adults (higher risk populations) often present at schools • Basketball, football, wresting, and other sporting events • Band, choir, and play performances • Community education programs and other events • Schools are a disaster resource • Contact your local emergency manager and disaster coordinator • Homeland security funds are available for preparedness. • Teaching a future generation • Strengthen the chain of survival and Educating teachers, staff, students how to SAVE A LIFE! • Introducing students to healthcare and recruiting a new healthcare workforce for the future. • Teaching a valuable “Life Skill”. R. Fischer-2005

Everyone needs to know… What, Where, When, Why and How to use an AED R. Fischer-2005

SCA in a Basketball Coach Chippewa Falls, Wisconsin R. Fischer-2005

Of the 600, 000 Cardiac Arrest, 16, 000 Are Pediatric Patients. R. Fischer-2005

A blow to the chest can bring on cardiac arrest, as seen in children struck by a baseball or other sports. This unusual cause of SCA is called Commotio Cordis. R. Fischer-2005

“Chain of Survival” • Early Access Dial 911 Immediately – • Early CPR– Everyone should know CPR • Early Defibrillation 1 st Responders & PAD – • Early ACLS– Local Ambulance service/ED Everyone should learn CPR & AED skills. • Prevention – Controlling/Reducing risk factors • Recognition – Signs / Symptoms • Action – Call 911, Check ABC’s, Perform CPR, operate an AED. Steps to “Save a Life” R. Fischer-2005

Key to Surviving SCA Early Defibrillation Only effective treatment is an electrical shock delivered by a defibrillator. Time is critical – each minute of delay before defibrillation reduces survival by about 10%. CPR (Cardiopulmonary Resuscitation) can help maintain the flow of oxygen to the brain and vital organs, but CPR cannot convert VF to a normal rhythm. Eisenberg MS. Annuals Emerg Med. 1990; 19: 179 -186. R. Fischer-2005

What is an AED? Device that “Looks” for a shockable heart rhythms. Delivers a defibrillation shock only if needed. Will not shock if not needed. SAFE! Small, portable, about the size of laptop computer. About $2, 000 per unit. R. Fischer-2005

When to use an AED • Anytime someone collapses and is unresponsive or unconscious. R. Fischer-2005

Do you have to be medically trained to use defibrillator? • No. Automated external defibrillators (AEDs) are simple, safe and easy to use • Non-medical personnel can use AEDs with minimum of training R. Fischer-2005

Who supports increased access to defibrillation? • • • American College of Emergency Physicians American Heart Association American Public Health Association American Red Cross Canadian Association of Emergency Physicians Citizen CPR Foundation Emergency Care Research Institute Heart and Stroke Foundation of Canada International Association of Chiefs of Police International Association of Fire Chiefs • • • International Association of Fire Fighters International Liaison Committee on Resuscitation National Association of EMS Physicians National Association of State EMS Directors National Association of State EMS Training Coordinators, Inc. National Center for Early Defibrillation National Heart Lung and Blood Institute National Safety Council Occupational Safety and Health Administration R. Fischer-2005

Athletic trainers promote AED use • Concordia College, Moorhead • < 1 month after the AED was purchased used on a retired professor – massive heart attack after playing a lunch-hour basketball game in the gym. • AED used by the athletic trainer – Stephanie Brandt. • Alive today • Syracuse University • Football referee collapsed during a game in September • AED used by the Athletic trainer – Tim Neal • Alive today • University of Iowa • Spectator collapsed in the bleachers. • AED used by the Athletic trainer – Dan Foster • “The results were dramatic. The immediate success has resulted in a continued high quality of life for the patient, an increase in AED purchases in the community and an improved general public awareness of AED’s. R. Fischer-2005

Developing Your Community “Champions”. • • School Administration School Nurse, Public Health Teachers and Health Educators Parents Local Ambulance Service (EMS) Police/Law Enforcement Community Service or School Liaison Officer Hospital and Healthcare organizations R. Fischer-2005

New York Schools and AED’s R. Fischer-2005

Site Assessment • Priority buildings • • • Campus Security/First Responders Large number of people Amount of time occupied Public or large events High risk group? • Current Location(s) • • Cover entire campus Plan for additional units/locations Easy access Obvious location for public use and school observation. R. Fischer-2005

Liability risk of using an AED • President Clinton in 2000 initiated a bill (Cardiac Arrest Survivor Act) that grants legal immunity to good Samaritans who use AED’s. • Since then, most states have rewritten their own good Samaritan laws to include language about the use of AED’s. • Minnesota Statute includes AED specific language • A plaintiff in a fitness facility received a $2. 5 million award after a lawsuit charging the facility for not meeting a member’s emergency-response needs when the plaintiff had a heart attack and there was no AED available. (Chai versus Sports Fitness Clubs of America, Circuit Court, 17 th Judicial District, Broward County, FL) • Represents a shift toward requiring fitness-related facilities and possibly other institutions to have AED’s available. • Understanding. AEDProgram. Legal. Issues 1104 F. pdf R. Fischer-2005

Other considerations • Maintenance cost of units – Every use or every 2. 5 years: Replace pads/battery pack: $90. 00 • Initial and on-going training – – – CPR / AED training, 4 hour class 1 Hour review every year, Safety training meeting refresher All school lyceum for students/staff Develop policies, test, and practice in school • Campus/Community Awareness – Students & Staff – Community-wide effort to train and inform public on CPR and AED’s – Basketball game half-time demonstration • Debriefing and EAP/support after use – Local EMS/Hospital/Regional EMS program can assist or arrange. • Physician oversight – Usually local EMS/Ambulance Medical Director R. Fischer-2005

SCA in a HS Football Referee R. Fischer-2005

CPR and AED Review • • Shake and Shout Call 911 – Get AED Open Airway Check Breathing • If no breathing Give 2 Breathes • Check for Circulation or “Signs” of Life? Coughing, moving, pulse? • Start CPR • Attach Defibrillator – As soon as it is there! • Follow voice prompts and defibrillate if indicated A – B – C –D R. Fischer-2005

Want More Information? Randy Fischer, Program Coordinator Emergency Medical Services for Children 2550 University Ave. West # 216 South St. Paul, MN. 55114 Phone: (612) 578 -8690 or (800) 660 -7022 fischers@info-link. net www. emscmn. org R. Fischer-2005

AED Videos • • • Good Morning America WCCO – Chippewa Falls, WI Video Football Referee Video KARE 11 – AED Video New York Schools and AED’s Airport Security Camera – SCA Video R. Fischer-2005

Good Morning America Video R. Fischer-2005

WCCO – Chippewa Falls, WI R. Fischer-2005

Football Referee Video R. Fischer-2005

KARE 11 – AED Video R. Fischer-2005

Airport Security Camera – SCA R. Fischer-2005