Download Ohio Schools Automated External Defibrillation Program Morton

Ohio Schools Automated External Defibrillation Program
Morton Middle School
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 3701.85. 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: 231 W. National Rd Vandalia, OH 45377
Phone #: 937-415-6600
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.
Ohio Schools Automated External Defibrillation Program
1
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: 888-627-0007
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: Teresa Buttelwerth
Room #: Clinic
Telephone:#: 937-415-6308
E-Mail address: [email protected]
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.
Ohio Schools Automated External Defibrillation Program
2
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: Morton Middle School are:
Name: Russ Garman
Room #: Office
E-mail address: [email protected]
Name: Brian Tregoning
Room #: Office of Asst. Principal
E-mail address: [email protected]
Name: Joe Grote
Room #: Field House
E-mail address: [email protected]
Name: Steve Bowels
Room #: Guidance Office
E-mail address: [email protected]
Name: Leslie Mann
Room #: Special Education
E-mail address: [email protected]
Ohio Schools Automated External Defibrillation Program
3
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 9-1-1 checklist to assess emergency and determine
appropriate level of response.
Contacting the external community 9-1-1 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: Main Hallway by the Guidance Office.
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
Ohio Schools Automated External Defibrillation Program
4
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.
Ohio Schools Automated External Defibrillation Program
5
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.
2.
Trained rescuers must renew first aid, CPR and AED training every
two years.
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.
Ohio Schools Automated External Defibrillation Program
6
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 9-1-1 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
Ohio Schools Automated External Defibrillation Program
7
c.
d.
and ventilation mask. If breathing, place in the recovery position and monitor
breathing closely.
Check for signs of circulation, such as pulse, coughing or movement (C).
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.
Ohio Schools Automated External Defibrillation Program
8
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 9-1-1 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.
e.
2.
If CPR and/or AED-trained individual is available, CPR and AED
procedure should be initiated until EMS arrives.
Follow procedures outlined above. (See “AED USE DURING SCHOOL
HOURS” Sections 4a, 4b, 4c and 4d).
Other school events. (If the AED is available.)
a.
Determine unresponsiveness.
b.
Through public or cellular telephone dial 9-1-1 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).
Ohio Schools Automated External Defibrillation Program
9
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.
Ohio Schools Automated External Defibrillation Program
10
Equipment operation and maintenance records.
Name of school site coordinator (print or type): Jeff Cassell
Address: 600 S. Dixie Dr. Vandalia, OH 45377
School: Butler High School
County: Montgomery
Telephone: 937-415-6300
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.
Ohio Schools Automated External Defibrillation Program
11