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HEART SAVER SCHOOL PROGRAM
A Community Partnership Between the
City of Everett, Everett Fire Department,
Everett Medic One Foundation & Everett Public School District
“The single best technology to save your life is an AED. Automated External Defibrillators stop the abnormal heart activity
associated with sudden death and allow your heart to pump normally and therefore save your life. This technology works best only
if citizens trained to use it apply it early. This technology is safe, easy to use, and extremely effective. That is why the American
Heart Association states this is the best life saving technology.”
-Dr. Jeff Wajda, Providence Emergency Room Director, Everett, Washington-
PUBLIC ACCESS DEFIBRILLATION IN EVERETT, WASHINGTON
The Everett Fire Department, EFD, provides basic and advanced life support to our community of 95,990. The EFD has long
recognized the value of fire-based emergency medical services and has provided paramedic-level care since 1982. With a tiered response
and response times averaging less than four (4) minutes for first arriving basic life support and six (6) minutes for advanced life support,
an out-of-hospital cardiac arrest survival rate of 29% is achieved. While this figure is greater than the national average, the Everett Fire
Department is not content to allow seven (7) out of every ten (10) cardiac arrest victims to die.
To that end, the Everett Fire Department has made every effort to improve cardiac arrest outcomes by the placement of defibrillators on
every piece of fire apparatus, including reserve and chief officer vehicles. The EFD has achieved the best survival rates possible, short of
adding additional fire stations and personnel to further reduce response times. The expense of such capital improvements make them
impossible to defend because of the nationally recognized standards that have been exceeded in response times and survival rates.
Nevertheless, the Everett Fire Department is committed to improving cardiac arrest survival.
The only affordable alternative to increasing staffing was to move AEDs closer to the victims. The advent of FDA approved, user
friendly AEDs has prompted a revolution in cardiac care. Layperson AED programs, knows as Public Access Defibrillation (PAD)
programs were born from this new technology. Facilities, which have fully implemented PAD programs, such as Chicago’s O’Hare
International Airport, report 90% survival rates. Everett has made enormous strides in implementing a regional PAD program, but there
is more work to be done. The Everett Medic One Foundation has enormously assisted with these efforts.
The Everett Medic One Foundation is a 501(c)3 non-profit organization funded solely by community donations. Its governing board is
made up of citizen activists, education and governmental leaders, physicians and members of the Everett Fire Department Administration.
Since 1982, the Everett Medic One Foundation has provided community training in CPR and first aid to literally tens of thousands of
citizens. Public Access Defibrillation was the next logical step in their commitment to the community.
HEART SAVER PROGRAM DESCRIPTION
The Everett Fire Department, in cooperation with the Everett Medic One Foundation, has developed an aggressive PAD program
within the city and region. The Everett Medic One Foundation has trained 28 Everett Fire Department personnel to be American
Heart Association CPR, (cardiopulmonary resuscitation), and AED, (automated external defibrillation), instructors. Initially, instructors
trained all 1,000 City of Everett employees, 1,500 Snohomish County employees, 3,000 Everett School District students, and 1,000
civilians within the greater Snohomish County region. The program started two years ago; and plans for the re-training have begun, as
required by the guidelines of the American Heart Association. The Everett Medic One Foundation has also overseen the placement of
165 AEDs within our community.
Advancement of the Heart Saver Program was developed to fulfill a significant need in the health education requirements in the new
curriculums of the Everett Pubic School District. More importantly, it provides students in our community with an early foundation of
skills to respond quickly and efficiently to sudden cardiac arrest or SCA.
CPR and AED training is presented by the Everett Medic One Foundation in conjunction with the Everett Fire Department Medic
One Program, with guidelines provided by the American Heart Association. The vision of the Heart Saver School Program is to
support the community based CPR/AED Program, helping with the procurement of AEDs for all schools in Everett and eventually
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throughout Snohomish County and providing the training for this program at no cost to the schools in Everett. The board of directors of
the Everett Medic One Foundation voted to provide the start-up funding for this very successful pilot program.
The Everett Medic One Foundation Heart Saver School Program also assists other communities with implementing their programs.
For example, one of the board members of the Everett Medic One Foundation is a teacher from the Lake Stevens School District, as
well as a volunteer firefighter in that community. With this involvement, we have successfully been able to extend our program to the
City of Lake Stevens, as well as the City of Lakewood and the City of Snohomish. As a 501(c) 3 organization, the Everett Medic One
Foundation fundraising efforts include reaching out into other communities, with designated funds and/or equipment going into their
community programs. For communities who want to manage their own programs, the Everett Medic One Foundation has expressed an
esprit de corps attitude and will provide a template of the program and help with their efforts as needed.
WHY is the Heart Saver School Program Needed?
The Centers for Disease Control estimates there are 400,000 to 450,000 sudden cardiac arrests in the United States per year. According to
the American Heart Association, 100,000 of these incidents are witnessed, and these lives could be saved by early access defibrillation
and advance life support. A small percentage of those are children in school. Disease processes such as hypertrophic cardiomyopathy
occur in one (1) of every 500 people, most being unaware of the condition. This condition, among others, leads to tragedies in our
schools.
In recent years, one notable example was a teenager on the basketball court at Everett High School who suffered from sudden cardiac
arrest. This child received the best care our system could offer at the time, but died in front of his parents and 2,000 spectators. Had an
AED been available in the gym at the time, his life may have been spared. In 2001, there were five (5) juveniles who suffered sudden
cardiac arrest in Washington State Schools; four (4) died and one (1) lives with severe brain damage. Recently, another teenage child
suffered from SCA at school shortly after sprinting in the 800 meters. Currently, that child is in a coma. For many, there is no previous
history of heart problems. Sudden cardiac arrest is often the first symptom. Although victims of sudden cardiac arrest tend to fit in
certain categories, sudden cardiac arrest, by its nature, is completely unpredictable. It can strike anyone, anywhere, any time.
High survival rates from cardiac arrest are due to early access – 911, early CPR-Cardiopulmonary Resuscitation, early defibrillation and
early ACLS-Advanced Cardiac Life Support. On any given day within our community, a time may arise where the use of an AED may
save a community member’s life, including the life of a student, teacher, or parent. It really doesn't matter who brings the
defibrillator to the victim's side. The important thing is to make sure a working defibrillator is readily available and there is an action plan
to ensure the device and trained rescuers reach the victim in time.
Survival rates are as follows:
No Care
0%
No CPR and delayed defibrillation (after 10 minutes)
0-2%
CPR (non medical person such as a teacher, support staff, student)
2-8%
CPR and defibrillation within 8 minutes
20%
CPR and defibrillation within 4 minutes, with paramedic help within 8 minutes
43%
CPR and defibrillation within 2 minutes, with paramedic help is estimated to be as high as
80%
As communities become more populated, 9-1-1 response times are amplified. Although response times in the City of Everett are
considered excellent, when reviewing the statistics of response times over the past ten years, response times have gradually increased.
This is a direct result of increased population and traffic challenges, as well as new safety laws required by Fire Departments.
It is impossible in most community settings to respond consistently to sudden cardiac arrest victims within the one to two-minute
timeframe documented in some cardiac rehabilitation centers. But all communities can aim to reduce the critical interval from collapse to
defibrillation. Since the exact time of collapse often is difficult to identify and measure, communities can focus on minimizing the interval
from the 9-1-1 calls to the first defibrillator shock. Communities that reduce this "call-to-shock" time to five (5) minutes or less can
expect as many as one-third to one-half of sudden cardiac arrest victims found in ventricular fibrillation to be resuscitated. Reducing
"call-to-shock" time by even one minute can mean the difference between life and death.
Sudden cardiac arrest does not have to be fatal. When sudden cardiac arrest occurs, most victims have an abnormal heart rhythm called
ventricular fibrillation (VF). But the victim doesn't have to stay that way. Ventricular fibrillation is a treatable rhythm. In this state,
electrical energy is present in the heart, but it is chaotic. If the heart can be shocked quickly with a defibrillator, a normal heart rhythm
may be restored. This is called defibrillation. If this shock is delivered within minutes after collapse, many victims can survive.
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HOW Does the Heart Saver School Program Operate?
The Everett School District enrollment for 2002 is 18,043 students. Their facilities include three (3) high schools, five (5) middle
schools and sixteen (16) elementary schools. The district also maintains a football and baseball stadium, a large public auditorium and
two (2) administrative campuses. Their employees number over 2,000 faculty and staff members. The district boundaries extend beyond
the City of Everett borders into outlying Snohomish County. The Everett School District has supported our PAD program by allowing
us into their classrooms, training some of their staff in the use of AEDs, and by accepting donated AEDs.
Teaching 3,000 students involves three eight-hour visits by six instructors to the junior and senior high schools in which each health class
receives the course over the three consecutive days. Student to instructor ratios of six (6) to one (1) are observed during these courses.
As we experienced in 2001, there are ten (10) three-day courses required to educate all of the District’s 8th and 10th graders.
Eighth grade and tenth grade students are provided with this early education with the potential benefit to the community that one of these
students may actually save the life of another student, teacher, community member or beloved family member. These skills impart
capabilities and leadership for a student to initiate care and take action to respond to sudden cardiac arrest and saving a life.
WHAT Does the Heart Saver School Program Cost?
The cost of the Heart Saver School Program is approximately $11 per student. The Everett Medic One Foundation budgeted
approximately $32,000 for the training of approximately 2,900 students. This is a very reasonable expense for the benefit to the Everett
community.
AED’s cost approximately $3,500 per unit. It is our hope that funding for the placement of AEDs in our schools will be provided by a
sponsor in the community or by the fundraising efforts of the school’s PTA (Parent-Teacher Association). The Everett Medic One
Foundation board will provide whatever information or help needed to assist in this effort.
Funding for the Heart Saver School Program is provided by an annual fundraising event scheduled during the Valentine’s Day holiday
to provide funding for the training costs. Fundraising for our February 14, 2002 event resulted in $37,246 in cash donations, $18,500 in
product donations, totaling $61,746 in donations to date.
HOW Does the Heart Saver School Program Benefit the City/Community?
PUBLIC ACCESS MEANS PUBLIC COOPERATION
Sudden cardiac arrest kills one person every 1 - 2 minutes. The key to survival is prompt defibrillation. The challenge for communities is
to respond, defibrillator in hand, to every victim of sudden cardiac arrest within minutes. The American Heart Association and others
have been advocating early defibrillation initiatives since the late 1980s. Since then, there has been steady, continuous growth in early
defibrillation capabilities in communities across the U.S. State laws and regulations have changed gradually to enable defibrillator use.
By 1997, all states allowed EMT’s to use AEDs, 28 states permitted non-EMT first responders to use AEDs, and six states allowed lay
rescuers to use AEDs. By 2000, nearly all states had modified their laws to permit use of AEDs by trained non-EMT first responders and
laypersons, under specific conditions.
The Everett Fire Department of the City of Everett and Snohomish County leadership have supported an early defibrillation
program, improving public safety by providing a high standard of care for the citizens of our community. Early defibrillation significantly
improves the survival odds of citizens struck down by sudden cardiac arrest (SCA).
Our children are our biggest treasures. Each day we give of ourselves to protect, guide, educate, and love them. Even with our best
efforts, the unexpected can happen. We believe that the Heart Saver School Program will not only save the life of a child, but this
training will also prepare the next generation of community citizens to be familiar and competent in the use of AEDs.
Also, our schools are one of the largest sources of community meeting space in Everett. Citizens of all ages use the campuses after hours
for all sorts of functions and events. We are more prepared as a community to respond to sudden cardiac arrest than ever before.
The Everett community Heart Saver School Program has recently been recognized nationally as a leader. At the recent international
“EMS Today” conference, the community partnership with the City of Everett, the Everett Fire Department, Everett Medic One
Foundation, and Everett Public School story was presented as a big success, to be used as a template for other communities. Other
communities have school programs, but do not provide the training to students. Further, the Everett Medic One Foundation provides
this training at no cost to the schools. The Everett Medic One Foundation donates the costs associated with the training of students
through an annual fundraiser for the program.
With the efforts of a community partnership such as ours, we are able to respond quickly to sudden cardiac arrest. Our public access
program has been very successful.