Quick Links

Lopatcong Links

United We Stand

Series 5000 - Pupils

5141.8 - Use Of Automated External Defibrillators - Regulation

Use Of Automated External Defibrillators

Purpose

To provide guidance in the management or administration of a school-based AED program.  Sudden Cardiac Arrest (SCA) is 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, delivered within a short time of the onset of VF.  An AED is used to treat victims who experience SCA. It is only to be applied to victims who are unconscious, without pulse signs of circulation and normal breathing.  The AED will analyze the heart rhythm and advise the operator if a shockable rhythm is detect4ed.  If a shockable rhythm is detected, the AED will charge to the appropriate energy level and advise the operator to deliver a shock.

Definitions

For purposes of this policy only, the following definitions shall apply:

1. “Authorized AED User” means a school district employee who has successfully completed a CPR/AED training program approved by the American Red Cross, American Heart Association, or other program recognized by the Department of Health and Senior Services within the last two years and has a current certification card.  In addition, AED trained members of the Lopatcong Emergency Squad or Police Department are considered Authorized AED Users.

2. “Automated External Defibrillator” means an automated computerized medical device programmed to analyze heart rhythm recognize rhythms that require defibrillation, and provide visual and voice instructions for the device operator, including, if indicated, to push the button to deliver an electric shock.

3. “Defibrillation” means administering an electrical impulse to an individual in order to stop ventricular fibrillation or rapid ventricular tachycardia.

4.  “Sudden Cardiac Arrest” means a significant life-threatening event when a person’s heart stops or fails to produce a pulse that is adequate to provide blood circulation.

5. “Volunteer Responder” means anyone that provides voluntary assistance to victims of medical emergencies.  The extent to which these individuals respond shall be appropriate to their training and experience.

Automated External Defibrillator Program

1. AED Program Coordinator

The AED Program Coordinator will be an employee of the Lopatcong Township School District, selected by the Chief School Administrator, who will manage the program for both schools.  The duties and responsibilities of the AED Program Coordinator include, but are not limited to:

1. Developing, implementing, and maintaining the school district’s procedures and protocols for AED use and its emergency response plan;

2. Communicating with the Medical Advisor and AED Building Coordinators;

3. Coordinating Authorized AED User training and certification that meets all the necessary requirements;

4. Maintaining a list of all Authorized AED Users;

5. Participating in AED use reviews, data collection, and other quality assurance activities;

6. Ensuring compliance with the Board’s policies and procedures for the AED program;

7. Ensuring compliance with state and local regulations regarding AED use; and

8. Ensuring all AEDs in the district are properly maintained.

2. Medical Advisor

The Medical Advisor of the AED Program is the physician of the Lopatcong Township School District, which currently is Eugene Decker, M.D.  The duties and responsibilities of the Medical Advisor include, but are not limited to:

1. General oversight over the AED program;

2. Writing a prescription for the AEDs;

3. Providing medical consultation and expertise;

4. Working with the AED Program Coordinator to establish AED response protocols, including the appropriate use of CPR and the AED;

5. Reviewing all incidents involving the use of the AED; and

6. Providing post-incident debriefing support.

3. AED Building Coordinator

The AED Building Coordinator will be an employee of the Lopatcong Township School District, selected by the Building Principal, who will manage the program in their school.  This position will usually be held by the school nurse.  The duties and responsibilities of the AED Building Coordinator include, but are not limited to:

1. Ensuring that the AED s and related response equipment are maintained;

2. Developing and maintaining school-specific emergency response plans and procedures;

3. Ensuring compliance with the procedures and protocols of the AED Program;

4. Ensuring compliance with all applicable state and local regulations pertaining to AED use at the school; and

5. Conducting post-event check procedures on the AED and completing and submitting the appropriate incident form to the AED Program Coordinator.

4. Authorized AED User

The duties and responsibilities of the Authorized AED User include, but are not limited to:

1. Successfully completing all training and skills evaluations required;

2. Following the guidelines of the AED program and remaining current on all certifications required of the AED program;

3. Responding to Sudden Cardiac Arrests according to the AED procedures and response protocol, including activating the internal emergency response system and providing prompt basic life support including CPR, use of the AED, and/or medical first aid according to their training and experience; and

4. Notifying the AED Building Coordinator when they have responded to a Sudden Cardiac Arrest and used the AED or any other medical emergency, and completing all required forms.

5. School Office Responsibilities

When school is in session, the duties and responsibilities of the office staff include, but are not limited to:

1. Receiving emergency medical calls from internal locations;

2. Using an established checklist to access the emergency and determine the appropriate level of response;

3. Contacting the external community (911) response team;

4. Deploying AED trained employees to emergency location; and

5. Assigning someone to meet responding EMS units and directing EMS personnel to the site of the medical emergency.

6. Equipment

1. Approved AED Equipment:

The LIFEPAK CR Plus Automated External Defibrillators (AEDs) have been approved for this program. The AED conforms to the state/county standards.

1. The AED will be brought to all medical emergencies.

2. The AED should be used on any person who displays ALL the symptoms of cardiac arrest.  The AED will be placed on the victim 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 and coughing, or movement.

Note:  The infant/child reduced energy electrodes should be used on victims below age 8 or 55 pounds.

2. Additional Resuscitation Equipment:

Each AED will have one set of defibrillation electrodes connected to the device and one spare set of electrodes with the AED.  One resuscitation kit will be connected to the handle of the AED.  This kit contains two pair latex-free gloves, one razor, one set of trauma shears, and one facemask barrier device.

3. Location of AEDs:

The location of the AEDs will be specific to each school, but should allow the device to be easily seen by staff.  The locations should allow staff members to retrieve the device outside of normal school hours.  During school hours, the AED will be at the following designated locations:

1. Hallway outside nurse’s office

2. Outside main office

3. Second floor outside library

4. Hallway between gym and cafeteria

5. Entrance along Buckley Hill Drive

7. Initial Training

1. Trained Employees:

Trained employees must complete training adequate to provide basic first-aid, CPR and AED that will be provided on site. AED training must be a course approved by the state.  The Business Office shall maintain training records for the trained employees.

2. Volunteer Responders:

Volunteer responders will possess various amounts of training in emergency medical response and their training may be supplied by sources outside of the school district.  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 use the AEDs deployed throughout the school.  Any volunteer wishing to potentially use one of the AEDs deployed on the school grounds should have successfully completed a state approved AED course including CPR within the last two years.  The school district will not maintain training records for the volunteer responders.

3. Refresher Training

Trained employees will renew their AED/CPR training every two years.

AED Response Protocols

To provide trained employees of the school district with uniform guidelines to follow when responding to sudden cardiac arrest incidents and in intervening with an AED.

1. Emergency Response

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 a victim must be made safe prior to attempts to assist.

2. Determine victim’s unresponsiveness.

3. Activate system:

1. At any school phone Dial 911.

2. At any public phone or cellular phone Dial 911 or local emergency number.

If during school hours:

3. Call main office and alert them to emergency and location of unconscious person.

4. Main office staff will assign someone to retrieve AED and meet responding volunteer at emergency scene.

5. The office staff will assign someone to wait at the facility entry to direct Emergency Medical Services (EMS) to the victim’s location.

If outside school hours:

3. Determine if there is an Authorized AED Responder present and request their assistance.

4. Assign someone to retrieve AED.

5. Assign someone to wait at the facility entry to direct Emergency Medical Services (EMS) to the victim’s location.

4. CPR-trained individuals will assess the emergency and, if needed, begin CPR until the AED has arrived:

1. Open airway (A).

2. Check for breathing (B).  If the victim is not breathing, or if their breathing is ineffective, give two slow breaths.  If the victim is breathing, place them in the recovery position and monitor their breathing closely.  Observe universal precautions by using gloves and ventilation mask, if available.

3. Check for signs of circulation (C) such as pulse, coughing, or movement.

4. If there are no signs of circulation, apply AED immediately.  If an AED is not immediately available, begin chest compressions and breathing (CPR) until AED arrives.

Note:  If a rescuer is trained in CPR and the victim is a child under eight years old or under 55 pounds, and has no known cardiac condition, perform one minute of infant/child CPR prior to activating the emergency response system and getting the AED.

5. Turn on the AED.

6. Apply the electrode pads (according to diagram on back of electrode pads) to the victim’s bare chest:

1. Peel the electrode pads, one at a time, from the backing or liner.

2. Shave or clip the victim’s chest hair if it is so excessive that it prevents a good seal between electrode pads and skin.

3. Wipe the victim’s chest clean and dry if the victim’s chest is dirty or wet.

4. Press the electrode pads firmly to skin

Note:  If the victim is under eight years old or under 55 pounds, remove pre-connected adult defibrillation electrodes, connect the Infant/Child Reduced Energy Defibrillation Electrodes to the AED and proceed with steps a, c, and d.  Do not delay therapy to determine precise age or weight of child.  If in doubt, defibrillate with pre-connected defibrillation electrodes.

7. Stand clear of victim while machine evaluates the victim’s heart rhythm.

8. Refrain from using portable radios or cell phones within four feet of the victim while the AED is evaluating heart rhythm.

9. If shock is advised:

1. Clear the area, making sure no one is touching the victim.

2. Push SHOCK button when prompted (if the AED is a fully automatic unit, the shock occurs without rescuer interaction).

3. Device will analyze the victim’s heart rhythm and shock up to three times.

4. After three shocks, 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. Device will countdown one minute of CPR and will automatically evaluate the victim’s heart rhythm when CPR time is over.

If no shock is advised:

1. Device will prompt rescuer to check pulse (or breathing and movement) and if absent, start CPR).

2. If pulse or signs of circulation such as normal breathing and movement are absent, perform CPR for one minute.

3. If pulse or signs of circulation are present, check for normal breathing.

4. If the victim is not breathing normally, give rescue breaths according to training.

5. AED will automatically evaluate victim’s heart rhythm after one minute.

10. If the victim regains signs of circulation, such as breathing and movement, place them on their side, in the recovery position, and monitor their breathing closely.

11. Continue cycles of heart rhythm evaluations, shocks (if advised) and CPR until EMS personnel arrive.

12. Leave AED attached to victim until EMS arrives and disconnects AED.

13. Turn over care of the victim to EMS personnel once they have arrived, follow the directions of EMS personnel for further actions.The victim must be transported to the hospital.

2. Post-Event Review

Following each deployment of the response team member, or if a volunteer responder uses an AED, a review shall be conducted to learn from the experience. T he AED Program Coordinator or designee shall conduct and document the post-event review.  All key participants in the event shall participate in the review.  Included in the review shall be the identification of actions that went well and the collection of opportunities for improvement as well as critical incident stress debriefing.  A summary of the post-event review shall be sent to the school district safety committee.  The school district safety coordinator according to the record retention policy shall maintain a copy of the post-event review summary.

3. System Verification and Review

The medical emergency response system is ultimately successful if necessary medical assistance is provided to victims in a timely and safe manner.  Since actual use of this system procedure is expected to be very infrequent, other measures of effectiveness are required.

4. Annual System Assessment

Once each calendar year, the AED Program Coordinator or designee shall conduct and document a system readiness review.  This review shall include review of the following elements:

1. Training records; and

2. Equipment operation and maintenance records.

5. AED Maintenance

1. AED Readiness

All AED equipment must be in good repair and subject to regular maintenance inspections.  The AED Building Coordinator, in exercising oversight over AED maintenance, shall take reasonable measures to ensure that:

1. AEDs are maintained and tested according to manufacturer’s guidelines;

2. AEDs are installed according to manufacturers’ specifications and procedures;

3. All AED units receive monthly maintenance checks to insure that all equipment is in ready-to-use condition and that the AED battery and a replacement battery are fully operational and ready to use; and

4. Following use of emergency response equipment, all equipment shall be cleaned and/or decontaminated as required.

2. Routine Maintenance

The AED will perform a self-diagnostic test that includes a check of battery strength and an evaluation of the internal components.  A volunteer, assigned by the AED Program Coordinator or designee, will perform a monthly AED check following the procedure checklist.  The procedure checklist will be initialed at the completion of the monthly check.  The procedure checklist will be posted with the AED.

1. If the OK icon is NOT present on the readiness display, contact the AED Program Coordinator or designee immediately.

2. If the battery icon is visible, the CHARGE-PAK charging unit needs to be replaced.  You  may continue to use the AED, if needed.

3. If the wrench icon is visible, the AED needs service.  You may attempt to use the AED, if  needed.  Continue to provide CPR until another AED is brought to the victim or EMS arrives to take over care.

4. If the expiration date on the electrode is near, notify the AED Program Coordinator or designee immediately.

Adopted:    February 14, 2006

Revised:     February 14, 2006

• BOE Home • Policy Home • Series 1000 • Series 2000 • Series 3000 • Series 4000 • Series 5000 • Series 6000 • Series 7000 • Series 9000 •

Send email to:  bill@lopatcong.org with questions and comments about, or suggestions for, this website.