3411 Procedure – Automated External Defibrillator (AED) Program

 

The procedural guidelines for an Automated External Defibrillator (AED) program will include the following components:

I. District AED Coordinator

II. Building AED Coordinator

III. Medical Oversight

IV. Responders

V. Equipment Maintenance

VI. Post Event Debriefing and Review

VII. Post Event Documentation

VIII. AED Selection

IX. AED Placement

X. AED Standing Orders per Medical Oversight

XI. Definitions

XII. AED Post Event Report Form- F1

XIII. AED Post Event Checklist- F2

XIV. Maintenance Log for Automated External Defibrillator- F3

 

Employees who have been trained and certified in CPR and Automated External Defibrillators (AEDs), and who are present at a site where an AED is located at the time a “sudden death” incident occurs, will react by activating the Whatcom County Emergency Medical Services (EMS) through the 911 system.

If the AED is not immediately available, the responder(s) shall perform CPR until an AED or the Whatcom County Emergency Medical Services arrives on the scene.

The AED is intended to be used only on victims (at least 8 years of age and weighing 55 pounds or more) who are unconscious and have no signs of breathing (Signs of Life). The guidelines to be followed by designated district responders will comply with the policy and procedures established by the Bellingham School District in conjunction with the Whatcom County Health Department.

I. District AED Coordinator

This person is the primary liaison among the Bellingham School District’s  Automated External Defibrillator (AED) Program, the Building AED Coordinator, and the Whatcom County Emergency Medical Services office. Responsibilities  include the following:

  1. Insure that the equipment, supplies, and records are being maintained at each building site.
  2. Maintain a file on specifications and technical information on each AED purchased or donated to the program.
  3. Insure that the District has personnel training and appropriate retraining programs for all of the schools that have AEDs.
  4. Institute a mechanism for forwarding data from any AED incident to the Whatcom County EMS and District Coordinator.
  5. Facilitate post-event debriefing sessions.
  6. Insure annual review of the “Code Red” procedure for all teaching and support staff by the Building AED Coordinator.
  7. Complete annual systems assessment at each AED building site:
    1. Training records;
    2. Review of AED operation/event records;
    3. Review of maintenance records; and
    4. Review of building medical response plan.
  8. Establish that each designated building runs a minimum of 2 “mock” drills annually.

 

II. Building AED Coordinator

This individual is designated by the District AED Coordinator. Responsibilities  include the following:

  1. Designate a minimum of two (2) employees per building to be responders. B. Insure that responders are current in CPR/AED certification.
  2. Complete or have a designee complete weekly or daily AED battery checks, (whichever is recommended by the AED company) and maintain a log to that effect.
  3. Coordinate building office’s responsibilities. E.  Coordinate volunteer responsibilities.
  4. Designate location of AEDs within the building.
  5. Insure that the Post Event Summary form is completed.
  6. Insure placement of a readily visible sign to indicate location of AED.

 

III. Medical Oversight

The Whatcom County Health Officer will assist in providing direction and protocols for the use of AEDs within the Bellingham School District.  Responsibilities  include the following:

  1. Assist in establishing medically appropriate standing orders to be followed by trained volunteers called upon to perform resuscitation.
  2. Assist in selection of AEDs that are approved by the Whatcom County EMS.

IV. Responders

Employees that volunteer to be the designated responders will be held to the standards of the Good Samaritan Act.  Responders will be expected to use an AED only if they have successfully completed the American Heart Association, Red Cross, or other nationally accredited CPR with AEDs course and feel confident using the equipment. The Bellingham School District shall advise each employee who volunteers in the AED program that, “A person who uses a defibrillator at the scene of an emergency and all other persons and entities providing services under this section are immune from civil liability for any personal injury that results from any act or omission in the use of a defibrillator in an emergency setting.  The immunity from civil liability does not apply if the acts or omissions amount to gross negligence or willful or wanton misconduct.” Additionally, any employee who has been properly trained in the use of an AED and who utilizes an AED during the course of his/her employment at the time of an accident or injury shall be deemed to be acting in the discharge of his/her duties within the scope of his/her employment or authorized volunteer duties under the direction of the Bellingham School District. The employee will be considered to be within the scope and protection of the defense and indemnification  statutes relating to claims of negligence. Thus, any trained employee who uses an AED is not liable, except for instances of gross negligence or willful or wonton misconduct.

  1. Employees initially identified to receive the training might include some of the following: administrators,  nurses, athletic/activities  coordinators, office staff who are likely to receive the alert first, or staff who can leave their positions rapidly without requiring a substitute staff.
  2. Activation of Emergency Response Procedure: The District AED Coordinator or designee will annually review the procedure for activation of the emergency AED response system with all appropriate staff. Teaching and support staff will be instructed on the “Code RED” procedure to be utilized upon finding an unconscious victim, namely:
    1. Immediately dial 911.
    2. Contact main office to announce “Code RED” and location.
    3. Main office will designate two individuals to meet EMS personnel and escort them to the victim.

V. Equipment Maintenance

The school employee(s) designated by the Building AED Coordinator shall maintain in a state of readiness all equipment and accessories necessary to support a medical emergency response. The school building main office will be informed of changes in availability of emergency response equipment. If the equipment is withdrawn from service, the office will be informed. The office will also be informed when the equipment is returned to service. The school building main office will notify designated responders of changes in equipment availability.

AED maintenance tasks shall be performed in accordance with equipment maintenance procedures outlined in the User’s Operating Guide for that AED manual.

VI. Post Event Debriefing and Review

The District AED Coordinator will conduct a debriefing with responders following each medical emergency requiring the use of an AED.  All participants in the event will attend the review.

VII.      Post AED Event Documentation

  1. Each activation of the AED response system  shall be documented.
  2. Responding employee(s) shall complete a Post Event Report  Form the same day.
  3. All patient information generated during the emergency response  must be collected for the patient’s confidential file. This would include  all recorded  data and all electronic  files captured  by the AED unit.
  4. A copy of the AED use information and data card shall be forwarded to the Whatcom County EMS Director  within 72 hours of the emergency.
  5. A copy of AED use information will be filed with the District AED Coordinator.

 

VIII.  AED Selection

  1. Approved Equipment: Automated External  Defibrillators (AEDs)  selected  for the Bellingham School District’s AED program  will conform  to the requirements of and be approved by the Whatcom  County Medical  Program  Director.
  2. The District AED Coordinator will maintain  a file on specifications and technical information for each approved AED used in the program.

 

IX. AED Placement

A. AED Accessibility

  1. During school hours the AED will be housed in a designated location.  This location  shall be specific  to each building  but will be positioned to allow the device to be easily seen and accessed.
  2. It is preferable to have the AED location  in the proximity of a telephone.

B. AED Availability

  1. The welfare of the student  body, staff, and attendees of school-sponsored events at the facility  is the primary  goal of the Bellingham School  District’s AED program.
  2. Contracted events  and other community activities are not guaranteed access to the AED or designated response  volunteers as part of the facility  use or rental contract.

C. After Normal School Hours or Non-School Sponsored Events

  1. When an event is scheduled, notification may be provided  regarding the placement  of the AED.
  2. Should a 911 situation arise, any individual  can activate the emergency response protocol:
    1. Assess Level of Consciousness;
    2. Call 911;
    3. If an AED trained  individual  is available, CPR and AED procedures should  be initiated  while waiting arrival of the EMS unit; and
    4. Notify the Building  AED Coordinator and complete the Post Event Report Form and AED restocking checklist.

X. AED Standing Orders Per Medical Oversight

  1. The Whatcom County Health Officer will provide the direction and protocols for the use of AEDs within the Bellingham School District.
  2. The standing orders and protocol followed will be compatible with the American

Heart Association/Red  Cross AED training courses.

XI.  Definitions

AED-Automated External Defibrillator is a portable defibrillation  unit capable of monitoring, sensing serious arrhythmias and delivering an electrical shock to a person’s heart.

Cardiac Arrest Survival Act (CASA)-The Act instructs the Secretary of Health and Human Services to make recommendations to promote public access to defibrillation programs in federal and other public buildings.  The Act also extends Good Samaritan protections to AED users and the purchasers of the devices in all states.

Chain of Survival-A sequence of four events that must happen as quickly as possible in response to a cardiac emergency.  The four links are early access, early CPR, early defibrillation, early advanced care.

“Code Red”-Discovery of an unconscious person. CPR-refers to Cardiopulmonary  Resuscitation.

Defibrillation-Defibrillation stops ventricular fibrillation (VF) using an electrical shock and allows the return of a normal heart rhythm.  It is the only known treatment for ventricular fibrillation.  An AED is a device that analyzes a heart rhythm and prompts a user to deliver a shock when necessary.

Emergency Medical Services (EMS)–This is accessed in most communities by calling 911.

“Good Samaritan Act”-Good Samaritan laws grant immunity or limited immunity to volunteers who help strangers in emergencies.  Good Samaritan laws vary by state.

Heart Attack-A heart attack occurs when one of the heart’s  major blood vessels becomes blocked so that blood (and thus oxygen) is not delivered to the heart muscle. Without oxygen the heart muscle starts to die, producing pain and other symptoms.  A heart attack may lead to a cardiac arrest.

Medical Oversight-A designated licensed medical professional provides oversight to an AED program.  He or she oversees medical control, program development, and implementation.  The medical professional also establishes response procedures and a quality improvement plan.  Some state legislation requires a licensed physician to provide medical oversight.

Public Access Defibrillation (PAD)-AEDs placed into the hands oftrained laypersons.

Standard Precautions-refers to the fact that ALL human blood is potentially infectious and protecting ones self from direct contact by using gloves should be applied universally.

Sudden Cardiac Arrest (SCA)-Sudden cardiac arrest cases are usually due to abnormal heart rhythms called arrhythmias. The majority of these are ventricular fibrillation (VF). This is a situation where the heart’s electrical impulses become chaotic causing the pumping of blood to be dysfunctional.  Unless a normal rhythm is restored, death will follow.

VF-Ventricular fibrillation is the most common arrhythmia among cardiac arrest victims; during VF the heart’s  electrical impulses suddenly become chaotic and ineffective.

 

Legal Reference:  Washington State Legislature, RCW 70.54.310, Semiautomatic external defibrillator-Duty  of Acquirer.

Washington State Legislature, RCW 70.136.070 -Verbal Emergency Assistance Agreements, “Good Samaritan Law” & RCW 70.136.050; RCW 4.24.300- Immunity from liability for certain types of medical care.

 

Adopted: 09/24/09
Revised: 09/24/09