This policy has been developed by the medical staff to provide guidance in the management or administration of a the medical team’s 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 detected. If a shockable rhythm is detected, the AED will charge to the appropriate energy level and advise the operator to deliver a shock.
Program Coordinator (e.g. team or school physician, nurse, health care coordinator, athletic trainer, athletic director)
The medical advisor of the AED program is
- Selection of employees for AED training and distribution of AED-trained employee lists as required;
- Coordination of training for emergency responders;
- Coordinating equipment and accessory maintenance;
- Maintain on file a specifications/technical information sheet for each assigned approved AED model;
- Revision of this procedure as required
- Monitoring the effectiveness of this system
- Communication with medical director on issues related to medical emergency response program including post-event reviews
Applicable Documents (examples)
- General safety and health standard
- County/State AED Guidelines
- Medical emergency action plan
- Infection control procedure for universal precautions
- State immunity from liability exclusion
- AED Procedure
The medical advisor of the AED program is , M.D. The medical advisor of the AED program has ongoing responsibility for:
- Proving 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 files downloaded from the AED
Authorized AED Users
The AED may be used by:
- Employees including: administrators, nurses, athletic/activities director, athletic trainers and office staff.
- Additional staff as identified by administration. Examples: teachers, coaches, field/game managers and security staff.
- Any trained volunteer responder who has successfully completed an approved CPR/AED training program within the last two years and has a current successful course completion card.
AED-Trained Employee 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 requirements of this policy
- Following the more detailed procedures and guidelines for the AED program
Volunteer Responder 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.
Designated Central Office Responsibilities
Designated office staff shall be responsible for:
- Receiving emergency medical calls from internal locations
- Using 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 location
- Assigning someone to meet responding EMS aid vehicle and direct EMS personnel to site of medical emergency
The AEDs approved for this program conform to the state/county standards.
- The AED and first-aid emergency care kit will be brought to all medical emergencies.
- The AED should be used on any person who is at least 8 years of age and displays ALL the symptoms of 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 and coughing, or movement
NOTE: If AED program includes the treatment of children under eight years old or under 25 Kg. (55 lbs), equip AEDs with Infant/Child Reduced Energy Defibrillation Electrode Starter Kit (includes one pair of electrodes, storage pouch and appropriate safety instructions and labels).
Location of AEDs
During regular hours, the AED will be at designated locations. These locations shall 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.
After school hours, the AED may be moved from its designated location by an AED-trained 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 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 they have possession of the AED.
Contracted and other community activities are not guaranteed access to the AED as part of standard rental contracts.
Location of AEDs:
Athletic Program AED Locations:
Administrative AED Locations:
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.
All equipment and accessories necessary for support of medical emergency response shall be maintained in a state of readiness. Specific maintenance requirements include:
- 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 equipment is returned to service.
- The main school office shall be responsible for informing response teams of changes to availability of emergency medical equipment.
- The AED Program Coordinator or designee shall be responsible for having regular equipment maintenance performed. All maintenance tasks shall be performed according to equipment maintenance procedures as outlined in the operating instructions.
- 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 procedure #_________________.
- 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.
- A volunteer, assigned by the AED Program Coordinator or designee, will perform a daily AED check following the procedure checklist. The procedure checklist will be initialed at the completion of the daily check. The procedure checklist will be posted with the AED.
- If the OK icon is NOT present on the readiness display, contact the AED Program Coordinator or designee immediately.
- If the battery icon is visible, the battery or charging unit needs to be replaced. You may continue to use the AED if needed.
- If the wrench icon is visible, the AED needs service. You may attempt to use the AED if needed. 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.
- If the expiration date on the electrode is near, notify the AED Program Coordinator or designee immediately.
- 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. Trained employees will also be trained in universal precautions against bloodborne pathogens. The trained employees shall be offered hepatitis B vaccination free of charge. The school office shall maintain training records for the trained employees. NOTE: If AED program includes the treatment of children under eight years old or under 25 Kg. (55 lbs), training should include infant/child CPR/FBAO since techniques differ from adult CPR/FBAO.
- These responders will possess various amounts of training in emergency medical response and their training may be supplied by sources outside of the company. 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 campus. Any volunteer wishing to potentially use one of the AEDs deployed on the campus should have successfully completed a state approved AED course including CPR within the last two years. The school will not maintain training records for the volunteer responders.
- Trained employees will renew first-aid and AED training every two years.
- AED-trained employees will refresh AED skills using computer-based training. Each AED-trained employee will have access to AED Challenge™ interactive training software. Every six months each will perform a three-scenario test that will be reviewed by the AED Program Coordinator or designee.
- Volunteer responders should obtain documented renewal training at least once every two years. Volunteer responders are encouraged to periodically refresh their AED skills. This can be accomplished through the use of AED Challenge interactive training software. A copy of AED Challenge software has been placed on the computer in the library. All trained volunteer responders are encouraged to practice anytime.
MEDICAL RESPONSE DOCUMENTATION
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 Program Coordinator or designee within 24 hours of a medical event:
- An accident report form shall be completed by a responding employee for each accident requiring first-aid of any type.
- The AED-trained employee or volunteer responder shall complete a medical event form (9-1-1 form) whenever an AED is used.
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, county, state officials as designated in state AED requirements and local regulations
- At a minimum, event information supplied shall include any recorded data, and all electronic files captured by the AED.
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. The 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 environmental health and safety committee. The environmental health and safety coordinator according to the record retention policy shall maintain a copy of the post-event review summary.
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.
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:
- Training records
- Equipment operation and maintenance records