Transcript Emergency Medical Services for Children Resource

Automated External Defibrillators
(AED) in Schools
Randall S. Fischer, B.A., EMT-P
Operations Director, Ringdahl EMS
Program Coordinator, EMSC
RINGDAHL
Fergus Falls & Pelican Rapids, MN
Jamestown & Lisbon, ND
AMBULANCE
A Collaborative program of
Children’s Hospitals and Clinics
Emergency Medical Services Regulatory Board
University of Minnesota Medical School
o
o
o
o
o
o
Claudia Hines, RN, Manager
Randy Fischer, NREMT-P, Program Coordinator
Jennifer Piccolo-Fisher, Office Coordinator
Lee Pyles, MD, Co-Medical Director, U of M
Jeff Schiff, MD, Co-Medical Director, Children’s Hospitals & Clinics
Mary Ann McNeil, Director, U of M Depart. of Emergency Medicine
R.Fischer-2005
How Common is Sudden Cardiac
Arrest?
• One of the leading causes of death in U.S.
• At least 250,000 suffer SCA each year
• Median age of victim is 65 years, but it affects
people of all ages, even teenagers.
R.Fischer-2005
What is Sudden Cardiac Arrest (SCA)?
 Electrical system in the
heart malfunctions
 Heart unexpectedly and abruptly stops beating
 Not the same as a heart attack.
 Usually caused by an abnormal heart rhythm
called Ventricular Fibrillation
 Results in death if not treated immediately.
Shockable
Shock Advis ed
Charge Com plete
Shock 1, 200 J
15:04:31 Paddles
Paddles
Segm ent 1
Analys is 2
Pos ts hock
Segm ent 2
Nons hockable
Nons hockable
No Shock Advis ed
15:04:42 Paddles Medtronic Phys io-Control
R.Fischer-2005
SCA: a public health crisis
250000
House fire
200000
Prostate cancer
150000
Breast cancer
100000
Car accidents
50000
Sudden cardiac
arrest
0
Annual incidence
R.Fischer-2005
Why is early defibrillation so important?
• Chance of survival from
SCA diminish 7-10%
with every minute after
collapse
R.Fischer-2005
Why is Public Access Defibrillation so
Important?
9-1-1
Call
Called Dispatched
Victim
Collapse
0
1st Responder
Paramedics
On-Scene
On-Scene
st
1 Responder
Applies AED
5
10
15
Transport
To Hospital
20
Public AED
Applied
75% Chance of Survival
R.Fischer-2005
Why is Public Access Defibrillation so
Important?
According to the May 3, 2004 issue of Aviation Week &
Space Technology, American Airlines has used an AED
on its aircraft 89 times in the last 7 years and saved 50
lives (a 56% survival rate).
R.Fischer-2005
Why put AED’s in schools?
• SCA in adolescents is a growing concern
• Some seemingly healthy physically fit children collapse without warning.
• Knowing CPR, First Aid and AED operation is critical.
• Schools are community gathering points
• Adults (higher risk populations) often present at schools
• Basketball, football, wresting, and other sporting events
• Band, choir, and play performances
• Community education programs and other events
• Schools are a disaster resource
• Contact your local emergency manager and disaster coordinator
• Homeland security funds are available for preparedness.
• Teaching a future generation
• Strengthen the chain of survival and Educating teachers, staff, students how to
SAVE A LIFE!
• Introducing students to healthcare and recruiting a new healthcare workforce for
the future.
• Teaching a valuable “Life Skill”.
R.Fischer-2005
Everyone needs to know…
What, Where, When, Why and
How to use an AED
R.Fischer-2005
SCA in a Basketball Coach
Chippewa Falls, Wisconsin
R.Fischer-2005
Of the 600,000 Cardiac Arrest,
16,000 Are Pediatric Patients.
R.Fischer-2005
A blow to the chest
can bring on cardiac
arrest, as seen in
children struck by a
baseball or other
sports. This unusual
cause of SCA is
called
Commotio Cordis.
R.Fischer-2005
“Chain of Survival”
•Early Access – Dial 911 Immediately
•Early CPR – Everyone should know CPR
•Early Defibrillation –1st Responders & PAD
•Early ACLS – Local Ambulance service/ED
Everyone should learn CPR & AED skills.
•Prevention – Controlling/Reducing risk factors
•Recognition – Signs / Symptoms
•Action – Call 911, Check ABC’s, Perform CPR, operate an AED.
Steps to “Save a Life”
R.Fischer-2005
Key to Surviving SCA
Early Defibrillation
 Only effective treatment
is an electrical shock delivered by a
defibrillator.
 Time is critical – each minute of delay
before defibrillation reduces survival
by about 10%.
 CPR (Cardiopulmonary Resuscitation)
can help maintain the flow of oxygen
to the brain and vital organs, but
 CPR cannot convert VF
to a normal rhythm.
Eisenberg MS. Annuals Emerg Med. 1990;19:179-186.
R.Fischer-2005
What is an AED?
 Device that “Looks” for a




shockable heart rhythms.
Delivers a defibrillation
shock only if needed.
Will not shock if not
needed. SAFE!
Small, portable, about the
size of laptop computer.
About $2,000 per unit.
R.Fischer-2005
When to use an AED
• Anytime someone collapses and is
unresponsive or unconscious.
R.Fischer-2005
Do you have to be medically trained to
use defibrillator?
• No. Automated external
defibrillators (AEDs) are
simple, safe and easy to use
• Non-medical personnel can
use AEDs with minimum of
training
R.Fischer-2005
Who supports increased access to
defibrillation?
•
•
•
•
•
•
•
•
•
•
American College of Emergency
Physicians
American Heart Association
American Public Health Association
American Red Cross
Canadian Association of Emergency
Physicians
Citizen CPR Foundation
Emergency Care Research Institute
Heart and Stroke Foundation of Canada
International Association of Chiefs of
Police
International Association of Fire Chiefs
•
•
•
•
•
•
•
•
•
International Association of Fire Fighters
International Liaison Committee on
Resuscitation
National Association of EMS Physicians
National Association of State EMS Directors
National Association of State EMS Training
Coordinators, Inc.
National Center for Early Defibrillation
National Heart Lung and Blood Institute
National Safety Council
Occupational Safety and Health
Administration
R.Fischer-2005
Athletic trainers promote AED use
• Concordia College, Moorhead
• < 1 month after the AED was purchased used on a retired professor
– massive heart attack after playing a lunch-hour basketball game in the gym.
• AED used by the athletic trainer – Stephanie Brandt.
• Alive today
• Syracuse University
• Football referee collapsed during a game in September
• AED used by the Athletic trainer – Tim Neal
• Alive today
• University of Iowa
• Spectator collapsed in the bleachers.
• AED used by the Athletic trainer – Dan Foster
• “The results were dramatic. The immediate success has resulted in a
continued high quality of life for the patient, an increase in AED purchases
in the community and an improved general public awareness of AED’s.
R.Fischer-2005
Developing Your Community
“Champions”.
•
•
•
•
•
•
•
•
School Administration
School Nurse, Public Health
Teachers and Health Educators
Parents
Local Ambulance Service (EMS)
Police/Law Enforcement
Community Service or School Liaison Officer
Hospital and Healthcare organizations
R.Fischer-2005
New York Schools and AED’s
R.Fischer-2005
Site Assessment
• Priority buildings
•
•
•
•
•
Campus Security/First Responders
Large number of people
Amount of time occupied
Public or large events
High risk group?
• Current Location(s)
•
•
•
•
Cover entire campus
Plan for additional units/locations
Easy access
Obvious location for public use and
school observation.
R.Fischer-2005
Liability risk of using an AED
• President Clinton in 2000 initiated a bill (Cardiac Arrest Survivor Act) that
grants legal immunity to good Samaritans who use AED’s.
• Since then, most states have rewritten their own good Samaritan laws to include
language about the use of AED’s.
• Minnesota Statute includes AED specific language
• A plaintiff in a fitness facility received a $2.5 million award after a lawsuit
charging the facility for not meeting a member’s emergency-response needs
when the plaintiff had a heart attack and there was no AED available.
(Chai versus Sports Fitness Clubs of America, Circuit Court, 17th Judicial District, Broward County, FL)
• Represents a shift toward requiring fitness-related facilities and possibly
other institutions to have AED’s available.
• UnderstandingAEDProgramLegalIssues1104F.pdf
R.Fischer-2005
Other considerations
• Maintenance cost of units
– Every use or every 2.5 years: Replace pads/battery pack: $90.00
• Initial and on-going training
–
–
–
–
–
CPR / AED training, 4 hour class
1 Hour review every year,
Safety training meeting refresher
All school lyceum for students/staff
Develop policies, test, and practice in school
• Campus/Community Awareness – Students & Staff
– Community-wide effort to train and inform public on CPR and AED’s
– Basketball game half-time demonstration
• Debriefing and EAP/support after use
– Local EMS/Hospital/Regional EMS program can assist or arrange.
• Physician oversight
– Usually local EMS/Ambulance Medical Director
R.Fischer-2005
SCA in a HS Football Referee
R.Fischer-2005
CPR and AED Review
•
•
•
•
Shake and Shout
Call 911 – Get AED
Open Airway
Check Breathing
• If no breathing Give 2 Breathes
• Check for Circulation or “Signs” of Life?
Coughing, moving, pulse?
• Start CPR
• Attach Defibrillator – As soon as it is there!
• Follow voice prompts and defibrillate if indicated
A – B – C –D
R.Fischer-2005
Want More Information?
Randy Fischer, Program Coordinator
Emergency Medical Services for Children
2550 University Ave. West # 216 South
St. Paul, MN. 55114
Phone: (612) 578-8690 or (800) 660-7022
[email protected]
www.emscmn.org
R.Fischer-2005
AED Videos
•
•
•
•
•
•
Good Morning America
WCCO – Chippewa Falls, WI Video
Football Referee Video
KARE 11 – AED Video
New York Schools and AED’s
Airport Security Camera – SCA Video
R.Fischer-2005
Good Morning America Video
R.Fischer-2005
WCCO – Chippewa Falls, WI
R.Fischer-2005
Football Referee Video
R.Fischer-2005
KARE 11 – AED Video
R.Fischer-2005
Airport Security Camera – SCA
R.Fischer-2005