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Georgetown Public Schools 

School-Based Public Access Defibrillation Program

Policies and Procedures

Table of Contents

 

Table of Contents                                                                                                        2

Introduction                                                                                                                   3

Purpose                                                                                                                        3

Goals and Objectives                                                                                                  3

System Organization                                                                                                   4

Training                                                                                                                         6

Procedures                                                                                                                   7

           Location, Mobility of Devices                                                                           7

           Maintenance                                                                                                       7

           Use of AED                                                                                                         8

           Post-Incident                                                                                                       9

Attachments:

1.      Event Summary Form

2.      Location of AED’s

3.      AED After Hours Notice

4.      AED Monthly Log

5.      a.  Skills Checklist

b.   Target Responder Acknowledgement and

     Skills Evaluation Form

              6.   AED General Log


GEORGETOWN PUBLIC SCHOOLS

TARGET RESPONDER AUTOMATIC EXTERNAL

DEFRIBILLATOR GUIDELINES

 

INTRODUCTION:

 

A target responder automatic external defibrillation program provides an opportunity for trained responders to deliver early defibrillation to victims of cardiac arrest.  Early CPR and defibrillation are major determinants of successful resuscitation from cardiac arrest.  Use of an Automatic External Defibrillator (AED) will enable trained responders in the Georgetown Public School System to deliver early defibrillation to victims in the first critical moments after a sudden cardiac arrest and before emergency medical services (EMS) arrive and assume responsibility for care of the victim.

 

Federal and State laws protect trained persons who provide AED emergency services in accordance with his/her training from liability other than for gross negligence or willful misconduct resulting from the rendering of the service.

 

PURPOSE:

 

The AED program is intended to make AED’s available for use by individuals who have current evidence of successful completion of a course in CPR and use of an AED that meets the standards established by the American Heart Association or the American Red Cross.  The guidelines do not create an obligation to use the AED’s, nor to create an expectation that a trained employee will be present at all events.  By training voluntary employees in the use of AED and CPR, the potential to save lives through AED intervention will increase the probability for survival of victims of cardiac arrest.

 

I.                   Goals and Objectives

 

The goals of this AED program are to:

 

1.                  Promote public awareness of AED use in the Georgetown community as partner of broader state and national initiatives;

2.                  Improve the likelihood of survival of persons suffering cardiac arrest by:

Ø                  Implementing an AED training program for Georgetown Public School personnel.

Ø                  Implementing a preparedness strategy intended to maximize the likelihood of a positive outcome for victims of cardiac arrest;

3.                  Meet the requirements of Massachusetts General Laws c. 12 Sections  ___ 12V ½ relating to public access defibrillation programs.

 

This AED program is intended to make AEDs available for use only by individuals who have current evidence of successful completion of a course in CPR and use of an AED that meets or exceeds the standards established by the American Heart Association or the American Red Cross.  The program requires that any such person, in each instance of responding to a request for emergency care, contacts EMS and provides a report to the AED program Medical Director.

 

II.                System Organization

 

1.         The Medical Director is a physician licensed to practice medicine in the Commonwealth of Massachusetts who practices in the Georgetown EMS region.  The Medical Director is knowledgeable about EMS protocols established under Massachusetts law, is familiar with CPR and AED action sequences, has specialized training and knowledge concerning public access defibrillation, and agrees to provide medical director services for Georgetown Public Schools. 

Ø      Oversee all medical aspects of the program coordination with the Georgetown Public Schools’ Nursing Leader

Ø      Review policies and procedures

Ø      Participate in a quality review and improvement program, including all post-drill and post-incident debriefing

Ø      Establish and maintain a relationship with local EMS

Ø      In accordance with the specific requirements of M.G.L. c. 112 ____ 12V 1/2 :

o       Coordinate with the School Nurse Leader the activities of the AED program and its AED providers

o       Evaluate the activities of the AED program

o       Be responsible for ensuring that the AED program complies with AED maintenance, provider training and notice requirements.

2.         AED Program Coordinator maybe the School Nurse Leader or other designee that is an employee of the public schools.  The AED Program coordinator will:

Have primary responsibility for AED program development and implementation                                                                                                                                                                          

Ø      Act as a primary liaison among the AED program participants (e.g. Medical Director, school site leaders, school nurses, local EMS)

Ø      Coordinate non-medical aspects of the AED program

Ø      Coordinate documentation related to training, AED maintenance, use and post-incident data collection

Ø      Coordinate compliance with appropriate legal requirements

Ø      Oversee replacing supplies, order repairs, and service of AED.

 

 

3.        A School Site Leader  may be the School Nurse or other designee that is an employee of the public schools will:

Ø      Be responsible for the day-to-day operation and checks of and be accountable for the AED program and readiness at the site.

Ø      Check AED equipment and accessories and document in accordance with maintenance procedures.

Ø      Maintain a list of all trained school personnel.

Ø      Coordinate and document site-specific drills and refresher training.

Ø      Maintain documentation regarding use of AEDs.

o       Requests for deployment of an AED and/or Attachment of defibrillator pads to a patient (Event Summary Form)

o       AED monthly log and inspection activities

Ø      Notify the Town of Georgetown Medical Director and School Nurse Leader as soon as possible any time defibrillator pads are attached to a patient.

Ø      Order supplies, repairs, and service of AED.

 

4.         The Georgetown Public Schools Training Coordinator is an employee of the Town of Georgetown who will

Ø      Coordinate and document initial AED training; annual refresher, biennial retraining and any additional training on an ad hoc basis for certain designated Georgetown Public Schools employees.

 

5.         The AED site advisory team at each school participating in the AED program is a group that will include the Site Leader and volunteer representatives of the custodial department, physical education department and school administration. 

 

The Site Team will

Ø      Develop site-specific policies and procedures and training programs in consultation with the Medical Director and Program Coordinator.

Ø      Support the implementation of the AED program at the site.

Ø      Support continuation of inclusion of AED and CPR training in the student curriculum whenever possible

 

            6.         Georgetown Fire Department

 

Responsibilities include:

Ø      Consultation with the emergency medical director and school physician for use of AEDs within the school district

 

Ø      Consultation with Nurse Leader, Georgetown Public Schools business office as well as Life Support Systems for AED purchases within the school district

Ø      Consultation with the school district regarding  policies and procedures related to AEDs and CPR training programs

Ø      Conduct quality improvement programs that includes the review of AED encounters and collection of all AED documentation

Ø      Conduct post-incident debriefing sessions that includes target responders performance and patient outcome (see Attachment 1).

 

III.             Training

 

The Georgetown Public Schools AED Program Coordinator will coordinate and document initial AED training; annual refresher and biennial retraining for certain designated Georgetown Public Schools employees.  At each participating school, the AED Site Advisory Team will make recommendations for the number and identity of targeted responders and will develop a plan for the initial AED training and retaining of the targeted responders for the site.

 

Site-based training will include a review of site-specific emergency communication and response plans as well as use of specific AED devices.  At lease once during each school year, site-based training will incorporate:

 

  • A site drill
  • Skills review for individual targeted responders.

 

Targeted responders in the AED program are

 

a.         Required to have and to submit to the School Site Leader current documentation of successful completion of a course in basic life support that includes CPR and use of AEDs according to the standards and guidelines of the American Heart Association or the American National Red Cross;

b.         Responsible for being familiar with the Georgetown Public Schools Public Assess Defibrillation Program Policies and Procedures and the relevant site-specific policies and procedures, and sign a Targeted Responder Acknowledgement (see Attachment III) once each year; and

       c.        Attend the AED Program site-based training and to achieve a satisfactory                                                      skills evaluation each school year.

 

 

The School Site Leader will maintain the following documentation for each targeted responder:

 

a.         Current evidence of CPR and AED training that meets the requirements of this policy; and

 

 

b.         A Targeted Responder Acknowledgement and Skills Evaluation Form (Attachment III) that is signed by the targeted responder and an evaluator at least once each year.

 

The Site Leaders will supply updated listings of all Targeted Responders to the Program Coordinator at least yearly.

 

The AED program encourages the AED Site Advisory Team to implement and sustain a CPR and AED training program for students integrated into the curriculum at participating schools.

 

IV.              Procedures

 

A.        Location, Mobility of Devices:

 

The AED devices shall be at sites and specific locations listed on Attachment IV.A.  Each AED will be the responsibility of the School Site Leader or a designee (indicated in writing) or by his/her designated back up.

 

B.        Maintenance:

 

See the AED Manufacturer’s Operating Instructions Manual for detailed maintenance information and instructions.  The Site Leader or designee responsible for an AED will perform and document as follows:

 

Ø      Monthly and after each use (See Attachment IV.B.1)

o       Check readiness display for “OK” and confirm no battery indicator or service indicator supplied

o       Visually inspect AED:  proper location, clean, no tampering

o       Inspect AED, housing, case, connectors, battery according to Operator’s Checklist

o       Check station against station inventory and restock as needed

o       Enter date, print and sign name on monthly log (Attachment IV.B.1)

 

Ø      After each use

o       Inspect exterior for dirt or contamination and clean as needed (See Operating Instructions).

 

Whenever the results of inspection require action (per Manufacturer’s Operating Instructions Manual or these procedures) and after each dispatch or use (anytime defibrillator pads are attached to a patient), document in the AED General Log

 

(Attachment IV.B.2).  If the unit needs immediate service or supplies, remove from service and notify the Program Coordinator immediately.  If the unit is still operational but requires service, or supplies are nearing expiration, the School Site Leader will notify the Program Coordinator promptly.

 

C.                 Use of AED

 

1.       Early access to EMS (911)

 

ü      Assess responsiveness:  tap victim and shout, “Are you okay?”

ü      If unresponsive, activate emergency response system

ü      If alone, activate EMS by phoning 911 and get AED

ü      If not alone, stay with victim and assign someone to activate EMS by phoning 911 and obtaining AED

 

When activating 911, state your location, the nature of the emergency, the telephone number, what aid is being provided (example:  “We are using an AED”).

 

2.       Early CPR

 

ü      Check ABC’s (Airway, Breathing, Circulation)

ü      If no breathing, provide rescue breathing

ü      If no circulation

 

o       If AED is immediately available, attempt early defibrillation

 

o       If AED is not immediately available, perform CPR and prepare to attempt defibrillation when the AED arrives.

  

3.       Early defibrillation

 

ü      Power on AED

ü      Attach AED electrode pads to victim’s bare chest

ü      Allow AED to analyze (do not touch victim)

o       Clear victim during analysis (“I’m clear, you’re clear, everyone’s clear”)

ü      If advised to shock (do not touch victim)

o       Clear victim (“I’m clear, you’re clear, everyone’s clear”)

o       Press check button

ü      Continue to follow AED prompts until EMS arrives.

 

4.       Early Advanced Care

 

ü      EMS takes charge of the victim upon arrival

ü      Provide victim information to EMS:  name, age, known medical problems, details of incident, victim condition and aid provided (including number of shocks administered)

ü      Electrodes remain in place on victim (detached from device); school’s AED remains with representative of school who returns the device to the Site Leader as soon as possible

ü      If AED is transported with victim, document in event report specifying destination.

ü      Activate a critical incident stress debriefing team (CISD).  See fire department preferable within 24 hours.

 

D.                Post-incident

 

ü      Targeted responder notifies School Site Leader.  Site Leader notifies the Program Coordinator who will in turn notify the Medical Director.

ü      AED responder must complete the event summary form (Attachment IV.D) and return to School Site Leader.  School Site Leader forwards copy to the Program Coordinator, who retains a copy and forwards a copy to the Medical Director.  Site Leader documents additional information relating to the incident as appropriate.

 

ü      Site Leader or designee takes the AED out of service.  Any AED data will be downloaded or printed from AED by or under the direction of the Program Coordinator.  The Program Coordinator will retain one copy of the data report and forward a copy to the Medical Director.

 

ü      Before the AED is entered back into service, the Site Leader will inspect, clean if needed, and restock the AED station (according to Maintenance above).

ü      The Medical Director will conduct a post-incident review (including quality improvement) and debrief program staff and those involved in the incident.  As appropriate, the Medical Director will also ensure patient outcome monitoring and a trained rescuer emotion support process.

 

E. After Hours Use of Facility

 

Georgetown Public Schools have gatherings, events, and meetings after the normal hours of operation.  Persons using the school facility after the normal hours of operation will be informed and made aware of the emergency medical response procedure including the presence and location of the AED.

 

1.         Acknowledgement Letter

 

All persons, who host a gathering, event, and/or meeting will be given a letter explaining the emergency medical response procedure and the location of the AED for that facility.  A responsible person who will be present at the gathering, event, and/or meeting will sign a letter of acknowledgement specifying the location of the AED.  Each facility will maintain on file the signed letter of acknowledgement with the bookings/scheduling book.

 

2.         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 that they are trained.  The emergency medical response of these individuals may include CPR, AED, or first aid.

 

 

Attachment 1

 

Georgetown Public Schools

School Based Public Access Defibrillation Program

Event Summary Form

 

Location of event: ________________________________________________________

Date of event: _____________________________ Time of event: __________________

PAD Medical Director: ____________________________________________________

PAD Program Coordinator: _________________________________________________

Site Leader: _____________________________________________________________

Victim’s Name: __________________________________ Gender: ________ Age: ____

Was the incident witnessed?                  Yes______ No_____

If yes, name of witness (es):                  __________________________________________

Name of trained rescuer(s):                   __________________________________________

                                                            __________________________________________

Internal response plan activated?            Yes ______ No______

Was 9-1-1 called?  Yes ______ No ______ if yes, name of caller: __________________

Was circulation assessed?                                  Yes _____ No _____

Was CPR given before the AED arrived?           Yes _____ No ______

If yes, the estimated length of time CPR given before AED arrived __________________

            Name(s) of CPR rescuers _____________________________________________

                                                     _____________________________________________

Were shocks delivered? Yes_____ No______ Total number of shocks _______________

Did victim

            Regain circulation? Yes _____ No ________

            Resume breathing? Yes ______ No _______

            Regain consciousness? Yes ______ No _______

Was the procedure for transferring patient care to the local EMS agency executed?

Yes ________ No __________ If no, please explain: ____________________________
________________________________________________________________________

Name of person completing form: ____________________________________________

 

RETURN COMPLETED FORM TO PROGRAM COORDINATOR

 

_______________________________________________              ___________

Program Coordinator                                                                             Date                   

 

 

 

Attachment 2

 

 

 

Location of AEDs in Georgetown Public Schools

 

 

School Building:                                     Specific Location:

 

Georgetown Middle High School         AED 1:        Outside front office at main entrance

 

                                                                 AED 2:        Athletic Department (portable)

                                                                 AED 3         Portable kept outside MS office 3rd fl

Perley School                                         AED 4:        Outside main office

 

Penn Brook School                                AED 5:        Outside front office

 

 

 

 

 

Attachment 3

 

                       AFTER HOURS NOTICE AND ACKNOWLEDGEMENT

Town of Georgetown

Georgetown Public Schools

 

 

 

Dear ___________________________________________

            (Name of responsible Person who will be present at the event)

 

            The Town of Georgetown is working hard to become a Heart Safe Community by implementing a Public Access Defibrillation Program. The aim of this program is to make early defibrillation immediately available in cardiac emergencies. Use of an Automated External Defibrillator (AED) is intended to maximize the chance of survival based upon the steps taken during the critical minutes before emergency medical services (EMS) providers arrive and assume responsibility for care of the victim.

 

 

There is an AED located in this facility at: ______________________.

 

 

            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 that they are trained. The emergency medical response of these individuals may include CPR, AED, or first aid.

 

            Please keep one copy of this letter for your information and please sign the other copy to acknowledge your awareness location of the AED.

 

Thank you.

 

 

 

______________________________                              _____________

Signature                                                                             Date

 

 

 

Attachment 4

 

 

Georgetown Public Schools

School Based Public Access Defibrillation Program

AED Monthly Log

 

School: _____________________________________________ Year: _____________

AED Serial#: ____________________________ Location: ______________________

 

Month

Date

Name (print)

Signature

 

September

 

 

 

October

 

 

 

November

 

 

 

December

 

 

 

January

 

 

 

February

 

 

 

March

 

 

 

April

 

 

 

May

 

 

 

June

 

 

 

July

 

 

 

August

 

 

 

 

The School Site Coordinator will check the AED station and its contents on the first day of each month using the operator’s checklist and the AED station inventory. A signature and date of inspection noted in the table above will indicate that they have performed the following on that date:

·     Inspect the device using the Operator’s Checklist in accordance with maintenance information included in the manufacturer’s operating instructions. Contact the AED Program Coordinator as needed regarding any corrective action performed including replacement parts, repair or service.

·     Inspect the station for items listed in the AED station inventory, checking all expiration dates. Restock or replace any items as needed. Contact the AED Program Coordinator regarding replacement supplies ordered.

 

 

 

 

Attachment 5a

 

Georgetown Public Schools

School Based Public Access Defibrillation Program

Skills Checklist

 

Activity

Critical skills

Date

Date

 

Assess responsiveness;

Activate internal

Response system & EMS;

Get AED

 

 

Taps victim and shouts “Are you OK?”

Demonstrates knowledge of site-specific steps to activate internal emergency medical response system and EMS, and to retrieve or dispatch AED device to victim’s location.

 

 

 

Early CPR

 

Demonstrates assessment of ABC’s. If no breathing, provides rescue breathing. If no circulation, attempts early defibrillation of begins CPR until AED arrives.

 

 

 

Use of AED

 

Powers on AED.

 

Attaches electrodes to victim’s bare chest correctly.

 

Stops CPR and allows AED to analyze.

 

Clears victim “I’m clear, you’re clear, we’re all clear.”

 

If advised to shock: clears victim (“I’m clear, you’re clear, we’re all clear.”); presses shock button.

 

Continues to follow AED prompts until EMS arrives.

 

 

 

Transfer to EMS

 

Demonstrates knowledge of appropriate transfer of care and information to provide to EMS.

 

 

 

After AED use

 

Notifies Site Leader of event and returns AED to Site Leader. Completes or provides information for Event Summary Form.

 

 

 


 

 

 

 

Attachment 5b

 

Georgetown Public Schools

School Based Public Access Defibrillation Program

 

Targeted Responder Acknowledgement and Skills Evaluation Form

 

 

Targeted Responder: ________________________________________________

 

At least once during each school year, each targeted responder must:

 

1)      Sign the acknowledgement below, and

2)      Be evaluated for AED skills by a certified AHA or American Red Cross instructor in CPR and AED.

 

This form should be kept on file with the Site Leader.

 

I, the above signed targeted responder, have read and understand the Georgetown Public Schools School Based Public access Defibrillation Program Guidelines and Procedures, including the site-specific policies and procedures. I agree to follow such Guidelines and Procedures. I understand I will be notified of any updates or changes in the Guidelines and Procedures.

 

Signature Responder: _________________________________ Date: ____________

 

Signature Site Leader: ________________________________ Date: _____________

 

 

Evaluation Date: _______________________

 

I have evaluated the above-named candidate and have determined that he/she meets or exceeds the skills performance criteria found on the reverse side of this form.

 

Signature: _____________________________________________   

 

Print Name: ____________________________________________

 

Affiliation/Title: _________________________________________

 

 

 

 

 

 

Attachment 6

 

Georgetown Public Schools

School Based Public Access Defibrillation Program

 

AED General Log

 

School: ___________________________ Year: ___________________ AED Serial #: ______________________________

 

 

Date    

Incident/issue/problem

Action/status/resolution

Name/initials

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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