Automated external defibrillators (AEDs) on school and university campuses have saved many lives. Students, teachers and community members have been among the fortunate ones pulled from the brink of death.
Student Jonathan Moore collapsed while warming up for football practice at Glenda Dawson High School in Pearland, Texas. Team trainers used the school's AED to jump-start his heart, the first in a series of medical interventions that enabled him to survive, the Houston Chronicle reported.
David Chapman, a history teacher at Bentonville (Ark.) High School, was saved because of the quick response of a student trained in first aid and two school nurses, according to Women's World magazine.
A man in Delta, Utah, who suffered sudden cardiac arrest in his yard, survived because he lived across the street from Delta High School, which had an AED. A neighbor notified the school's football coach, who, along with one of his players, ran to the scene with the AED.
These lifes were saved because AEDs were placed on school campuses. Medical studies validating the effectiveness of AEDs in schools and other public settings have been published in numerous medical journals.
Still, only 16 states have laws mandating or encouraging AEDs on school campuses, according to the National Conference of State Legislatures' website (www.ncsl.org). Regardless of whether a school or university is bound by such mandates, it's a good idea for an institution to obtain its first AED, or additional AEDs to cover a large campus.
Deploying AEDs on campus
Having an AED program is more than just buying an AED. Administrators should carefully determine where AEDs should be placed on campus, who should receive AED/CPR training, and how AED maintenance should be coordinated and assured, says Lisa Levine, president of the Sudden Cardiac Arrest Association:
Assemble a team to ensure program quality. Decisions about a school's AED program should be made according to the recommendations of school staff and community members. The program must be planned and carried out in accordance with state and local requirements relating to AED placement, AED/CPR training, program medical supervision, and registration with local EMS. In addition, a school should have a dedicated AED program coordinator responsible for day-to-day aspects of the program, including staff training and AED maintenance. Some examples of good AED program coordinators would be a school nurse, business official, or a coach or physical-education instructor.
Choose and place AEDs wisely. When placing AEDs on a large campus, follow the "three-minute" rule of thumb: In an emergency, a rescuer should be able to retrieve an AED and return to the victim within three minutes. Common locations for campus AEDs are athletic or multipurpose facilities, cafeterias, lobbies and community meeting areas. Another option is purchasing AEDs that teams can take to out-of-town games.
Choose an AED that can be updated easily to meet the latest American Heart Association resuscitation guidelines via a software update onsite at the school or university. For example, a current AHA guideline recommends "hands only" CPR — providing rapid and deep chest compressions at a rate of 100 per minute. It's important that an AED's audio instructions — which tell the user how to operate the device and to provide CPR — match the latest guidelines.
Because of the nature of the school environment, it is particularly important to choose an AED that is easy to use. Schools are open to the community at night and on weekends. Should sudden cardiac arrest occur when a school nurse or other trained staff are not present, the AED should be easily accessible so it can be operated by a bystander that may not have received AED/CPR training. Place the AED in an open area where it is visible; do not place it behind a locked door or cabinet.
Train as many staff as possible, and designate an emergency response team. An AED/CPR certification training course typically lasts three or four hours. Train as many staff as possible, and form an emergency response team from the trained staff. The program coordinator also should coordinate timely recertification courses. In addition to training staff, many schools offer training to students as extra credit in health classes.
Training should emphasize starting chest compressions before rescue breathing, delivering them without interruption and enabling full chest recoil after each compression. The training also should cover another relatively new guideline: "Shock first" — that is, use the AED as soon as possible, rather than after CPR. Previous guidelines directed rescuers to provide 1.5 to 3 minutes of CPR before using the AED, but the relatively new "shock first" now is recommended because studies show that about 90 percent of sudden cardiac arrest victims who receive shocks within the first few minutes after cardiac arrest survive. Survival rates decline with each passing minute; of victims shocked after 10 minutes, only about 10 percent survive.
Some manufacturers produce AEDs that can serve as training aids, providing video and voice coaching and on-demand video help. This feature enables a response team to practice after receiving certification training and to gain confidence before they have to respond to a real-life emergency.
Maintain the AED program diligently, either with school staff or through outsourcing. Once AEDs are situated throughout campus, they must be maintained properly. The maintenance process includes monitoring the condition of the battery, defibrillation pads and other supplies, and making sure they are replaced on time. Maintenance also involves regularly checking AED indicator lights, which show that the device is in working order.
Take steps now
Virtually all schools are facing tough budget circumstances. For this reason, many schools have raised money for AEDs through fundraisers or by applying for grants.
With a little old-fashioned initiative, education institutions can raise a few to several thousand dollars — enough to buy one, two, three or more AEDs. The effort will be worth it.
- Read the "Five Myths About Sudden Cardiac Arrest, AEDs and CPR" sidebar.
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