911: Is Your Campus Ready for a Medical Emergency?

Transcription

1 911: Is Your Campus Ready for a Medical Emergency? United Educators Telephone Roundtable Reference Materials Thursday, June 5, :00 p.m. Eastern Time Presented by: Robert C. Dillard Chief, University Police Department University of Richmond Christiane Groth Risk Analyst United Educators Moderator: D. Frank Vinik Senior Risk Analyst United Educators

2 Contents Speaker Biographies... 3 Roundtable Agenda... 4 United Educators Resources A Checklist for AED Programs in Educational Settings, From the UE Toolbox, May Improving Your Institution s Response to Accidents by Avoiding Common Mistakes, UE Safety Dispatch, Issue 9, Additional Resources American Heart Association: AED Program Implementation Resources National Collegiate Emergency Medical Services Foundation (NCEMSF) UE Telephone Roundtable, : Is Your Campus Ready for a Medical Emergency? Page 2

3 Speaker Biographies Robert C. Dillard has served as chief of the University of Richmond Police Department for 38 years. His responsibilities include oversight of patrol, security, communications, and investigative services for the department, including fiscal, public relations, career development and training, special events, and accreditation activities. Chief Dillard earned his B.S. in Administration of Justice and Safety from Virginia Commonwealth University and has attained numerous professional achievements. He led the department to be the first private university to be nationally accredited. Under his leadership, the department has received awards such as the Governor s Community Crime Prevention Award and the Secret Service Certificate of Recognition for superior contributions to the law enforcement responsibilities of the United States Secret Service and for outstanding support and cooperation with the Secret Service during the 1992 Presidential debate held on campus. Chief Dillard also serves, or has served, on the Board of Directors of the Virginia Association of Chiefs of Police, and the Virginia Police Chiefs Foundation, the Capital Area Alcohol Safety Action Program, and both the Virginia and the International Associations for College Law Enforcement Executives and Administrators. Christiane Groth is a risk analyst at United Educators responsible for developing publications on emergency planning and response, campus safety, and security. Prior to joining United Educators in 2003, she served as an assistant to the president at The College of William & Mary, developing presidential communications, serving as a liaison to student affairs, and coordinating a review of the college s emergency response plan following September 11. Groth also worked at Georgetown University, serving in a development position focused on identifying avenues for research collaboration and funding. She is a business continuity specialist and received a B.A. and Master in Teaching from Virginia Commonwealth University and an Ed.D. in higher education policy from The College of William & Mary. Frank Vinik (moderator) is a senior risk analyst at United Educators. Before joining United Educators in 1998, Vinik practiced law in North Carolina, where he represented numerous schools and colleges. He also worked in the administration of the University of California at Berkeley. Vinik received his undergraduate degree from the University of California and his law degree from the University of Virginia. UE Telephone Roundtable, : Is Your Campus Ready for a Medical Emergency? Page 3

4 Roundtable Agenda Introduction Part I: Medical Emergency Response on Campus Assessing campus access to emergency medical services in the community Understanding where medical emergencies are likely to occur Preparing campus responders for medical emergencies o Identifying responders o Training staff on medical emergency response Part II: AED Program Management Starting a campus program Understanding challenges involved with program oversight o Establishing a centralized program o Training staff on AED use Part III: Special Considerations Establishing student ambulance and emergency medical technician (EMT) clubs Developing an approach regarding medical transports UE Telephone Roundtable, : Is Your Campus Ready for a Medical Emergency? Page 4

5 From the UE Toolbox A Checklist for AED Programs in Educational Settings Automated external defibrillators (AED) can increase the survival rate of persons suffering cardiac arrest on your college campus or school grounds. Educational institutions choosing to establish an AED program need to think carefully about a range of issues, including: Program management AED selection and placement AED maintenance and support equipment Selection and training of personnel AED use Post-incident follow-up This checklist is designed for administrators responsible for establishing and overseeing a campus AED program. It can be used when planning a new program or conducting periodic reviews of an existing program. In addition to this checklist, the prudent administrator will consult the institution s legal counsel to ensure that the program is established or operated in accordance with all applicable state and local statutes, including any laws regulating the use of AEDs and Good Samaritan statutes. Up-to-date guidance on AED operations and oversight should also be sought from the American Heart Association, the Red Cross, or other advisory bodies responsible for AED standards and program operation. A. Program Management Indicate Whether the Following Is True at Your Institution Physician appointed to provide medical oversight of the program Program s physician responsible for: Assisting with selection of AED devices Evaluating AED deployment following an incident Program coordinator appointed to manage day-to-day operation Program coordinator responsible for: Establishing policies governing the placement, maintenance, and use of AED equipment Establishing policies governing the selection and training of personnel Overseeing the placement and maintenance of AED equipment Overseeing the selection and training of personnel associated with the program UE Telephone Roundtable, : Is Your Campus Ready for a Medical Emergency? Page 5

6 From the UE Toolbox B. AED Selection and Placement Indicate Whether the Following Is True at Your Institution AED devices selected under the guidance of the program s physician Selected devices have FDA approval Wall-mounted AEDs: Located in one or more of the following: Facilities with a high number of visitors (e.g., sports venues, concert halls, academic or administrative buildings) Facilities in which high-stress activities take place (e.g., gymnasiums, fitness centers, track facilities, swimming facilities) Designated health-care facilities Mounted in the following ways: On publicly accessible walls In a manner that is secure to prevent tampering Near a telephone Identified by easy-to-read signs Labeled with sign advising use by persons with AED and CPR training Portable AEDs: Stored in one or more of the following: Secure locations to prevent tampering Locations from which device can be quickly deployed (e.g., central locations, offices that dispatch emergency responders, offices that are accessible 24 hours a day) Emergency vehicles C. AED Maintenance and Support Equipment Indicate Whether the Following Is True at Your Institution AED units inspected and tested according to manufacturer guidelines Battery of AED units checked and replaced according to manufacturer guidelines Electrode pads of AED units inspected and replaced according to manufacturer guidelines Nonfunctioning equipment removed for repair UE Telephone Roundtable, : Is Your Campus Ready for a Medical Emergency? Page 6

7 From the UE Toolbox Posted sign states unavailability and gives the location of the closest available unit Program coordinator maintains record of inspection and testing for all AED equipment AED support equipment kept with unit, including: Disposable gloves Disposable facemasks Extra electrode pads Safety razors Absorbent towels or trauma pads Pair of scissors AED incident report form and pen D. Selection and Training of Personnel Indicate Whether the Following Is True at Your Institution First responders trained to administer cardiopulmonary resuscitation (CPR) and use the AED device include: Public safety personnel Fire response personnel Additional personnel considered for CPR and AED training include: Members of emergency response team Volunteers willing to respond to cardiac emergencies Personnel selected for training are on the premises during routine business hours or during a facility s peak use hours CPR- and AED-training program meets local and state requirements CPR- and AED-training cover: Recognizing signs of a cardiac attack Notifying emergency medical services (EMS) Performing CPR Determining whether use of AED device is appropriate Using the AED device Safety protocols governing use of the AED device UE Telephone Roundtable, : Is Your Campus Ready for a Medical Emergency? Page 7

8 From the UE Toolbox 4 Retraining occurs every two years (recommendation of the American Heart Association) Between training sessions, all AED-trained personnel are provided regular opportunities to practice trained skills in: Activating a medical emergency response Administering CPR Using AED device All AED-trained personnel demonstrate proficiency with the required skills following any training session Program coordinator monitors training and skill level of all AED-trained personnel to ensure proficiency Program coordinator offers refresher training, when needed E. AED Use Indicate Whether the Following Is True at Your Institution Before administering CPR or using AED device, responder is trained to: Call EMS personnel immediately, prior to initiating CPR and any AED use Assess the patient and the scene prior to initiating CPR and any AED use Determine that the patient needs resuscitation (e.g., patient is unresponsive, not breathing, or does not have a pulse) Check the scene for hazards (e.g., electrical, chemical, physical, fire) prior to using the AED Remove the patient from water or dry the patient, if wet, before using AED device Remove the patient from metal surfaces before using AED device While administering CPR or using AED device, responder is trained to: Follow training protocols for administering CPR and using AED device Continue CPR per training protocols and any use of AED device as directed by the device until EMS arrives on scene Ask a bystander to direct EMS personnel to the scene, if necessary After administering CPR or using AED device, responders are trained to complete an incident form with the following information: Incident location Date and time of the incident Witness information (name, address, telephone number, address) UE Telephone Roundtable, : Is Your Campus Ready for a Medical Emergency? Page 8

9 From the UE Toolbox Time that responder arrived on scene Time that responder notified EMS Gender and estimated age of patient If available, patient information (name, address, telephone number) Condition of the patient Time that responder initiated CPR Time that responder initiated use of AED device Time of EMS arrival Incident outcome F. Post-Incident Follow-Up Indicate Whether the Following Is True at Your Institution Program physician and program coordinator: Review each incident report for completeness Review emergency medical response procedures for each incident Decide on strategies to improve emergency medical response, if necessary Review any changes in emergency medical response procedures with AEDtrained personnel during subsequent training session Program coordinator ensures: AED device ready for future use Any supplies used during emergency medical response are replaced AED device returned to designated location Resources AED Program Implementation Guides Automated External Defibrillation Implementation Guide American Heart Association Public Access Defibrillation Guidelines Federal Occupational Health, Department of Health and Human Services UE Telephone Roundtable, : Is Your Campus Ready for a Medical Emergency? Page 9

10 From the UE Toolbox 6 Sample AED Program Policies Public Access Defibrillation (PAD) Program George Mason University Automated External Defibrillator (AED) Use Policy Michigan State University Automated External Defibrillator Policy University of Notre Dame The material appearing in this publication is presented in summary form and should not be considered legal advice. The results of using any material appearing in this publication does not establish that relevant legal requirements or best practices have been met. Copyright 2008 by United Educators Insurance, a Reciprocal Risk Retention Group. All rights reserved. Contents of this document are for members of United Educators only. Permission to post this document electronically or to reprint must be obtained from United Educators. UE Telephone Roundtable, : Is Your Campus Ready for a Medical Emergency? Page 10

11 Safety Dispatch Issue 9, 2004 Improving Your Institution s Response to Accidents by Avoiding Common Mistakes Mary Johnson, a 62-year-old woman wearing a cast on her arm, slipped and fell near the entrance of an educational institution s stadium restroom during a football game. Lily Paterson, a member of the housekeeping staff, offered assistance while commenting that she had told maintenance many times about the restroom s overflowing-toilet problems. As Mary got up off the floor, Lily asked her if she needed a doctor or any further help. Mary said no and limped to the exit, at which point a family member appeared and escorted her from the area. At the end of her shift, Lily told her supervisor about Mary s fall. He called the security office to report the accident. Based on this telephone report, security staff wrote a bare-bones incident report, which it stored in its files. Several months later, Mary sued the college alleging that the negligent upkeep of the toilets in the stadium bathroom caused her to fall and maintaining that she sustained multiple fractures in her arm and a severe sprain of the hip that have required two corrective surgeries and ongoing physical therapy. To respond to the suit, the only information the college could provide defense counsel was the incident report. When counsel spoke with Lily, she did not recall the incident. This scenario, though fictitious, illustrates some of the common mistakes UE has seen over the years. An analysis of what went wrong at this hypothetical college provides an important lesson in steps institutions can take to protect students, faculty, staff, and themselves when accidents occur. Avoiding Common Mistakes An institution that fails to respond adequately to an accident or fails to document an accident altogether is at greater risk of liability if an injured party later pursues legal action. Particular problems may occur when the institution has not responded to a victim s injury, detailed the accident in a written incident report, or provided ongoing support to the victim, when needed. Unfortunately, poor accident response practices are often evident in the claims that educational institutions report to United Educators. Mary s scenario illustrates five mistakes that frequently occur in responding to accidents on campus. Institutions that avoid these errors will likely ensure that an injury is evaluated and that appropriate assistance is provided on the spot. A thorough and welldocumented accident response that results in a written report to preserve important UE Telephone Roundtable, : Is Your Campus Ready for a Medical Emergency? Page 11

12 information can later be used to defend against a claim. Institutions that avoid these errors will likely ensure that their accident response is thorough and well-documented, with an evaluation of any injuries and the provision of appropriate assistance. This comprehensive response would result in a written report that preserves important information that could later be used to defend against a claim. Following are descriptions of the five common oversights with details on how to avoid them: Mistake 1: Failing to Establish and Conduct Training on Accident Reporting. In Mary s case, Lily either did not know or failed to follow the college s accident-reporting procedures. She didn t say anything about the accident until the end of her shift, several hours after Mary s fall, causing a delay that impeded a thorough initial investigation. This mistake is compounded by her telling Mary about the malfunctioning toilets, thereby implying that they caused her fall although there had not been an assessment to show that they were related to Mary s injury. A common pitfall for institutions is the failure to train faculty and staff in procedures to follow when they witness an injury. Formal procedures are a valuable tool to guide them through critically important steps sometimes even life-saving steps at a time when emotions may be high following an accident. Adherence to these steps may result in getting needed medical attention for someone who has been injured while protecting the institution from liability. It is critical that faculty and staff especially those most likely to witness an accident know what an institution s procedures are for reporting injuries. Following are two important ingredients in accident reporting: a. Reporting Procedures: A typical comprehensive training program specifies that employees should report all accidents, and it defines whom to notify so that personnel trained in accident response can provide timely help. Most organizations employ a one-call reporting system that quickly brings to the scene campus security or public safety personnel trained first responders. b. On-Site Communications: An institution s liability may be complicated by an employee s statements to the injured party or witnesses. Staff meetings and orientation sessions are useful venues for training employees on how they should conduct themselves when faced with an injured individual. Case scenarios can vividly portray the harm that thoughtless comments may cause the institution should an injury later result in a claim or lawsuit. Proper training would have taught Lily to call campus security as soon as Mary fell and not to say anything that could cast blame on the institution, even if the toilets had been malfunctioning. Copyright 2004 by United Educators (UE). All rights reserved. Page 2 of 8 UE Telephone Roundtable, : Is Your Campus Ready for a Medical Emergency? Page 12

13 Mistake 2: Failing to Document an Accident. Because the campus security did not learn about Mary s accident until several hours after it occurred, the staff was unable to respond to or investigate the circumstances surrounding the injury promptly. Even so, when security personnel finally received notification, they did nothing more than write a report confirming that there had been an injury. As first responders, campus security or public safety should be trained in the following: Assessing the condition of the accident victim and the surrounding accident scene. Determining what other resources (internal or external, or both) may be required to respond to the injury. Preparing an accident report. Providing appropriate care to the victim. Gathering information critical for the institution to have in the event the accident results in a claim. Training should also address appropriate handling of an accident that is reported late. In those cases, first responders should still examine the accident scene and gather relevant information from witnesses. In the case of Mary s fall, had security attempted to properly document the accident when Lily s supervisor called, details of the accident would have been fresh in Lily s mind; instead, when they spoke to her, the information was a faded memory. In a timely inquiry, security personnel would have discovered Lily s comments about the toilets, and they could have documented if the toilets were working on the day of the accident. While not a perfect initial investigation, these actions would have better positioned the college in the event Mary took legal action. Mistake 3: Failing to Provide Medical Assistance. Because campus security did not fully document details pertinent to the accident and injury while Mary was still at the scene, the staff missed an opportunity to assess her medical condition soon after the fall and to inquire about the cast on her arm and her condition prior to the fall. Further, while Mary refused medical assistance which could suggest that her fall did not cause any serious injury no one at the college obtained documentation from Mary confirming this. Offering medical assistance, and in certain cases obtaining it, is critical for two reasons. First, by providing medical assistance, an institution gets a professional evaluation of the victim s injury. Second, the institution is able to ensure that the victim gets appropriate treatment promptly. First responders can ensure that medical assistance is provided by knowing the emergency medical services available in the locality and the procedures for summoning appropriate assistance when necessary. Also, if the victim declines any assistance, first responders should obtain the injured party s signed statement that he or she does not need and is declining medical assistance. Copyright 2004 by United Educators (UE). All rights reserved. Page 3 of 8 UE Telephone Roundtable, : Is Your Campus Ready for a Medical Emergency? Page 13

14 Mistake 4: Failing to Document the Accident and Preserve Evidence. The accident report that campus security generated in Mary s case was based solely on an oral report from Lily s supervisor. When the suit was filed, the report confirmed that the accident occurred, which supported Mary s claim, but it failed to provide any details that could support the college s defense. An accident report should capture the factual details an institution will rely on if a suit is filed. First responders need to examine the accident scene and collect evidence such as photos and witness statements and clearly record their observations in the accident report. However, the report should not contain any analysis, opinions or speculations about the evidence, the credibility of witnesses, or who or what was to blame for the injury. An institution should train first responders in interviewing the injured party and other witnesses, examining the surrounding premises, and ascertaining pertinent, contributory conditions. The report may be so crucial to a case that institutions should consider making refresher courses in basic writing available and incorporating good report preparation in personnel evaluation criteria. Institutions might also develop a report template to assist responders in documenting accidents and ensure they collect all necessary information. Most institutions have employee accident report forms for their workers compensation carrier, which can serve as a template for creation of an accident report. See the resources section that follows for several different examples of accident report forms. Following are details on preparing a report: a. Injured Party Information: Gather as much information as possible directly from the injured party. If the victim s condition permits, ask for his or her full legal name and all contact information and have the person show a driver s license or other legal identification to ensure that this information is accurate. Also if possible, obtain a statement from the victim by asking for a detailed description of the circumstances leading up to and including the accident itself. The victim should also describe his or her physical condition prior to and after the accident. As the victim provides this information, first responders should create a written statement and, if possible, ask the injured party to sign the statement or provide a verbal agreement that it is accurate. When interviewing the injured party, first responders should use open-ended questions that cannot be answered with a yes or no answer as a means to encourage the injured party to describe what happened. b. Other Witness Statements: Eyewitness statements are important in providing further perspectives on the accident. Anyone who saw or heard any aspect of the accident can provide information. Students, Copyright 2004 by United Educators (UE). All rights reserved. Page 4 of 8 UE Telephone Roundtable, : Is Your Campus Ready for a Medical Emergency? Page 14

15 faculty, and staff may be witnesses, and their statements need to be included in the accident documentation. c. Description of the Premises and Relevant Conditions: Beyond witness statements, a thorough investigation should note the physical environment pertinent to an injury. It is important to note surrounding conditions and those of the victim, including the following: The injured party s clothing, general appearance, conduct, and physical condition. Equipment or objects in the area that may have contributed to the accident. Weather conditions. People in the area (such as crowded or sparsely populated). Take photographs of all relevant items and supplement the photographs with a written narrative to detail the description of the surroundings and contributing factors. d. Securing Additional Evidence: Investigators should secure any physical evidence pertinent to the injury, including objects, equipment, and security camera videotapes or other videotapes that may have captured the events in question. Mistake 5: Failing to Continue Monitoring Appropriate Cases. Because the college did not fully document the circumstances of Mary s injury, it was not in a position to consider whether to check her condition or otherwise monitor her medical treatment and recuperation. The institution s inattention to her injury may have prompted Mary to file suit, especially given the ongoing medical care her condition required. While not all claims are avoidable, institutions can take additional steps to avoid future claims by demonstrating compassionate care for the injured party both at the scene and after medical treatment. In UE s experience, accident victims often assert claims after feeling that the institution neglected them or did not care about the accident or their injuries. This is particularly true with severe injuries or those that produce life-altering results. Institutions should not be deterred from demonstrating concern for the injured person s health and well-being by fears of admitting liability through their actions. In appropriate cases, particularly those involving a death or serious injury, an institutional liaison for the accident victim and family members should be designated promptly. Depending on the situation, an athletics director, a student life administrator, or a risk manager can serve this role. Copyright 2004 by United Educators (UE). All rights reserved. Page 5 of 8 UE Telephone Roundtable, : Is Your Campus Ready for a Medical Emergency? Page 15

16 Offering to assist the injured person by identifying or offering to cover costs associated with appropriate health-care providers is an important way to demonstrate ongoing concern about his or her well-being and recovery. Sincere inquiries about the person s progress demonstrated through flowers, cards, and telephone calls can build good will for the institution without admitting liability. Resources General Accident Investigation Resources UE Safety Dispatch, Be Prepared: Worksheet for Campus Response to Death or Serious Injury, December Available in the UE Members Only Library at. International Risk Management Institute On the Trail of Truth: Conducting an Accident Investigation League of Minnesota Cities Reporting Employee Accidents and Conducting Incident Investigations National Oceanic and Atmospheric Administration Accident Investigation Sherman Safety Management Conducting Effective Accident Investigations Texas Workers Compensation Commission Accident Investigation U.S. Department of Labor OSHA Small Business Training Series Accident Investigation State of Wisconsin Department of Administration Bureau of State Risk Management Principles of Accident Investigation and Analysis Copyright 2004 by United Educators (UE). All rights reserved. Page 6 of 8 UE Telephone Roundtable, : Is Your Campus Ready for a Medical Emergency? Page 16

17 Sample Accident Investigation Policies and Procedures Bowling Green State University Accident Reporting and Investigation Reports Colorado State University Guide to Accident/Incident Investigations n.pdf Princeton University Accident Investigation Procedure Texas A&M Incident Investigation and Analysis University of California, Berkeley Sample Accident Investigation Forms Colorado State University Guide to Accident/Incident Investigations (including sample form) n.pdf Princeton University Accident Investigation Form School Board of Alachua County Accident Investigation Report Texas A&M University Incident/Injury/Property Damage Report University of Missouri System Click on Forms and then on Risk and Insurance Management for Student or General Public Injury and Property Damage Report Copyright 2004 by United Educators (UE). All rights reserved. Page 7 of 8 UE Telephone Roundtable, : Is Your Campus Ready for a Medical Emergency? Page 17

18 Yale University Conducting an Effective Accident Investigation Sample Accident Investigation Training Programs East Carolina University Accident Investigation n.pdf Oregon OSHA Online Training Accident Investigation Procedures We welcome your suggestions of safety concerns that you would like to see UE address. Contact us at For more information about UE, its services, and its policies, please visit our website at. You may also access all the issues of UE Safety Dispatch through our Members Only Library at the UE website. Past Safety Dispatches have covered many topics, including athletics safety, crisis planning, alcohol and drug abuse, and dorm safety. Copyright 2004 by United Educators (UE). All rights reserved. Page 8 of 8 UE Telephone Roundtable, : Is Your Campus Ready for a Medical Emergency? Page 18

19 Additional Resources American Heart Association (AHA) AED Program Implementation Resources Information and materials developed by AHA to help organizations understand the importance and role of AEDs in saving lives and to start their own AED programs. The AHA offers an online tool to help organizations locate CPR or AED training providers in their area. Use the following link to be connected to the tool: National Collegiate Emergency Medical Services Foundation (NCEMSF) NCEMSF was founded in 1993 as a membership organization for Emergency Medical Services (EMS) on college and university campuses. Its focus is the development and expansion response groups. The Campus EMS Resources section of the website provides links to a wide range of resources including campus standard operating procedures manuals and essays by experienced campus EMS administrators. UE Telephone Roundtable, : Is Your Campus Ready for a Medical Emergency? Page 19