Emergency Treatment (AED)

Transcription

1 Emergency Treatment (AED) Staff are encouraged to become trained and/or maintain skills in recognized first aid procedures, especially through Red Cross certified providers. Staff have the affirmative duty to aid an injured student and act in a reasonable and prudent manner in obtaining immediate care. The staff member who exercises his/her judgment and skills in aiding an injured person during the school day or during a school event is protected by the district's liability insurance except when the individual is operating outside the scope of his/her employment or designated duties. Any child who appears to be very ill or who has received a serious injury should be either sent home or to a physician or hospital as quickly as possible. The principal shall be responsible for making the appropriate decision. In the event the principal or nurse is not available, the staff member designated by the principal to take charge in emergency situations shall be responsible for the decision. For a life-threatening emergency (severe bleeding, shock, breathing difficulty, heart attack, head or neck injuries), call for an aid car. The principal, nurse, responsible designated person, or involved staff member should contact the parent as quickly as possible to determine whether the child should: A. Be sent to a hospital, or B. Be sent to a doctor, or C. Be sent home, or D. Remain at school. If the parent cannot be contacted, call the emergency number listed on the child's enrollment card to determine the next course of action. If a seriously ill or injured child is sent home or to the hospital by private automobile, be sure that someone trained in first aid accompanies the child. This is in addition to the driver of the vehicle. Do not let a child walk home if he/she has a high fever (102+), has a head injury, or is likely to go into shock from injury. Even if the parent says to send the child, do not send home unaccompanied if the way home is not likely to be a safe route. If illness or injury is not life-threatening, the parent should arrange transportation. If ambulance service is required, ask the parent to call the ambulance or secure permission from the parent to call one. The child should be sent to the hospital of the parent's choice. Be sure to notify the hospital that the child is on the way. If the injury is deemed to be minor, the trained staff member should: A. Administer first aid to the child as necessary (following flip chart in nurse's office or standard Red Cross procedure). B. Notify the nurse, principal or responsible designated person. The nurse may be consulted by phone if not in the building. C. Remain with the child until released by the principal, nurse, responsible person, or the parent. D. The nurse, principal or other responsible person so designated should make the decision whether an ill or injured child who has received first aid should return to class. If there is any doubt the parent should be consulted. Page 1 of 9

2 If a serious injury occurs during a physical education class or during an athletic team practice or game, emergency procedures shall be conducted in the following manner: A. Stop play immediately at first indication of possible injury or illness. B. Look for obvious deformity or other deviation from the athlete's normal structure or motion. C. Listen to the athlete's description of his complaint and how the injury occurred. D. Act, but move the athlete only after serious injury is ruled out. The teacher or coach should avoid being hurried into moving an athlete who has been hurt. He/she should attempt to restore life-sustaining functions, (e.g., stop/repair uncontrolled bleeding, suffocation, cardiac arrest) before moving the athlete to an emergency facility. An athlete with a suspected head, neck or spinal injury should not be moved. If no physician is available, call 911 and proceed with caution according to first aid procedures. If he/she must accompany the student to a doctor, the activity or event should cease. An accident report must be completed by the activity director, as soon as possible, from information provided by the person at the scene of the accident. The written report should include a description of the circumstances of the illness or injury and procedures followed in handling it at school. A copy should be included in the student's folder and a copy should be sent to the superintendent. School staff may not accept and may not agree to comply with directives to physicians that would withhold or withdraw life-sustaining treatment from students. Use 0f Automated External Defibrillator (AED) An Automated External Defibrillator (AED) is used to treat victims who experience Sudden Cardiac Arrest (SCA). 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. AED may only be used to treat victims eight years of age and older who are unconscious, without pulse, signs of circulation, and without 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. This emergency medical treatment must be delivered within a short time of the onset of VF. Use of the AED is authorized for emergency response personnel (EMS) trained in CPR and use of the AED. In addition, trained employees of Ridgefield School District are to follow the uniform protocols when responding to sudden cardiac arrest incidents and when intervening with an AED. When School Is In Session: 1. Assess scene safety. Remember, on-site first responders are volunteers and are not expected to place themselves at risk in order to provide aid to others. Rather, first responders shall make the scene or environment around a victim safe prior to any attempts to assist. Page 2 of 9

3 2. Determine unresponsiveness of victim. 3. Summon help. a. Call (9) b. Call school office and alert staff to emergency and location of person. c. School office staff will assign someone to retrieve AED and meet responding volunteer at emergency scene. d. School office staff will assign someone to wait at facility entry to direct EMS to the victim s location. 4. CPR trained individuals will assess the emergency and, if necessary, begin administering CPR until the AED has arrived. 5. First responder shall open the airway of the victim and check for breathing. If the victim is not breathing, or if breathing is ineffective, give two slow breaths. Observe universal precautions using gloves and ventilation mask, if available. If breathing, place in the recovery position and monitor breathing closely. 6. Check for signs of circulation such as pulse and coughing, or movement. 7. If no signs of circulation, apply AED immediately. If AED is not immediately available, begin chest compressions and breathing (CPR) until AED arrives. 8. Turn on AED. 9. Apply electrode pads (according to diagram on back of electrode pads) to victim s bare chest: Peel electrode pads, one at a time, from the backing or liner. Shave or clip chest hair if it is so excessive it prevents a good seal between electrode pads and skin. Wipe chest clean and dry if victim s chest is dirty or wet. Press electrode pads firmly to skin. 10. Stand clear of victim while machine evaluates victim s heart rhythm. 11. Refrain from using portable radios or cell phones within four feet of victim while AED is evaluating heart rhythm. If Shock Is Advised: 1. Clear area, make sure no one is touching the victim. 2. Push shock button when prompted (if the AED is a fully automatic unit, the shock occurs without human interaction). 3. Device will analyze the victim s heart rhythm and shock up to three times. 4. After three shocks, device will prompt to check pulse (or for breathing and movement) and if absent, start CPR. 5. If pulse or signs of circulation such as normal breathing and movement are absent, perform CPR for one minute. 6. Device will countdown one minute of CPR and will automatically evaluate victim s heart rhythm when CPR time is over. If No Shock Advised: 1. Device will prompt to check pulse (or breathing and movement) and if absent, start CPR. 2. If pulse or signs of circulation such as normal breathing and movement are absent, perform CPR for one minute. 3. If pulse or signs of circulation are present, check for normal breathing. 4. If victim is not breathing normally, give rescue breaths according to training. 5. AED will automatically evaluate victim s heart rhythm after one minute. Page 3 of 9

4 6. If victim regains signs of circulation, such as breathing and movement, place victim on his/her side, in the recovery position, and monitor breathing closely. 7. Continue cycles of heart rhythm evaluations, shocks (if advised) and CPR until professional help arrives. 8. Victim must be transported to hospital. 9. Leave AED attached to victim until EMS arrives and disconnects AED. 10. Turn over care of the victim to EMS personnel. Once they have arrived, follow the directions of EMS personnel for further actions. When School Is Not In Session: 1. Athletic director supervised events: Determine unresponsiveness of victim. Activate system. 2. Call (9) Alert athletic staff of emergency by sending a runner to inform the athletic staff and person in charge. 4. If CPR/AED trained, the person in charge will retrieve the AED. 5. CPR and AED procedures should be initiated until EMS arrives. 6. Follow procedure outlined above. See School Hours section starting with #4. After Use: 1. Send within 48 hours (weekdays) a copy of AED use information documenting the emergency to: Dr. Lynn Wittwer Clark County Medical Program Director (MPD) PO Box 1600 Vancouver WA The volunteer responder will document the event using the School District s Accident Form and an AED Use Reporting Form. Forward a copy of the completed AED Use Reporting Form and Accident Report to the athletic director or designee on the next business day. 3. The AED will be wiped clean according to the procedures. 4. Electrode pads must be replaced and reconnected to device (electrode pads and Charge- Pak charging unit must be replaced in the LifePak Cr Plus AED). 5. Contents of attached resuscitation kit must be replaced if used. 6. The athletic director will conduct critical event stress debriefing. Automated External Defibrillator (AED) Administrative and Protocols System Owner: Ridgefield School District Program Coordinator at High School: Athletic Director/Assistant Principal Program Coordinator at Middle School/Elementary Schools: Principal Coordinator s Responsibilities: Coordinate training for emergency responders. Coordinate equipment and accessory maintenance. Page 4 of 9

5 Maintain a file of the specifications/technical information sheet for each approved AED model assigned or donated to the school. Monitor the effectiveness of this system. Communicate with medical director on issues related to medical emergency response program including post-event reviews. Maintain any necessary records. Revise this procedure as required. Medical Control: The medical advisor of the AED program is Lynn Wittwer, M.D. The medical advisor of the AED program has ongoing responsibility to: Provide medical direction for use of AEDs. Write a prescription for AEDs. Review and approve guidelines for emergency procedures related to use of AEDs and CPR. Evaluate post-event review forms and the digital files downloaded from the AED. Authorized AED Responders: Nurse, athletic director, assistant principal, and first responders. Additional staff as identified by administration such as, teachers, coaches, and field/game managers. Any trained volunteer responder who has successfully completed an approved CPR/AED training program within the last two years and has a current course completion card. AED Trained Employee Responsibilities: Activate internal emergency response system and provide prompt basic life support including AED and first aid according to training and experience. Understand and comply with requirements of this procedure. Follow the detailed procedures and protocols 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, experience and comfort level. The emergency medical response of these individuals may include CPR, AED, or medical first aid. School Office Responsibilities (during regular school hours): The school office staff is responsible to: Receive emergency medical calls from internal locations. Use an established checklist to assess the emergency and determine appropriate level of response. Contact the external community response team (EMS) if required. Deploy AED trained employees to emergency location. Assign someone to meet responding EMS vehicle and direct EMS personnel to site of medical emergency. Page 5 of 9

6 Equipment: The LifePak Automated External Defibrillators (AEDs) have been approved for this program. The AED conforms to the state/county standards. Use of the Equipment: 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 (eight) years of age and displays all the symptoms of cardiac arrest. The AED will be used only after the following symptoms are confirmed: o Victim is unresponsive. o Victim is not breathing, or is breathing ineffectively. o Victim has no signs of circulation such as pulse and coughing, or movement. Location of AEDs: During school hours, the AED will be housed in the high school office. Signage will note the location. After school hours, the AED may be moved from its designated location by an AED trained athletic director to support athletic department activities. A trained volunteer would need to be available and willing to sustain this effort during non-school hours. If the AED is removed from its location the athletic director shall leave a visible sign in the place of the AED with the name and phone number of the person having the AED. The community education program and groups who use school facilities are not guaranteed access to the AED as part of standard rental contracts. 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 pairs of latex-fee gloves, one razor, one set of trauma shears, and one facemask barrier device. Equipment Maintenance: All equipment and accessories necessary for support of medical emergency response shall be maintained in a state of readiness. Maintenance requirements include the following: The athletic director shall notify the school office of any change in the availability of emergency medical response equipment. If equipment is withdrawn from service, the school office shall be notified of that removal and then notified when equipment is returned to service. The school office shall be responsible for informing response teams of changes to availability of emergency medical equipment. The athletic director or designee shall be responsible for having regular maintenance performed on the equipment. All maintenance tasks shall be performed according to equipment maintenance procedures as outlined in the operating instructions. Following use of the emergency response equipment, the athletic director shall be responsible to have the equipment cleaned and/or decontaminated as required. If contamination includes body fluids, the equipment shall be disinfected. Page 6 of 9

7 Routine Maintenance: 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. The athletic director shall perform a monthly AED check according to the procedure checklist. The procedure checklist shall be initialed at the completion of the monthly check. The procedure checklist will be maintained in the school office. If the ok icon is not present on the readiness display proceed as follows: o If the battery icon is visible, the battery or Charge-Pak charging unit needs to be replaced. Continue to use the AED if needed. o If the wrench icon is visible, the AED needs service. Attempt to use the AED if needed. o 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. o If the expiration date on the electrode is near, place an order for replacements. Initial Training: Trained employees: Must complete training adequate to administer basic first-aid, CPR and AED on site. The AED training course must conform to accepted standards (e.g. American Red Cross, American Heart Association). Clark County Fire District 12 will be involved in the training of the employees. Trained employees will also be trained to follow the universal precautions against blood borne pathogens. Trained employees shall be offered Hepatitis B vaccination free of charge. The athletic director shall maintain training records for the trained employees. Volunteer Responders: These responders will possess various amounts of training in emergency medical response and their training may be supplied by outside sources. Volunteer responders can assist in emergencies, but must only participate to the extent allowed by their training, experience, and comfort level. 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 athletic director is not responsible for maintaining training records for the volunteer responders. Refresher Training: Trained employees will renew first-aid and AED training every two years. Volunteer responders will obtain documented first-aid and AED training at least once every two years. 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 athletic director or designee within 24 hours of a medical event: A district Accident Report Form shall be completed by a responding employee for each accident requiring first aid of any type. Page 7 of 9

8 The AED trained employee or volunteer responder shall also complete an AED Use Reporting Form whenever an AED is used. External Post-Event Documentation: A copy of AED use information which includes any recorded data and all electronic files captured by the AED 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. Post-Event Review: Following each deployment of the AED, a post event review shall be conducted to learn from the experience. The athletic director or designee shall conduct and document the post event review. All key participants in the event shall participate in the review. o Included in the review shall be the written identification of actions that went well and those that need improvement, as well as the written critical event stress debriefing. A summary of the post-event review shall be maintained in the athletic director s office. The athletic director s office, shall maintain the post-event review summary according to the records retention policy. System Verification and Review: The medical emergency response system is ultimately successful provided that the necessary medical assistance is provided to victims in a timely and safe manner. Since actual use of this system is expected to be infrequent, other measures of effective medical assistance are required. Annual System Assessment: Once each calendar year, the athletic director shall conduct and document a system readiness review. This shall include a review of the following elements: Training records. Equipment operation and maintenance records. RCW Persons rendering emergency care or transportation -- Immunity from liability -- Exclusion. Any person, including but not limited to a volunteer provider of emergency or medical services, who without compensation or the expectation of compensation renders emergency care at the scene of an emergency or who participates in transporting, not for compensation, there from an injured person or persons for emergency medical treatment shall not be liable for civil damages resulting from any act or omission in the rendering of such emergency care or in transporting such persons, other than acts or omissions constituting gross negligence or willful or wanton misconduct. Any person rendering emergency care during the course of regular employment and receiving compensation or expecting to receive compensation for rendering such care is excluded from the protection of this subsection. [1985 c ; 1975 c 58 1.] Page 8 of 9

9 NOTES: Severability -- Effective date c 443: See notes following RCW Citizen's immunity if aiding police officer: RCW Infectious disease testing availability: RCW RCW Semiautomatic external defibrillator -- Duty of acquirer -- Immunity from civil liability. Procedure 3418P (1) As used in this section, "defibrillator" means a semiautomatic external defibrillator as prescribed by a physician licensed under chapter RCW or an osteopath licensed under chapter RCW. (2) A person or entity who acquires a defibrillator shall ensure that: (a) Expected defibrillator users receive reasonable instruction in defibrillator use and cardiopulmonary resuscitation by a course approved by the department of health; (b) The defibrillator is maintained and tested by the acquirer according to the manufacturer's operational guidelines; (c) Upon acquiring a defibrillator, medical direction is enlisted by the acquirer from a licensed physician in the use of the defibrillator and cardiopulmonary resuscitation; (d) The person or entity who acquires a defibrillator shall notify the local emergency medical services organization about the existence and the location of the defibrillator; and (e) The defibrillator user shall call 911 or its local equivalent as soon as possible after the emergency use of the defibrillator and shall assure that appropriate follow-up data is made available as requested by emergency medical service or other health care providers. (3) A person who uses a defibrillator at the scene of an emergency and all other persons and entities providing services under this section are immune from civil liability for any personal injury that results from any act or omission in the use of the defibrillator in an emergency setting. (4) The immunity from civil liability does not apply if the acts or omissions amount to gross negligence or willful or wanton misconduct. (5) The requirements of subsection (2) of this section shall not apply to any individual using a defibrillator in an emergency setting if that individual is acting as a good samaritan under RCW [1998 c ] Date: ; Page 9 of 9