School Defibrillators

Overview

In the United States as many as 450,000 people suffer and die from sudden cardiac arrest (SCA) each year. 7,000 – 10,000 of these are children. Approximately 7% of SCA victims are under 30 years old and 3.5% are under 8. Children may seem like unlikely candidates for sudden cardiac arrest but obviously they are not. There are several reasons why a seemingly healthy child might suffer an SCA.


Long QT Syndrome and Hypertrophic Cardiomyopathy are both congenital heart defects and Commotio Cordis is caused by a blow to the chest. A Commotio Cortis SCA occurs most often in baseball but any blow to the chest can cause the heart to stop beating. Other causes of SCA in youth can be undetected congenital coronary artery defects or electrolyte imbalances caused by eating disorders, rapid weight loss, or dehydration. Preventing SCA in children is difficult because many congenital heart defects go undetected and blows to the chest can happen any time children are playing organized or unorganized sports. However, preparing for, and treating SCA need not be difficult.

 

Benefits

Sudden cardiac arrest occurs when there is an interruption to the rhythm of the heart’s electrical system. When this ventricular fibrillation occurs, treatment (including defibrillation) needs to begin within three to five minutes of the attack; otherwise, brain damage and death will occur. Equipping schools with automated external defibrillators (AEDs) is the only way to ensure that children suffering from an SCA can receive the treatment they need within this critical treatment window.

School nurses can take the lead and play an important role in a school’s AED program. Because they oversee hearing, vision and other health-related screening programs, schools nurses are ideally suited to developing and leading a school’s AED program.

“He’s gurgling, he’s gurgling,” George Arciba called out, referring to the limp six-year-old lying below him on the concrete floor of Casa Linda Elementary School’s physical education class.

Jeanie Parker, the school’s nurse was running in with a physical education teacher, Jeannie Cantu, right behind her. Scared kindergartners watched from the side.

Cantu came in with a Cardiac Science G3 Plus Auto AED, or Automated External Defibrillator, swinging from her arm.

“CPR training tells you that if a person is gurgling to wait, but he was turning blue,” said Parker later.

Fortunately, she said, the laptop-sized AED took the guess work out of the situation. Once the pads were on little Emiliano’s chest the machine instructed the nurse to administer a shock.

With one jolt he was revived, paramedics arrived soon after and the boy was on his way to the hospital with a beating heart.

In addition to the school nurse, the school’s coaches are an ideal group to be trained in the use of automated external defibrillators. Because SCAs can occur during organized sports activities: baseball, football, basketball and soccer, or during a physical education class, training coaches and their assistants in the use of AEDs is important and necessary.

Sean Morley stepped up to bat in the fifth inning of his junior high school baseball game. The air was still and balmy at Deerfield, Illinois’ Jewett Park. Shifting from one foot to the other, the 13-year old tightened his grip and watched the pitcher wind up and throw. Suddenly the ball slammed into Sean’s chest, hitting his heart at a vulnerable time during the cycle between beats. His heart muscle quivered erratically as he slumped to the ground, unconscious. Sean was in cardiac arrest.

One parent called 911 while another ran up to the adjacent Deerfield police department and flagged down an officer. By an astonishing stroke of luck, six Deerfield squad cars had recently been equipped with Philips portable automated external defibrillators (AEDs). Officer Geoff Ruther grabbed his defibrillator and ran onto the field. He attached the electrode pads and, following the voice prompts, pressed the flashing button indicating “Shock Advised.” Immediately the electrical shock restored an organized rhythm, and blood surged through Sean’s heart once again.

The paramedics arrived moments later and Sean was hospitalized overnight for observation. Aside from having a hard time catching his breath the first night, and being very tired, Sean had no pain or discomfort. “I was really hungry,” he remembered. “I was ready to eat dinner.” Sean was incredibly lucky that events happened the way they did that day and a defibrillator was close by when it was needed. Unfortunately, paramedics and police can’t always get there so quickly. That’s why schools around the country are equipping their campuses with defibrillators.

 

Features

Because many children do not exhibit signs of sudden cardiac arrest, having an AED nearby and ready to go is of the utmost importance. Preparing schools and training teachers and other school workers to be ready in an SCA emergency is necessary. Cardiopulmonary Resuscitation (CPR) alone cannot restart (defibrillate) an SCA victim’s heart. Only an AED can do that. Therefore, making sure that teachers and school staff are CPR certified and AED trained is a life-saving necessity.

Modern automated external defibrillators are lightweight and easy to use. Most are portable and have sensors that tell the emergency first-responder if a shock is needed, and when it should be done. AEDs have become so easy to use that even a minimally trained sixth grader can correctly operate the device. Having AEDs in schools not only ensures that the students are protected but that staff and school visitors are too.

The number of AED trained first responders should be based on the size of the school. And everyone should know where the AED or AEDs are placed. Just having one in the school’s heath office might not be enough if the school has a large building, more than one floor, or if the SCA occurs outside on the playground. Remember, brain damage can occur if defibrillation does not happen within three to five minutes and sudden cardiac death is practically a given if more than seven minutes passes.

Equipping schools with automated external defibrillators is an important health care concern and it need not be difficult to set up an AED program. Reaching out to local physicians’ organizations, the local EMS system or other heath care organizations may be all that is needed to get the program off the ground. Some of these organizations donate equipment to the schools and help with the training of first responders. And there is usually no need to be worried about legal liability issues. Many states have laws that protect schools, and there is a federal law, the Cardiac Arrest Survival Act, that preempts state laws. This protects users or providers of AEDs from lawsuits unless gross negligence or reckless behavior is suspected or proven.

Automated External Defibrillators can cost over $1,000 and training and other materials are not free either. However, the cost need not be a stumbling block. Many resources are available to help pay for these costs. Donations from local donors, such as hospitals, churches, local businesses, and groups like the Elks, Kiwanis Clubs, Lions Clubs or Rotary Clubs may be willing to help. And don’t forget to ask parents of the children who attend the school. Safety for their children while at school is a huge concern and many parents won’t hesitate to donate when they hear how important it is to have an AED in their child’s school.

Grants from foundations are another way to cover the cost of starting an AED program. There are foundations that serve communities in the health and fitness arena and they may be the perfect partners. Local government agencies can be an option as well; they may have funds available for school health and safety programs.

Once an AED has been purchased or donated to a school, it’s important to make sure that everyone knows where they are and that there are enough trained first responders on staff. Having an AED with no one available to use it in an emergency is a tragedy waiting to happen. Training staff, teachers and older students in the use of an AED can help ensure that when sudden cardiac arrest happens, it will not be followed by sudden cardiac death.