Public Access to Automated Defibrillators: Public Access to Early Defibrillation Programs in DC Public Schools

1. Public Access to Automated Defibrillators:Public Access to Early Defibrillation Programs in DC Public Schools Presented by Arthur R. Bradley SR, MPA, NREMT-P Manager Critical Care Data and DC PAD Programs District of Columbia Fire & Emergency Medical Services

2. What is Sudden Cardiac Arrest? • Condition in which heart stops abruptly • Usually caused by ventricular fibrillation (abnormality in heart’s electrical system) • Not the same as a heart attack • Results in death if not treated immediately

3. How Common is Sudden Cardiac Arrest? • One of the leading causes of death in U.S. • At least 250,000 suffer SCA each year • Median age of victim is 65 years, but it affects people of all ages, even teenagers 35 12 58 13 17 43

4. Sudden Cardiac Arrest: A Public Health Crisis

5. How Can Sudden Cardiac Arrest Be Treated? • Ideal treatment for most cases: • Early access to the local EMS system • Early CPR (cardiopulmonary resuscitation) to keep heart viable until defibrillator arrives • Early defibrillation (delivery of electrical shocks with defibrillator)

6. Don’t You Have to Be a Doctor to Use Defibrillator? • In the early days of defibrillation, only Physicians could defibrillate a patient, and the equipment really wasn’t portable. 1965 Battery Powered Defibrillator

7. Do You Have to Be a Paramedic to Use Defibrillator? • In the 1970s, Paramedics came into America’s living room • ‘Roy & Johnny’ began to show the world pre-hospital cardiac care • ‘Clear’ took on a whole new meaning.

8. Do You Have to Be Medically Trained to Use Defibrillator? • In the early 1990s, technology delivers the first usable Automated External Defibrillators (AEDs) that require no medical training • AEDs are simple, safe and easy to use • Non-medical personnel can use AEDs with a minimum of training (and many are used by untrained bystanders).

9. AEDs in Public Use • AEDs are now becoming as common as Fire Extinguishers • Can be found in • Airports • Public Buildings • Health Clubs • Schools One of the many AEDs deployed along a concourse of Chicago’s O’Hare Airport. The device is clearly signposted (not seen in picture), alarmed, and connected by automatic phone to the emergency medical center.

10. Why is Early Defibrillation So Important? • Chance of survival from SCA diminish 7-10% with every minute after collapse

11. Why is Public Access Defibrillation so Important?

12. Why is Public Access Defibrillation so Important?According to the May 3, 2004 issue of Aviation Week & Space Technology, American Airlines has used an AED on its aircraft 89 times in the last 7 years and saved 50 lives (a 56% survival rate).

13. Why is Public Access Defibrillation So Important? • Only 7% now survive • 30% or more could survive in community settings • If even 20% survive, 50,000 lives could be saved each year

14. Are AED Programs Cost-Effective? • Cost of first responder AED programs over five years: $4,400 to $8,000 per year of life saved • Compares favorably with costs of other medical interventions

15. District of ColumbiaPublic Access to Early Defibrillation (PAD) Program

16. Public Access to Early Defibrillation (PAD) Program • Public Access to Automated External Defibrillator Act of 2000 • Promotes AED use and accessibility • Establishes Criteria for Establishing PAD Programs in the District of Columbia • Expand the “Good Samaritan” Law

17. Public Access to Early Defibrillation (PAD) Program • DC Heart Safe Community Initiative • Public Private Partnership with: • DC Chamber of Commerce • American Heart Association • American Red Cross • Medtronic Physio-Control • Program Administered by the EMS-CQI Unit of the District of Columbia Fire & EMS Department

18. Public Access to Early Defibrillation (PAD) Program • DC Heart Safe Community Initiative Goal Strengthening the Chain of Survival and Saving More Lives From Sudden Cardiac Arrest

19. Public Access to Early Defibrillation (PAD) Program • DC Heart Safe Community Initiative • Objectives • Promote Healthy Life Styles • Educate the Public of the Early Warning Signs of Cardiac Arrest • Increase Training in CPR/AED • Promote the Placement of AED in Public Places Where Citizens Work and Congregate

20. Working with District of Columbia Public Schools Initiative began at the beginning of the September 2003-2004 School Year To select schools to participate

21. Working with District of Columbia Public Schools Cardozo HS chosen 5 Cases of Sudden Cardiac Arrest to include 3 children and two adults over the past 3 years.

22. Working with District of Columbia Public Schools • Meetings were held key personnel from DC Department of Health, AHA, DC PS Medtronic and the DC Fire and EMS Medical Director • A number of civic organizations were also contacted to include the Masons

23. Working with District of Columbia Public Schools Key People • Director of Department of Health • Medical Director for DCPS School Nurses • Fire/EMS Chief and Medical Director • Superintendents of DCPS • AHA and Medtronic • Community Stakeholders

24. Key People • Director of Department of Health • Buy in • Instructor Support • Fire/EMS Chief and Medical Director • Ensured Medical Oversight • Bulk of the Instructor Support • Training Equipment • Assistance in establishing the PAD Program

25. Key People • AHA • Provided all training material necessary to train 500 students via a grant provide by The Phillip Graham Fund. Over 1500 trained utilizing this grant. • Medtronic • Promoted the initiative and ensured media coverage for the Kick-Off at Cardozo HS October 20, 2003 • Supplied AED Trainers and Instructor Support • Donated First AED to a DCPS • Superintendents of DCPS • Facilitated training (MOU) • Helped us to navigate the legal issues pertaining teaching children and utilizing their likeness to promote our program

26. Other Stakeholders • Howard University • Instructor Support • 459th Aeromedical Evacuation Squadron AAFB • Provided audio visual equipment for schools that did not have the capability • Administrative support to register participants and grade test • Instructor Support • Phillips Medical System • Donated an AED to Anacostia HS • Instructor Support • Zoll Medical Corporation • Donated an AED to Coolidge HS • Instructor Support Carol Stemple RN for ensuring instructional support

27. Working with District of Columbia Public Schools Truly a Lay Rescuer Program • Must obtain buy in from staff, and faculty at the school Key Players • Medical Oversight Physician • AED/PAD Program Coordinator

28. Medical Oversight Physician Must be licensed in the District of Columbia Duties • Responsible for overseeing all aspects of the PAD Program to include: • Training • Deployment strategies • Equipment Maintenance • Performing QA functions

29. AED/PAD Program Coordinators AED Coordinators are responsible for on site management and administration of the school’s PAD Program. Good Candidates Are: • Custodians • Secretaries • Counselors • Teachers

30. AED/PAD Program Coordinator’s • Major Duties • CPR/AED Training • AED Maintenance • AED Deployment Plan • Administrative Duties • Maintain Records of above • Notify Oversight Physician of Use • Ensure data from AED is extracted and sent to Oversight Physician • Renew PAD Application after four Years

31. Why Register YourPAD Program? • Ensures your PAD Program is covered under the District of Columbia Public Access to Early Defibrillation Act of 2000 which expands existing “Good Samaritan” Laws to • Facilities that have PAD Programs • AED Coordinators, Medical Oversight Physicians, and any other entity that provided training or oversight • Individual who uses the AED in good faith • Coverage is also extended to the owners, managers and supervisors of the facility

32. What Schools Received Training • Cardozo address • Anacostia • Coolidge • Dunbar • Eastern • Ballou

33. Where Are We Today • Revising the Memorandum of Understanding with DCPS, and AHA (possibly other stakeholders) • AED will be donated to Dunbar HS by Medtronic possible during EMS Week May 15-21, 2005 • Tentatively plan to train 1,000 students in a Family and Friends CPR Course During EMS Week • Honor student at Georgetown Day School for saving his father by performing CPR • CPR is a part of the Curriculum at Georgetown Day

34. Congratulations • Makes Your PAD Program Part of a Nationally Recognized Heart-Safe Community • 2004 Recipient of the Heart-Safe Community Award by the International Association of Fire Chiefs

35. Need More Information? • For More Information on Public Access to Defibrillation programs • National Center for Early Defibrillationwww.early-defib.org • Citizen CPR Foundationwww.citizencpr.org • Federal Occupational Health Automated External Defibrillator Programwww.foh.dhhs.gov/Public/WhatWeDo/AED/AED.asp

36. Need More Information? • For More Information on the District of Columbia Public Access to Defibrillation program, contact • Lt. Arthur BradleyEMS-CQI Unit1018 13th Street NW, Suite 300Washington, DC 20005202-673-6488

37. Thank You Special Thanks to: • Sgt Robert Austin, NREMT-P • Sgt Frances Covington, NREMT-P • Captain La Shon Frazier, BS, NREMT-P

38. Questions?