BOROUGH OF AUDUBON BOARD OF EDUCATION Audubon, NJ 08106 Policy

File Code: 4112.5 Monitored Mandated Other Reasons

AUTOMATED EXTERNAL DEFIBRILLATOR POLICY The Audubon Board of Education recognizes that more than 350,000 Americans die annually from out-ofhospital sudden cardiac arrest. Many die needlessly because life saving defibrillators are not immediately available. The American Heart Association estimates that almost 100,000 deaths could be prevented each year if defibrillators were more widely available to designated responders. The recommendations from the American Heart Association Chain of Survival include early defibrillation as a link in the survival of sudden cardiac arrest. Brain death and permanent death start to occur in just four to six minutes after someone experiences cardiac arrest. Cardiac arrest can be reversed in most victims with defibrillation if administered within a few minutes. The victim’s chances of survival are reduced by 7-10% with every minute that passes. Few attempts at resuscitation succeed after ten minutes. Automated external defibrillator (AED) or defibrillator means a medical device heart monitor and defibrillator that:   

Has received approval of its premarket notification filed pursuant to 21 U.S.C. s.360 (k) from the United States Food and Drug Administration; Is capable of recognizing the presence or absence of ventricular fibrillation or rapid ventricular tachycardia, and is capable of determining, without intervention by an operator, whether defibrillation should be performed; and Upon determining that defibrillation should be performed, automatically charges and requests delivery of an electrical impulse to an individual’s heart.

Upon acquisition of an Automated External Defibrillator (AED) the Board of Education shall notify the appropriate first aid, ambulance, or rescue squad or other appropriate emergency medical services provider that a defibrillator has been acquired – its type and location. The prescribing licensed physician(s) will be provided with documentation that the school district has a policy and procedure in place to comply with the requirements of N.J.S.A. 2A: 62A-25-26. The Audubon School District will maintain an automated external defibrillator (AED) on the premise of Audubon Jr./Sr. High School, Mansion Avenue Elementary School, and Haviland Avenue Elementary School. The automated external defibrillators will be maintained and tested in accordance with operational guidelines of the manufacturer. The defibrillators used by the Audubon School District are the Heartstart FR2+ and the Heartstart Onsite. The automated external defibrillator (AED) will be kept on school property and will not accompany EMS personnel to a hospital emergency room. In accordance with N.J.S.A. 2A: 62A-25-26 and under the direction of the school physician(s), an Audubon Board of Education employee may use the automated external defibrillator (AED) under the following circumstances: 

The Audubon Board of Education employee has successfully completed and holds current certification from the American Red Cross, American Heart Association or other training program recognized by the Department of Health and Senior Services in cardio-pulmonary resuscitation and use of the defibrillator.

Page 1 of 2

AUTOMATED EXTERNAL DEFIBRILLATOR POLICY: (continued)    

File Code: 4112.5

The victim is in cardiopulmonary arrest as determined by unconsciousness, absent pulse, and no spontaneous breathing. “911” is activated. Cardiopulmonary Resuscitation (CPR) is performed until the automated external defibrillator (AED) is brought to the scene. The school nurse notifies the school physician(s) of the use of the automated external defibrillator (AED) after the victim has been transferred to the care of the Emergency Medical Services (EMS).

Any person or entity who, in good faith, acquires or provides a defibrillator, renders emergency care of treatment by the use of a defibrillator or supervises such care or treatment and, who has complied with the requirements of N.J.S.A. 62A-27, shall be immune from civil liability for any personal injury as a result of such care or treatment, or as a result of any acts or omissions by the person or entity in providing, rendering, or supervising the emergency care or treatment. The immunity provided should include the prescribing licensed physician(s) and the person or entity that provided the training in cardiopulmonary resuscitation and the use of the defibrillator. Immunity shall not be provided to a person or entity for any act of gross negligence or willful or wanton misconduct. It shall not be considered gross negligence or wanton misconduct to fail to use a defibrillator in the absence of an otherwise preexisting duty to do so.

Adopted: March 10, 2004 Reviewed and Revised: December 19, 2007 Annual Review and Approval: May 4, 2011, May 16, 2012, May 15, 2013, May 21, 2014

Page 2 of 2

Automated External Defibrillator Procedure

Location, Maintenance and Testing of the AED 1. AED will be located in the school nurse’s office at the elementary schools and in the athletic trainer’s office at the high school. 2. Maintenance and testing is conducted according to the manufacture’s guidelines by the school nurse as follows:  Documentation of the maintenance and testing of the AED is maintained by the school nurses.  Documentation shall include a record of the date and type of maintenance /testing and the signature of the person performing the maintenance/testing (see attached).  Monthly maintenance/testing will be performed on the AED system Checklist (see appendix B).  Post use maintenance/testing will be performed after each use. Use of the AED Remember not for use on children under 8 years of age unless pediatric electrodes are available for use. 1. Determine unresponsiveness of victim and activate Emergency medical Service (EMS) by calling 911. 2. Send for AED. 3. Assess scene for safety. Remove victim from water or metal surface. 4. Assess the victim for breathing and pulse. 5. Initiate cardiopulmonary resuscitation (CPR) based on assessment until AED arrives at the scene. 6. Place AED near the head of the victim close to the AED operator. 7. Bare and prepare the chest for AED use:  Wipe moisture off chest with towel if needed.  Remove any transdermal medication patches and wipe chest clean.  Check chest for pacemaker or implanted cardioverter-defibrillator (these devices create a hard lump beneath the skin of the upper chest or abdomen about the size of a half deck of cards.) Make sure you place the AED electrode pad at least one inch to the side of any implanted device.  Shave the chest with a razor if necessary. 8. Power on the AED.

9. Stop CPR and attach electrode pads to the victim’s chest positioning the pads as shown on the electrode package. 10. Attach electrode cables to the AED. 11. Allow the AED to analyze the victim’s heart rhythm. Voice prompt will instruct you to stand clear while the AED is analyzing the victim’s heart rhythm. This takes about 9 to 13 seconds. 12. Follow the voice prompts that will either say, “shock advised” or “no shock advised” and will tell you what to do next. 13. For “shock advised” make sure everyone is clear from the victim prior to delivering the shock to the victim. 14. Allow the AED to follow the shock sequence. If necessary, it will deliver three shocks before you can reassess the victim. CPR is then performed for one minute if the shocks were unsuccessful. Next you must push the analyze button and repeat the sequence. 15. If “no shock” advised check the victim for pulse and breathing. If no pulse and/or no breathing are detected, resume CPR until voice prompt tells you to stop CPR to analyze victim’s heart rhythm. 16. Remember to leave the electrodes and the AED on until the EMS arrives and you transfer the care of the victim to the EMS. 17. Follow the transfer of the victim to EMS; complete the AED Incident Report (see appendix A). Give the completed report to the school nurse. 18. The school nurse notifies the school physician(s) of the use of the AED after the victim has been transferred too the care of the EMS. The use of the AED is contraindicated under the following circumstances:  Consciousness of the victim  Presence of breathing in the victim  Presence of detectable pulse in the victim  Victim is lying in water  Victim is lying on a metal surface.

Audubon School District Appendix A - AED Incident Report Please complete all of the information to the best of your ability and forward it to the school nurse. The school physician will review the information.

School: _________________________

Location: _____________________

Name of Victim: _________________________

Age of Victim: ________________

Date of Incident: _________________________

Time of Incident: _______________

Victim’s Known Medical History: __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ Check One:

_____ Audubon Student _____ Audubon Board of Education Employee _____ Other

Circumstances of how victim was found: __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ Who called “911”: __________________________________________________________________________ Who used AED and how many shocks were delivered: __________________________________________________________________________ Time victim was placed in the care of Emergency Medical Services: __________________________________________________________________________ Victim transported to which hospital: __________________________________________________________________________ Family notified:

_____ Yes

_____ No

If so, by whom: __________________

Other information: __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________

Signature of AED user: _______________________________________________________ Name (Please Print): ________________________________________________________ Date form completed: ________________________________________________________ OPERATOR’S CHECKLIST

HeartStart FR2+ Model No.: ____________________ Serial No. _____________________ HeartStart Onsite Model No: ____________________ Serial No. _____________________ HeartStart FR2+ Location or Vehicle ID: ____________________________________________ HeartStart Onsite Location or Vehicle ID: ___________________________________________ Date Scheduled Frequency HeartStartFR2+/Heartstart Onsite Clean, no dirt or contamination; No signs of damage Supplies Available  Two sets of defibrillator pads, sealed, undamaged, within expiration date  Ancillary supplies (hand towel, scissors, razor, pocket mask, gloves)  Spare M3863A/M5070A battery, within “install before” date  Data cards, undamaged, and Spare data card tray Status Indicator Shows alternating hourglass/square; selftest passed. Inspected by Signature or initials of operator completing the maintenance inspection. Remarks, Problems, Corrective Actions