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Transcript of Medical Emergency Response Planning Schools
Response to Cardiac Arrest and Selected Life-ThreateningMedical Emergencies
Presented by
The New England Community Strategies Council
American Heart Association Training
Programs Are Discussed In This
Presentation.
Disclosures
ECC Mission
Build healthier lives, free of cardiovascular diseases andstroke by improving the Chain of Survival in every
community.
This is accomplished by improving the quality ofresuscitation provided by all rescuers and increasing the
probability that collapsed victims will receive prompt CPR.
CPR Facts and Statistics Adobe PDF, File Size 76.0 KB
Preventing Unnecessary Death from SCA• Bystander CPR rates are less than 30%
• Many deaths from SCA can be prevented
• Survival rates after
cardiac arrest almost
double when CPR is
initiated and access to
a defibrillator is provided
Educational Objectives
• Review and understand the related evidence based guidelines and recommendations
• Learn about innovative strategies for the delivery of CPR education
• Use these guidelines and recommendations in establishing response plans in schools
Life-threatening emergencies can happen in any school at any time as a result of preexisting health problems,
violence, unintentional injuries, natural disasters, and toxins. In
recent years, stories in the press have documented tragic premature deaths in schools from SCA, blunt
trauma to the chest, firearm injuries, asthma, head injuries, drug
overdose, allergic reactions, and heatstroke.
Life-threatening
emergencies in
schools are uncommon.
When they do occur,
they require a planned,
practiced, and efficient response.
Case for Support
School nurses, athletic
trainers, and
teachers are often
required to provide
emergency care.
Gagliardi M, Neighbors M, Spears C, et al. Emergencies in the school setting: are public school teachers adequately trained to respond? PrehospDisaster Med. 1994;9:222–225.Sapien RE, Allen A. Emergency preparation in schools: a snapshot of a rural state. Pediatr Emerg Care. 2001;17:329–333.
Children and Adults
• School medical emergencies can involve students or adults.
• All schools have adult faculty and staff, and most schools host large numbers of adults during extracurricular activities.
Injury vs. Illness Causes
1. Prevention of injury and other causes of cardiac arrest
2. Early CPR
3. Early activation of the EMS system
4. Early advanced careThe American Heart Association in collaboration with the International Liaison Committee on Resuscitation. Part 9: pediatric basic life support.In: Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2000;102(suppl 8):I-253–I-290.
SCA in the Young
A reality…
Ventricular Fibrillation
Liberthson RR. Sudden death from cardiac causes in children and young adults. N Engl J Med. 1996;334:1039–1044.Maron BJ, Thompson PD, Puffer JC, et al. Cardiovascular preparticipation screening of competitive athletes: addendum. An addendum to astatement for health professionals from the Sudden Death Committee (Council on Clinical Cardiology) and the Congenital Cardiac DefectsCommittee (Council on Cardiovascular Disease in the Young), AmericanHeart Association. Circulation. 1998;97:2294.Maron BJ. Sudden death in young athletes. N Engl J Med. 2003;349:1064–1075.
SCA in Adults
• SCA is a leading cause of death for adults 35 to 40 years of age and is the most common cause of death for those 45 years of age
• The risk of SCA in adults is100 to 200 times the estimated risk in children and adolescents and those under 35
The American Heart Association in collaboration with the International Liaison Committee on Resuscitation. Part 4: the automated externaldefibrillator: key link in the chain of survival. In: Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.Circulation. 2000;102(suppl 8):I-60–I-76.Kannel WB, Wilson PW, D’Agostino RB, et al. Sudden coronary death in women. Am Heart J. 1998;136:205–212.de Vreede-Swagemakers JJ, Gorgels AP, Dubois-Arbouw WI, et al. Out-of-hospital cardiac arrest in the 1990’s: a population-based study inthe Maastricht area on incidence, characteristics and survival. J Am Coll Cardiol. 1997;30:1500–1505.Kuisma M, Maatta T. Out-of-hospital cardiac arrests in Helsinki: Utstein style reporting. Heart. 1996;76:18–23.
Survival
Nurse? Not Always!
MERPS Elements
1. Effective and efficient communication throughout the school campus
2. Coordinated and practiced response plan3. Risk reduction4. Training and equipment for first aid and
CPR5. Implementation of a lay rescuer AED
program
Effective Communications
Establish a rapid communication
System linking all parts of the
school campus, including
outdoor facilities and practice
fields, to the EMS system
Pictures are for presentation purposes only. The American Heart Association does not endorse any particular products, models or manufacturers.
Coordinated Response
Pictures are for presentation purposes only. The American Heart Association does not endorse any particular products, models or manufacturers.
Risk Reduction
• Prevent injuries
• Identify those at risk
• Training and equipment
Training and Equipment
Pictures are for presentation purposes only. The American Heart Association does not endorse any particular products, models or manufacturers.
Sample First Aid Kit
AED Program
• Medical/healthcare provider oversight
• Training and use of the AED
• Coordination with the EMS
• Device maintenance
• Ongoing quality improvement
CPR Training
Accessibility
Pictures are for presentation purposes only. The American Heart Association does not endorse any particular products, models or manufacturers.
AED?
“EMS call–to-shock interval of 5 minutes
cannot be reliably achieved with
conventional EMS services…”
Calculating Risk
When funds are limited, but there is a desire to establish some AED school programs, priority should be given to establishing programs in large schools, schools used for community gatherings, schools at the greatest distance from EMS response, and schools attended by the largest number of adolescents and adults (eg, high schools and trade schools).
Location of AED
Pictures are for presentation purposes only. The American Heart Association does not endorse any particular products, models or manufacturers.
Legislative Mandates
Unfunded legislative mandates, particularly those that address the purchase of equipment rather than programs of planned response, will limit effectiveness and place a substantial burden on school budgets
MERPS Conclusions
The medical emergency response plan includes:
1. Communication system 2. Coordination3. Risk reduction4. Training in and equipment5. AED program when need
identified
Staying Alive!
Teaching Students CPR
• To increase bystander CPR and accelerate CPR education, creative new approaches exist to reach a larger public audience
• The development and validation of a 22-minute self-instructional CPR course has provided a tool for educating large numbers of school-aged children
• This presentation will also provide an overview of schools that have implemented training for their student bodies and how this may impact survival from SCA
Reducing Barriers is Key
• Bystander CPR can substantially improve rates of survival from SCA
• CPR is a highly accessible therapy that requires little medical training and no equipment when provided in its most basic form
• Potential rescuers from school age to the elderly can learn CPR skills
• Survival rates from witnessed SCA associated with ventricular fibrillation have been reported to be as high as 49% to 74%
• Equipping the public with the skills to perform the first 3 links in the AHA chain of survival can make a dramatic difference in survival from SCA
http://www.americanheart.org/presenter.jhtml?identifier=3054555
Why Train the Public?
• Once called, EMS systems in the U.S. have an average response time of about 4 to 7 minutes; for some it is over 10 minutes
• 80% of all out-of-hospital cardiac arrests occur in the home
• Relatives are frequent witnesses to cardiac arrests
Students and CPR
CPR Anytime
• A personal, inflatable CPR manikin, “Mini Anne”
• An American Heart Association Family & Friends™ CPR booklet
• CPR Skills Practice DVD
• Accessories for the program
School Successes in Other Countries
Denmark schools program• Funded by an insurance
company foundation• 50% of schools• 2.5 multiplier• 120,000 citizens* trained
in under 6 weeks* 2.2% of the total population
School Successes in Other CountriesNorway schools program• Funded by donations
through the Norwegian Air Ambulance
• 98% of schools• 2.5 multiplier• 200,000 citizens*
trained in under 6 weeks!* 4.3% of the total population
Schools in New England
Boston, MA
• Funded by the Boston Public Health Council and donations
• >3,000 trained• 2.5 multiplier• 7,500 citizens*
trained!
Schools in New England
Providence, RI
• Funded by donations through Heart Safe Foundation
• >2,000 trained• 2.5 multiplier• 5,000 citizens*
trained!
Schools in New England
Westborough, MA
• Funded by the Metro West Community Healthcare Foundation
• 300 students in a day• 2.5 multiplier• 750 citizens* trained!
Teaching Students CPRConclusion• To increase bystander CPR and
accelerate CPR education, creative new approaches exist to reach a larger public audience
• The development and validation of a 22-minute self-instructional CPR course has provided a tool for educating large numbers of school-aged children
When IT Happens…Which Story Will be YOURS?