West Texas CPR & Safety Training Associates in cooperation with the Region 14 Education Service Center

1. West Texas CPR & Safety Training Associatesin cooperation with the Region 14 Education Service Center UIL Member High School AED Requirements Lynn Bivens, AHA Training Center Faculty/Coordinator Penny Bivens, AHA Regional Faculty Dr. Sandy Bridges, AHA Training Center Faculty

2. UIL Member High School AED Requirements Agenda • Cardiac Arrest • Texas Health Code-Automated External Defibrillators (AED) • AED Implementation Guide • Internal Medical Emergency Response Plan • Dr. Dan Munton, Abilene Sports Medicine • AED Manufacturers

3. UIL Member High School AED Requirements • Sudden Cardiac Death– American Heart Association Scientific Position • Sudden death from cardiac arrest is a major health problem that it has received much less publicity than heart attack. • The American Heart Association supports implementing the "chain of survival" to rescue people who suffer a cardiac arrest in the community. The adult chain of survival consists of: • Early Access to Medical Care (calling 9-1-1 immediately) • Early CPR • Early Defibrillation • Early Advanced Care

4. UIL Member High School AED Requirements What is sudden cardiac death? Sudden cardiac death (also called sudden arrest) is death resulting from an abrupt loss of heart function (cardiac arrest). The victim may or may not have diagnosed heart disease. The time and mode of death are unexpected. It occurs within minutes after symptoms appear. The most common underlying reason for patients to die suddenly from cardiac arrest is coronary heart disease (fatty buildups in the arteries that supply blood to the heart muscle). About 335,000+ people a year die of coronary heart disease without being hospitalized or admitted to an emergency room. That's about half of all deaths from CHD — more than 1000 Americans each day. Most of these are sudden deaths caused by cardiac arrest.

5. UIL Member High School AED Requirements Can the cardiac arrest that causes sudden death be reversed? Brain death and permanent death start to occur in just four to six minutes after someone experiences cardiac arrest. Cardiac arrest is reversible in most victims if it's treated within a few minutes with an electric shock to the heart to restore a normal heartbeat. This process is called defibrillation. A victim's chances of survival are reduced by 7 to 10 percent with every minute that passes without defibrillation. Few attempts at resuscitation succeed after 10 minutes. If someone becomes unconscious, call 9-1-1 immediately.  They may be suffering from sudden cardiac arrest.

6. TEXAS HEALTH & SAFETY CODECHAPTER 779. AUTOMATED EXTERNAL DEFIBRILLATORSSec. 779.001. UIL Member High School AED Requirements In this chapter, "automated external defibrillator" means a heart monitor and defibrillator that: (1) has received approval from the United States Food and Drug Administration (2) is capable of recognizing the presence or absence of ventricular fibrillation or rapid ventricular tachycardia and is capable of determining, without interpretation of cardiac rhythm by an operator, whether defibrillation should be performed; and (3) on determining that defibrillation should be performed, automatically charges and requests delivery of an electrical impulse to an individual ’s heart. Added by Acts 1999, 76th Leg., ch. 679, Sec. 1, eff. Sept. 1, 1999.

7. UIL Member High School AED Requirements Sec.779.002. TRAINING • A person or entity that acquires an automated external defibrillator shall ensure that: • (1) each user of the automated external defibrillator receives training given or approved by the Texas Department of Health in: • (A) cardiopulmonary resuscitation; and • (B) use of the automated external defibrillator; • and • (2) a licensed physician is involved in the training program to ensure compliance with the requirements of this chapter. • (b) In adopting rules under this section, the Texas Department of Health shall consider the guidelines for automated external defibrillator training approved by the American Heart Association, the American Red Cross, or another nationally recognized association.

8. UIL Member High School AED Requirements Sec.A779.003. MAINTENANCE OF AUTOMATED EXTERNAL DEFIBRILLATOR A person or entity that owns or leases an automated external defibrillator shall maintain and test the automated external defibrillator according to the manufacturer ’s guidelines. Sec.A779.004. USING AN AUTOMATED EXTERNAL DEFIBRILLATOR A person or entity that provides emergency care to a person in cardiac arrest by using an automated external defibrillator shall promptly notify the local emergency medical services provider. Sec.A779.005. NOTIFYING LOCAL EMERGENCY MEDICAL SERVICES When a person or entity acquires an automated external defibrillator, the person or entity shall notify the local emergency medical services provider of the existence, location, and type of automated external defibrillator.

9. UIL Member High School AED Requirements Sec.A779.006. LIABILITY EXEMPTION. The prescribing physician who authorizes the acquisition of an automated external defibrillator in accordance with this chapter, a person or entity that provides approved training in the use of an automated external defibrillator in accordance with this chapter, and the person or entity that acquires the automated external defibrillator and meets the requirements of this chapter are not liable for civil damages for such prescription, training, or acquisition unless the conduct is willfully or wantonly negligent. Any person or entity that acquires an automated external defibrillator and negligently fails to comply with the requirements of this chapter is liable for civil damages caused by such negligence.

10. UIL Member High School AED Requirements • Sec.A779.007. POSSESSION OF AUTOMATED EXTERNAL DEFIBRILLATORS. • Each person or entity, other than a licensed practitioner, that acquires an automated external defibrillator shall ensure that: • the automated external defibrillator has been delivered to that person or entity by a licensed practitioner in the course of his professional practice or upon a prescription or other order lawfully issued in the course of his professional practice;

11. UIL Member High School AED Requirements The 4 Key Steps for Implementing Your Facility’s AED Program Step 1: Medical Oversight and Quality Improvement • Provided by a physician or facility nurse • Provides medical leadership and expertise • Serves as an advocate for the AED program • Identifies and reviews local and state AED regulations • Assists in coordinating the program with local EMS • Helps develop facility program procedures

12. UIL Member High School AED Requirements The 4 Key Steps for Implementing Your Facility’s AED Program Step 2: Notification of Local EMS • Discuss with Local EMS the location of AEDs on the property • Transfer of Patient Care—policy and procedure for transferring patient care to local EMS upon arrival • Sharing Event Data—local EMS will give the decision to capture event data stored in AED

13. UIL Member High School AED Requirements The 4 Key Steps for Implementing Your Facility’s AED Program Step 3: Selection, Placement and Maintenance of AEDs • Choosing the AED • Determining AED placement • Should the AED be secured or unsecured? • Will the AED have a notification system? • Maintenance—conduct scheduled maintenance according manufacturer recommendations. Usually the responsibility of the facility AED Program Coordinator. • Putting AEDs back into service after an Emergency

14. UIL Member High School AED Requirements The 4 Key Steps for Implementing Your Facility’s AED Program Step 4: Designation and Quality Training of On-Site Responders • Identifying Responders—those who are required to respond as part of their job and those who may volunteer to be part of response team • Training Requirements—AHA Heartsaver AED course • Response Procedures—responders should be trained in the facility’s Medical Emergency Response Plan • Skills Reviews—critical to ensure responders continue to be prepared • Retraining Policy and Procedure should be written to guide AED programs and responders.

15. UIL Member High School AED Requirements Internal Emergency Response Plan sample Tailor the internal MERP to the AED program site environment and the AED device used in the program. 1. Assess the scene for safety before approaching the victim. 2. Assess the victim for unresponsiveness. 3. Assess airway, breathing and circulation. If there are no signs of circulation (normal breathing, coughing or movement), call for or get the AED and call 9-1-1. 4. Perform CPR until the defibrillator arrives. (If un-witnessed incident, perform 2 minutes of CPR) ( If witnessed incident start AED procedure as soon as AED arrives) 5. Turn on the AED. 6.Stop CPR. 7. Apply pads to the patient’s bare chest. Identify specific instructions for the AED device. 8.Make sure that no one is touching the patient. 9. Follow the AED’s voice and/or screen prompts until EMS arrives.

16. UIL Member High School AED Requirements AED suggested supplies: • At least one spare set of pads • Razor • Scissors • Towel • Bio Hazard equipment -Gloves -Safety Glasses -BioHazard disposal bag

17. UIL Member High School AED Requirements Recommended Web Sites: • www.westexcpr.com • www.americanheart.org • www.uil.utexas.edu/athletics/health/every-school-aed.html • www.suddencardiacarrest.org