HEALTH CARE AND EMERGENCIES

 

 

A.                  Purpose

 

To provide procedures to ensure that first aid and/or medical attention is provided as quickly as possible when student accidents and injuries occur and that parents/guardians are notified as appropriate.

 

B.         General

 

1.   In order to facilitate contact in case of an emergency or accident, parents/guardians shall furnish the principal or designee with the information specified below:

 

a.      Home address and telephone number

 

b.      Parent/guardian’s business address and telephone number

 

c.      Parent/guardian’s cell phone number and email address, if applicable

 

d.      Name, address and telephone number of a relative or friend to whom the student may be released and who is authorized by the parent/guardian to care for the student in cases of emergency or when the parent/guardian cannot be reached

 

e.      Local physician to call in case of an emergency

 

2.   Any person 18 years of age and older who files with the district a completed caregiver’s authorization affidavit for a minor district student shall have the right to consent to or refuse school-related medical care on behalf of the student.  The caregiver’s authorization shall be invalid if the district receives notices that the minor student is no longer living with the caregiver.

 

The caregiver’s consent to medical care shall be superseded by any contravening decision of the parent or other person having legal custody of the student, provided that this contravening decision does not jeopardize the student’s life, health or safety.

 

 

 

 

 

 

 

 

 

 

 

 

 

AUTOMATED EXTERNAL DEFIBRILLATORS

 

A.                  Purpose

 

To provide guidance in the management or administration of a school-based Automated External Defibrillator (AED) program.

 

B.         General

 

1.         Definition:  Sudden Cardiac Arrest (SCA) is a condition that occurs when the electrical impulses of the human heart malfunction causing a disturbance in the heart's electrical rhythm called ventricular fibrillation (VF). This erratic and ineffective electrical heart rhythm causes complete cessation of the heart's normal function of pumping blood, resulting in sudden death. The most effective treatment of this condition is the administration of an electrical current to the heart by a defibrillator, delivered within a short time of the onset of VF.

 

2.         Definition:  Automated External Defibrillator (AED) is used to treat victims who experience Sudden Cardiac Arrest (SCA).  It is only to be applied to victims who are unconscious, without pulse and without signs of circulation and normal breathing. The AED will analyze the heart rhythm and advise the operator if a shockable rhythm is detected. If a shockable rhythm is detected, the AED will charge to the appropriate energy level and deliver a shock or advise the operator to deliver a shock.

 

3.         Notification:  When an automated external defibrillator (AED) is placed in the school, the principal or designee shall ensure that:  (Health and Safety Code 1797.196)

 

a.                  School employees annually receive a brochure which describes the proper use of an AED with contents and style approved by the American Heart Association or American Red Cross,.

 

b.                  The American Heart Association or America Red Cross brochure or similar information is posted next to every AED located on school grounds.

 

c.                  School employees are annually notified of the location of all AED units on school grounds.

 

d.                  Trained employees will be available to respond to an emergency that may involve the use of an AED during normal operating hours or when a school-sponsored activity is occurring on school grounds. 

 

4.                  AED System Coordinators:  The Placentia-Yorba Linda Unified School District’s Program Coordinator is the supervisor of Risk Management.  Each site will designate their Site Program Coordinators.

 

5.         Responsibilities of District Program Coordinator

a.         Collect monthly service reports from each school site where AEDs are located.

b.         Distribute AED information yearly.  (See 3a)

c.         Record and maintain all information relative to the AED training of site personnel.

 

6.         Responsibilities of the Site Program Coordinator

 

a.         Develop a Site Plan for Emergency Response Program (Exhibit A).

 

b.                  Determine placement of the AEDs in a secured location and determine designated trained personnel to be provided AED access keys. The location of the AEDs on the school site must be identified on the CPR/AED Emergency Response Site Plan (Exhibit A). A copy of the Emergency Response Site Plan must be mailed via school mail to the District Program Coordinator.

 

c.         Coordinate AED equipment and accessory maintenance.

 

d.         Select AED Emergency Response Team members (trained personnel).

 

e.         Maintain a file of specifications/technical information sheet for each approved AED model assigned to the school.

 

f.          Coordinate the post‑incident review to evaluate the effectiveness of Site AED Emergency Response.

 

g.         Revision of this procedure as required.

 

7.         Authorized AED Users

 

a.         District employees, including nurses, administrators, coaches, and athletic trainers who have volunteered and have received approved CPR/AED training.

 

b.                  Additional staff as identified by the Site Program Coordinator, such as teachers and office staff, who have volunteered and have received approved CPR/AED training.

 

c.                  Any trained volunteer responder who has successfully completed an approved CPR/AED training program within the last two years with a current successful course completion card.

 

d.                  As stated in the California Civil Code § 1714.21 (b) "A person who has completed a basic CPR and AED use course that complies with regulations adopted by the Emergency Medical Services (EMS) Authority and the standards of the American Heart Association or the American Red Cross for CPR and AED use, and who, in good faith and not for compensation, renders emergency care or treatment by the use of an AED at the scene of an emergency shall not be liable for any civil damages resulting from any acts or omissions in rendering the emergency care."

 

e.                  Any volunteer who, at their discretion provides voluntary assistance to victims of medical emergencies shall do so to the extent appropriate to their training and experience. These responders are encouraged to contribute to emergency response only to the extent they are comfortable. The emergency medical response of these individuals may include CPR, AED use or medical first aid.

 

8.         Location of AEDs

 

a.                  The AED(s) locations designated at each site will allow the device to be easily seen and retrieved by staff outside of normal school hours.

 

b.                  After school hours the AED may be moved from its designated locations by an AED-trained coach(s) or athletic trainer(s) or program director (band, etc.) to support department activities on a voluntary basis. A trained volunteer would have to be available and willing to support this effort during non-school hours. A visible sign must be left in the place of the AED, with the phone number of the coach/athletic trainer/program director, clearly indicating they have possession of the AED.  The unit shall be returned to its normal location prior to the start of the next school day.

 

c.                  Contracted and other community activities are not guaranteed access to the AED as part of standard rental contracts.

 

9.         Approved Equipment:  The Cardiac Science Powerheart G3 Automatic AED has been approved for this program.

 

10.       Additional Equipment:  Each AED will have one set of adult electrodes pre-connected to the device and one spare set of adult and pediatric electrodes with the AED in the carrying case. One ready kit will be connected to the handle of the carrying case. This kit contains two pair latex-free gloves, one razor, one set of trauma sheers, and one facemask barrier device and two pieces of gauze.

 

C.        Procedures

 

1.                   Equipment Maintenance

 

a.                  All equipment and accessories necessary for support of medical emergency response equipment shall be maintained in a state of readiness. 

 

b.                  As described in the California Health and Safety Code § 1797.196: "The defibrillator is maintained and regularly tested according to the operation and maintenance guidelines set forth by the manufacturer, the American Heart Association, and the American Red Cross, and according to any applicable rules and regulations set forth by the governmental authority under the Federal Food and Drug Administration and any other applicable state and federal authority."

 

c.                  The AED Site Program Coordinator or designee shall be responsible for having regular equipment maintenance performed and documented. All maintenance tasks shall be performed according to equipment maintenance procedures as outlined in the operating instructions.

 

2.         Routine Maintenance

 

a.                  The AED performs a self‑diagnostic test every 24 hours that includes a check of battery strength and an evaluation of the internal components.

b.         A staff member, assigned by the AED Site Program Coordinator or designee, performs a monthly AED check following the procedure check list. (Exhibit B)

c.         The procedure checklist is initialed at the completion of the monthly check. The procedure checklist is posted with the AED.

d.                  If the AED is giving either, or both, an audible indication or the visual indicator is red with a black “X” through it, the AED Site Program Coordinator or designee is notified immediately. 

e.         If the expiration date in the electrode or battery is near expiration, the AED Site Program Coordinator or designee is notified immediately.

3.         Internal Procedures following the use of the AED

a.         A Student Injury Report or Employee/Visitor Injury Report form is completed by a responding employee for each incident in which an AED was used.  Exhibit C

b.         An AED Usage Report form Exhibit C is completed for each incident in which an AED was used.  Exhibit D

c.         Restock all necessary AED supplies.

 

d.         Clean AED according to manufacturer's recommendations.

 

4.         External Procedures following the use of the AED

a.         A copy of the AED usage report is presented within 4 hours of the emergency to the following:

·                     supervisor of Risk Manager at the district.

·                     AED Site Program Coordinator

·                     Medical advisor of the AED program – Cardiac Science

·                     Local EMS (Emergency Medical System)

b.         At minimum, event information supplied includes any recorded data, and all electronic files captured by the AED.

5.         Post Event Review

 

Following an emergency response where an AED was used, the Site Program Coordinator reviews, conducts and documents the post‑event review. All key participants in the event participate in the review. Included in the review will be the identification of actions that went well, the collection of opportunities for improvement and suggestions for emotional support. 

 

A Medical Advisor Report must be completed by the District’s Medical Advisor. Exhibit E

 

6.         Use of the AED

 

a.         Assess the scene for safety and activate the AED Emergency Response Site Plan.

 

b.         Determine the responsiveness of the victim. If unresponsive, activate Emergency Medical System (EMS) by calling 911.

 

c.         Give location of the victim and designate a person to wait for EMS to direct them to the victim.

 

d.         Get the AED to the victim.

 

e.         Assess the victim: airway, breathing and circulation.

 

f.          Initiate CPR while the AED is brought to the victim and placed on the victim's left side near the head.

 

g.         CPR/AED trained personnel prepare to use the AED.

 

h.         There in no on/off button. To activate unit, lift lid and follow verbal and text prompts.

 

i.          Apply gloves, especially if blood or body fluids are present.

 

j.          Bare and prepare the chest for AED use.

 

k.                   Attach the defibrillation electrode pads to the victim.  In case of a victim 8 years or younger attach the pediatric defibrillation pads to the AED device.

 

l.                     Follow verbal and text prompts given by the AED. Stop CPR when directed by the AED prompt while the AED analyzes the heart rhythm.

 

m.                If SHOCK is advised, follow the machine prompts for action. Be sure all rescuers are "clear" and no one is touching the victim before shock is delivered (say out loud, "I'm clear, you're clear, everybody is clear"). The Cardiac Science AED is completely automatic.  The machine will act on its own.  After shock is delivered perform CPR.  The AED will continue to monitor the patient's heart rhythm during CPR. Continue to follow the machine's prompts.

 

n.                  If NO SHOCK is advised:

 

·                     If no signs of circulation, continue CPR.

·                     If pulse is present, check breathing.

·                     If victim is not breathing or breathing abnormally, start rescue breathing. AED will continue to analyze the heart rhythm.

 

o.                  Continue cycles of analysis, shocks (if advised) and CPR until EMS arrives. Continue CPR until EMS rescuer tells you to stop. Victim must be transported to the hospital by the EMS. Leave AED attached to the victim; EMS will disconnect the AED.

 

p.         Assist EMS as directed until they take complete charge of the victim. Provide EMS with information about the victim: name, age, any known medical problems and time of incident. Also provide information as to current condition and number of shocks administered.

 

q.         Notify the Site Administrator who will make necessary reports to District Administration.

 

r.          Site Administrator notifies the AED District Program Coordinator about the incident.

 

s.         If victim is a student, notify parent/guardian.  For victims other than students, notify responsible party.

 

D.        Reports Required

 

1.                  Following each incident send completed forms to supervisor of Risk Management.

2.                  Immediately after an event, the responder completes an AED Usage Report Form (Exhibit D) included with this administrative policy. 

 

E.         Record Retention

 

Document in student health record.

 

 F.        Responsible Administrative Unit

 

1.                  Site administrator or designee

2.                  Assistant Superintendent, Executive Services

 

G.     Approved by:

 

         Responsible division head:        Doug Domene                                    1/7/08

         Superintendent:                          Dennis M. Smith, Ed.D.          1/7/08

 

 

Legal Reference:

 

         Education Code

         32040-32044 First Aid equipment

         49300-49307 School safety patrols

         49407 Liability for treatment

         49408 Emergency information

         49409 Athletic events; physicians and surgeons; emergency medical care; immunity

         49470 Medical and hospital services for athletic program

         49471 Medical and hospital services not provided or available

         49472 Medical and hospital services for pupils

         49474 Ambulance services

         51202 Instruction in personal and public health and safety

 

         Health and Safety Code

         1797.196 Automatic external defibrillators, immunity from civil liability

 

         Management Resources:

         Web Sites

         American Heart Association: http://www.americanheart.org

         American Red Cross: http://ww.redcross.org

         California Department of Health Services: http://dhs.ca.gov

 

 

Regulation adopted:  1/7/08

 


                                                                                                                                  Exhibit A

                                                                                                                                                      Page 1 of 2

           

AUTOMATED EXTERNAL DEFIBRILLATOR (AED) PROGRAM

 

CPR/AED Emergency Response Site Plan

 

School Nurse:

           

Date:

School:

           

Phone:

Exact Location of the AED(s):

 

1

 

2

 

3

 

4

 

 

 

CPR/AED Emergency Response Team Members

 

Date of CPR/AED

Certification

Expiration

1

 

 

 

2

 

 

 

3

 

 

 

4

 

 

 

5

 

 

 

6

 

 

 

7

 

 

 

8

 

 

 

9

 

 

 

10

 

 

 

11

 

 

 

12

 

 

 

13

 

 

 

14

 

 

 

15

 

 

 

16

 

 

 

17

 

 

 

Exhibit A (cont.)

Page 2 of 2

 

 

AUTOMATED EXTERNAL DEFIBRILLATOR (AED) PROGRAM

 

CPR/AED Emergency Response Site Plan

 

Incident Commander/Administrator in Charge: 

 

Communications Director:

 

Alternate Communications Director:

 

First Responders (See Previous List):

 

Health Clerk:

 

 

Responsibilities: 

 

1.         Initial First Responder:  Arrives first to victim.  Notifies Incident Commander of current situation.  Provides necessary first aid/CPR until AED and/or emergency health care arrives at scene.  Continues to communicate with Incident Commander.

 

2.         Incident Commander:  Activates Emergency Response Plan.  Notifies Communications Director to call 911 (EMS). Responds to scene.

 

3.         Communications Director:  Receives emergency call from first responder.  Contacts 911 and remains on line until situation has ended.  Communicates throughout emergency with Incident Commander and First Responder.

 

4.         First Responders:  If available, accesses AED and brings AED to victim.  Initiates AED protocol if no other trained personnel has arrived on scene.  Continues to follow prompts until emergency personnel has arrived.

 

5.         Health Clerk or designee:  Collects emergency card and responds to scene with AED.  Initiates AED protocol if no other trained personnel has arrived on scene.  Continues to follow prompts until emergency personnel has arrived.

 

Health Clerk is responsible for documentation of the emergency.

 

·                     The CPR/AED Emergency Response Site Plan must be reviewed and updated annually by the 1st Monday in October each school year. Maintain the original copy of the CPR/AED Response Site Plan at your school site.

 

·                     Annually send a copy of the CPR/AED Response Site Plan to the District Program Coordinator in Risk Management.

 

 

Exhibit B

 

 

 

AUTOMATIC EXTERNAL DEFIBRILLATION (AED) PROGRAM

 

AED Monthly Checklist

 

 

 

Site:

 

Month/Year

 

 

When examining the Cardiac Science Powerheart G3 Automatic AED, check that the visual indicator is green and that no audible signal is present.  If both are the case, the AED machine is in appropriate working order.  A red light with an “X” indicates the AED needs attention.

 

 

Defibrillator Serial #

Status

Corrective Action/Remarks

 

 

 

 

   Green - OK

 

   Red  - Needs Attention

 

 

 

 

 Call Risk Management

            714-985-8776

 

 

 

 

   Green - OK

 

   Red - Needs Attention

 

 

 

 

 Call Risk Management

            714-985-8776

 

 

 

 

   Green - OK

 

   Red - Needs Attention

 

 

 

 

 Call Risk Management

            714-985-8776

 

 

 

 

   Green - OK

 

   Red - Needs Attention

 

 

 

 

 Call Risk Management

            714-985-8776

 

Check performed by:  Print Name:

 

Date:

 

Signature:

 

 

Submit form to AED Site Program Coordinator.
                                                                                                                           Exhibit C           

CONFIDENTIAL SCHOOL ACCIDENT REPORT

CONFIDENTIAL – ATTORNEY/CLIENT WORK PRODUCT PRIVILEGE

This report is to be completed by school district employees.  This form is a confidential,

 internal document:  its contents are not to be shared or copied for any persons

who are not school district employees and/or their legal representatives.

IN CASE OF SERIOUS INJURIES A TELEPHONE REPORT IS TO BE MADE IMMEDIATELY.

 

DATE OF REPORT

 

 

  NOTE:        The school employee either witnessing the accident or supervising at the time should complete and submit this form within 24 hours.

                        Complete all of the highlighted areas and print the completed form. You may print a blank report to complete by typing or using a ballpoint pen.

1. NAME AND ADDRESS OF SCHOOL/SITE

 

NAME OF INJURED PERSON (LAST, FIRST, M.I.)

2.

AGE

 

GRADE

 

TELEPHONE NUMBER OF INJURED PERSON

 

IS INJURED PERSON A MINOR?

 

                  YES               NO

NAME OF PARENT OR LEGAL GUARDIAN

 

ADDRESS OF PERSON INJURED (NUMBER, STREET, CITY, STATE, ZIP CODE)

3.                                                                                                                                                                                                                                                                                                                       

WHERE DID ACCIDENT OCCUR?

4.

DATE (MONTH, DATE, YEAR)

 

TIME

                          A.M.       P.M.

DESCRIBE HOW ACCIDENT OCCURRED (USE FACTS ONLY; EXCLUDE OPINIONS AND/OR ASSUMPTIONS)

5.

 

FIRST AND LAST NAME OF PERSON IN CHARGE AT THE TIME OFACCIDENT

6.

TITLE OF PERSON (TEACHER, VOLUNTEER, ETC.)

 

WAS HE/SHE PRESENT AT THE TIME?

           YES           NO

INJURED VIOLATED SCHOOL RULE?

           YES           NO

7.      

NAME(S) OF WITNESS(ES)

ADDRESS

TELEPHONE NO.

STATUS

(Student, Volunteer, etc.)

 

 

 

 

 

 

 

 

8.

Apparent nature of injury (please check all that apply)

9.

Injured part of body (please check all that apply)

       Abrasion

       Fracture

       Strain/Sprain

       Head

       Finger

       Arm

       Abdomen

       Contusion

       Cut

       Dislocation

       Neck

       Eye

       Leg

       Hand

       Internal

       Concussion

      

       Back

       Chest

       Face

       Foot

       Other (Explain)

 

       Other (Explain)

 

FIRST AID PROCEDURES USED

10.

NAME OF PERSON WHO ADMINISTERED FIRST AID

 

DISPOSITION OF INJURED AFTER ACCIDENT OR CLASS

11.

WHO WAS NOTIFIED?

12.

RELATIONSHIP TO INJURED?

 

WHO NOTIFIED THE PARENT OR GUARDIAN?

IF INJURED STUDENT LEFT SCHOOL TO WHOM RELEASED?

13.

NAME AND ATTITUDE OF ANYONE CONTACTING SCHOOL

14.

STUDENT ACCIDENT BENEFITS AVAILABLE?  NAME OF INSURANCE COMPANY

15.       YES           NO     

REMARKS

16.

REMARKS (CONT’D)

 

For your protection, California law requires the following to appear on the form.  “It is unlawful to: (a) present or cause to be presented any false or fraudulent claim for payment of a loss under a contract of insurance; (b) prepare, make or subscribe any writing with intent to present or use the same, or allow it to be presented or used in support of such claim.  Every person who violates any provision of this section is punishable by imprisonment in the State Prison not exceeding 3 years or by fine not exceeding $1,000 or by both.”

NAME OF PERSON COMPLETING REPORT

17.

STATUS

 

TELEPHONE NUMBER

 

ADDRESS OF PERSON (NUMBER, STREET, CITY, STATE, ZIP CODE)

 

WAS THIS PERSON AN EYE WITNESS?

                   YES           NO

NAME OF PERSON APPROVING REPORT

18.

SIGNATURE OF PERSON APPROVING REPORT

 

DATE SIGNED

 

Submit to:         PYLUSD Risk Management

                        1301 E. Orangethorpe Ave.

Placentia, CA 92870     

(714) 985-8776                                       Alliance of Schools for Cooperative Insurance Programs

12750 Center Court Drive, Suite 205, Cerritos, CA 90703   Phone (563) 403-4640   Fax (562) 403-4644


 

 

Exhibit D

 

AUTOMATIC EXTERNAL DEFIBRILLATION (AED) PROGRAM

AED Usage Report

 

Incident Details:

 

Name of Responder :

 

 

AED Serial #: 

Names of other Employees involved:

 

 

 

Date of Incident:

Approximate Time of

Incident Notification:                                                            Approximate

CPR Started:    Yes     No

By Whom:

Time AED Applied:

 

Time Transfer Started:

 

Ambulance on Scene:

   Yes      No

Patient Transported to:

 

Victim Information:

 

Last Name:

First Name:

Middle Initial:

DOB:

Age:

Gender:

 

Description of Events:

 

 

 

 

 

 

 

Report Completed by:                                                                                     Date:

Print Name:

 

Signature:                                                                    

 

Site Coordinator:

 

        Forward completed AED Usage Report form for the AED used in the incident to AED District Program Coordinator.

 

        Restock supply kit.

 

Exhibit E

 

AUTOMATIC EXTERNAL DEFIBRILLATION (AED) PROGRAM

 

Medical Advisor Report

To be Completed by Medical Advisor

                                                                                                                                                                                           

AED Serial #:

AED Brand/Model:

Victim Name:

Victim Age or Grade:

Incident Date:

Number of Shocks Delivered:

Responder Name:

 

Pre-hospital Outcome:

 

        No Perfusion Change

        Pulse- regained after AED Use

        Other:

 

Internal Events Record Review: 

 

 

 

 

 

 

AED Usage Report Review: 

 

 

 

 

 

 

Recommendations: 

 

 

 

 

 

 

Signature Medical Advisor:

Date:

Signature AED Site Program Coordinator:

Date:

12/20/07