AHA policy on medical emergencies in schools - Clinical Briefs - American Heart Association

Author: Carrie Morantz, Brian Torrey
Date: March 1, 2004

The Emergency Cardiovascular Care Committee of the American Heart Association (AHA) has published a policy statement on medical emergencies in schools. "Response to Cardiac Arrest and Selected Life-Threatening Medical Emergencies: the Medical Emergency Response Plan for Schools" appears in the January 6, 2004 issue of Circulation. The policy statement introduces a public health initiative to help schools prepare to handle life-threatening medical emergencies.

Life-threatening emergencies can occur in any school, at any time. They can be caused by preexisting health problems, violence, injuries, and other unexpected events. They can affect students or the adults who teach and supervise them. At the same time, schools now employ fewer nurses than before, leaving teachers, coaches, and other staff in charge of first aid before the arrival of emergency medical services (EMS) personnel. Yet, in one recent Midwestern survey, one third of teachers had no training in first aid, and almost one half had never completed a course in cardiopulmonary resuscitation (CPR).

The following five key elements are recommended by the AHA for medical emergency response plans in schools:

1. Effective and Efficient Communication Throughout the School Campus. The statement recommends establishing a rapid communication system that links all parts of a school campus, including outdoor facilities and practice fields, to the local EMS system.

2. Coordinated and Practiced Response Plan. Schools are encouraged to develop a response plan applicable to a variety of common medical emergencies. Potential resources for developing a plan include the school nurse, athletic team physicians and trainers, and the local EMS agency. The emergency response plan should be practiced at the beginning of each school year and periodically throughout the year.

3. Risk Reduction. The statement emphasizes injury prevention with appropriate precautions in classrooms and on playgrounds. It suggests identifying students, faculty, and staff members who have medical conditions that might increase their risk of life-threatening emergencies. School personnel should be trained and equipped to respond to the emergency conditions.

4. Training and Equipment for First Aid and CPR. The statement encourages schools to train as many teachers and school personnel as possible in first aid and CPR, and to provide the equipment necessary to respond appropriately to emergencies. It also encourages schools to train all high school students in CPR.

5. Implementation of a Lay-Rescuer Automated External Defibrillator (AED) Program in Schools with an Established Need. AED programs have been shown to improve survival in adults who have cardiac arrest outside of a hospital.

The statement was written to address both the need for school medical emergency planning and questions raised by recent publicity and unfunded legislation requiring schools to acquire an AED. The statement makes the point that schools should not focus on a piece of equipment such as an AED, which only may have the potential to help in a small percentage of occurrences. Rather, schools should focus on more important and more common events through comprehensive school medical emergency planning as outlined in the statement.

Organizations endorsing the AHA statement include the American Academy of Pediatrics, the American College of Emergency Physicians, the American National Red Cross, the National Association of School Nurses, the National Association of State EMS Directors, the National Association of EMS Physicians, and the National Association of Emergency Medical Technicians.

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