School AED programs that work in the real world: you can start your own AED program. Just follow the lead of these people who've done it - leading by example

School Administrator, Oct, 2003 by Keith Griffiths

Where's the safest place in the U.S. to suffer a sudden cardiac arrest? It could be Everett (Wash.) High School, with five AEDs strategically located about the campus and more than 800 trained, motivated responders nearby. Nearly all teachers, staff and the entire student body have learned CPR and AED use.

What's the magic formula for creating success in school AED programs like the one in Everett? Advocates point to a variety of factors, but one theme clearly emerges: collaboration. "It's a triad with the schools, the families and the community organizations," says Cheryl Drewel, former health coordinator for the Everett School District.

Three years ago, Drewel faced the challenge of implementing new state school standards requiring students to "acquire the knowledge and skills necessary to maintain a healthy life: recognize patterns of growth and development, reduce health risks and live safely." When members of the Everett Fire Department, including Deputy Chief Jack Robinson, expressed interest in helping, she gladly invited them to a brainstorming session. "I went in thinking they'd recommend teaching the Heimlich maneuver to fifth-graders," she says. By the time they were done, they had outlined a bold plan to make AED implementation and training an integral part of the school health curriculum.

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Three years after that initial outreach, 9,000 Everett district students have gone through the required program, which consists of three 50-minute sessions, including CPR and AED training. (The class is taught in middle school and again in high school.) In addition to the five at Everett High School, 10 AEDs have been placed in other district schools.

Connie Carmany is the AED coordinator for P.A.D.S (Public Access Defibrillation in Schools) of Lorain County, Ohio. She faces the challenge of implementing AED programs in 21 school districts. She agrees that partnering is critical: "You need to have a cross-section of the medical, public health, education and public safety communities." Contact the superintendents, athletic directors, school nurses and other key people in each district early on, she says, and be clear on your goals. A needs-assessment survey can provide baseline information and an opening for education.

"Find an individual champion in each school district, someone who understands the importance of the issue and who will carry it through," she suggests. "By far the easier way is to start with a single district, but if you have the energy and organizational ability, I think it's great to organize on a county basis. That way you can share information between districts-grant sources, ideas and proposals."

Training

In Everett, firefighters provide training at no cost through the Medic One Foundation, the non-profit educational arm of the fire department. (Donations offset the cost to the Foundation.) Drewel sees great advantage with using uniformed emergency responders for training. "There's something magical when you see an emergency medical technician down there on the floor with a student," she says.

Other programs have found it cost-effective to use staff members as trainers. Sandi Clark, R.N., is the district nurse coordinator for Warren County Public School District in Bowling Green, Kentucky, where there are 21 defibrillators in 18 Schools. Clark and several aides became certified trainers so they in turn could train nearly 240 coaches and staffers. "They were initially apprehensive--can we do this?--until they went through the program and found out how easy it was," she says.

That's the same experience they had in Broward County, Florida, says Jerry Graziose, director of safety for schools there. The county is nationally recognized for its community AED program. The school board budgeted to provide an AED to any school that had a minimum of two CPR/AED trained staff members. Thus far, with 104 defibrillators deployed, nearly 50 percent of schools have taken advantage of the program. "Once they began the training," Graziose says, "they could see for themselves that the devices were really foolproof."

Liability and Funding

"Aren't you opening yourself up to lawsuits if you accidentally hurt someone?" risk managers sometimes ask when they first hear about AED programs. To Carmany, liability is a question to be answered, not a real obstacle. "Once you explain the issues," she says, "people quickly understand that there's more risk associated with not having an AED program." In Broward County, the risk managers who initially questioned the wisdom of the community program are now some of its most ardent backers.

Funding is the other major issue. Says Carol Whitehead, Everett superintendent of schools: "Our number-one priority is health and safety. Parents expect that their most precious possession is OK at school. In tight financial times you simply need to look for other ways to make sure that your priorities are met--I don't believe AED programs should move down on the priority list just because there is no money in the budget." Eventually, schools will budget for AEDs as they do fire extinguishers and other safety equipment, says Everett High School Principal Pat Sullivan. In the meantime, "you have to rustle up resources to get things started." In Everett, donations have paid for the devices.