Policy 5.323

Automated External Defibrillators

1. Definitions.-- For purposes of this Policy, the following definitions shall apply:

1. "Automated External Defibrillator" (AED) means, pursuant to Fla. Stat. § 768.1325(2)(b), a computerized lifesaving device that: is commercially distributed as a defibrillation device in accordance with the Federal Food, Drug, and Cosmetic Act; is capable of recognizing the presence or absence of ventricular fibrillation and is capable of determining, without intervention by the user of the device, if defibrillation should be performed; and is capable of delivering an electrical shock to an individual upon determining that defibrillation should be performed. The AED should provide visual and voice instructions for the device operator.

2. "Automated External Defibrillator Response Team" or "AED Response Team" means the individuals at any school or District facility where an AED(s) is located who have been trained to use an AED.

3. "Defibrillation" means the administration of a controlled electrical charge to the heart, from the AED device, to restore a viable cardiac rhythm in cases of ventricular fibrillation or rapid ventricular tachycardia.

4. "Emergency Medical Services System" or "EMS," pursuant to Fla. Stat. § 401.107(3) means an authorized provider of services to prevent or treat a sudden critical illness or injury and to provide emergency medical care and prehospital emergency medical transportation to sick, injured, or otherwise incapacitated persons. Activation of the Emergency Medical Services (EMS) System is normally initiated by calling 911.

5. "Risk Management" and "Safe Schools," mean, respectively, the School District Department of Employee Benefits and Risk Management, and the School District Department of Safe Schools, or the functional successors thereof by whatever name.

6. "Sudden Cardiac Arrest" (SCA) means a significant life-threatening event when a person's heart stops or fails to produce a pulse.

7. "Trained AED User" means, pursuant to Fla. Stat. § 401.2915(1), a person who has obtained appropriate training, to include successful completion of a course in cardiopulmonary resuscitation (CPR), or a basic first aid course that includes CPR, and demonstrated proficiency in the use of an AED. This training should be in accordance with the standards of a nationally-recognized organization such as the American Heart Association or American Red Cross and must meet any applicable requirements of the Florida Department of Health. In addition to training on use of AEDs, it is important for lay responders to be trained on the maintenance and operation of the specific AED model in their facility.

2. Structure of the Automated External Defibrillator Program.-- An AED program is hereby established and shall include the following roles, which have the duties and responsibilities described below.

1. Medical Director.-- The School Board shall authorize the appointment of a medical director for the AED program whose duties and responsibilities shall include, but not be limited to, the following:

1. providing general oversight of the AED program, including working with Safe Schools and Risk Management to establish AED response protocols; to formulate procedures for collecting, recording and filing AED incident reports; and to implement and maintain a training program for personnel along with an online database of employees who are trained AED users;

2. providing medical consultation and expertise regarding AED use;

3. developing and/or approving protocols for the use of AEDs and related medical equipment;

4. acting as a liaison between the AED program sites and EMS;

5. reviewing all incidents involving the use of an AED; and

6. assisting with assuring program compliance with AED response protocols, this Policy, and training procedures.

2. AED Training Coordinator.-- The AED training coordinator shall be a qualified representative from Safe Schools and shall provide system-wide oversight and implementation of a training program designed to instruct personnel (and students of appropriate age) in the use of an AED in response to a sudden cardiac arrest incident. The duties and responsibilities of the AED Training Coordinator shall include, but not be limited to, the following:

1. coordinating training in AED emergency medical care that meets all necessary requirements;

2. ensuring that all AED training is conducted by trainers with the qualifications necessary to instruct AED users to be safe and effective; and

3. maintaining a list of trained AED responders as submitted by the AED Site Coordinators.

3. AED Program Coordinator.-- The AED Program Coordinator shall be a qualified representative from Risk Management and shall manage both system-wide and site-based components of the AED program. The duties and responsibilities of the AED Program Coordinator shall include, but not be limited to, the following:

1. communicating with the Medical Director, AED site coordinators, and AED response team members as necessary and EMS regarding the AED program;

2. participating in case reviews, oversight of responder training and retraining, data collection, and other quality assurance activities;

3. participating in the maintenance of the system-wide AED emergency response plan and procedures;

4. ensuring compliance with this Policy and applicable protocols for the AED program; and

5. assisting with ensuring compliance with applicable regulations regarding AED use.

6. reviewing and approving the site plans before implementation of an AED program at a facility.

4. AED Site Coordinator.-- AED site coordinators shall manage the AED program at facilities having AED response teams. The principal shall designate a school's AED Site Coordinator, who must be an employee with AED, First Aid, and CPR certification; and the principal shall ensure that the designee carries out the duties and responsibilities of the position. These duties and responsibilities include, but are not limited to, the following:

1. developing and maintaining school-based emergency response plans and procedures, based on templates to be obtained from the AED Training Coordinator, and submitting those plans and procedures for pre-approval by the AED Program Coordinator;

2. providing to the AED Program Coordinator the names of AED-trained individuals at the site;

3. assuring the maintenance of AEDs and related response equipment;

4. ensuring site compliance with this Policy and applicable protocols of the AED program;

5. obtaining pre-approval from the AED Program Coordinator regarding placement of an AED and ensuring compliance with applicable state and local regulations pertaining to AED use at the site;

6. training AED response team members in AED maintenance and AED response protocols, including the requirement of Fla. Stat. § 401.2915(3) that any person who uses an AED shall activate the emergency medical services system as soon as possible upon use of the AED;

7. conducting post-event check procedures and completing and submitting a post-incident critique form to the AED Program Coordinator;

8. registering with local emergency medical services medical director, consistent with Fla. Stat. § 401.2915(2), the existence, quantity, type, brand, location, and most-recent placement of each AED device in the facility, within a reasonable period of time after the device is placed; and

9. properly maintaining and testing the AEDs at that facility.

5. AED Response Team Members.-- The responsibilities of AED response team members at a site include, but are not limited to, the following:

1. completing successfully all training and skills evaluations required by this Policy;

2. responding to sudden cardiac arrest (SCA) incidents according to the site procedures and AED response protocol;

3. activating the emergency medical services system as soon as possible upon use of the AED, as required by Fla. Stat. § 401.2915(3); and

4. following this Policy and the guidelines of the AED program and remaining current on all certifications required of the AED program.

3. AED Implementation Principles.-- Consistency and uniformity in the implementation of the AED program is important to its mission of providing lifesaving emergency care to SCA victims at sites. The following principles are designed to promote the consistent and uniform system-wide implementation of the AED program.

1. AED Emergency Response Protocols.-- The Medical Director, AED Program Coordinator, and AED Training Coordinator, in consultation with appropriate members of the emergency medical care community, shall develop emergency response protocols that should be followed by all AED response teams in the event of an sudden cardiac arrest (SCA) incident. The protocols shall be reviewed annually by the Medical Director, AED Program Coordinator, and AED Training Coordinator, and revised as needed. The protocols will address issues pertaining to AED use such as, but not limited to, the following:

1. AED response plan;

2. initial assessment in response to an SCA incident;

3. CPR procedures;

4. AED application;

5. AED defibrillation safety precautions;

6. patient monitoring and EMS system activation through 911;

7. transfer of a patient's care to EMS; and

8. post-incident procedures.

2. AED Training.-- No AED unit will be installed in a school, stadium facility, administrative offices, or other facility until individuals at the facility have received AED training. The training, overseen by the AED Training Coordinator, shall be consistent with, but is not limited to, the following guidelines:

1. a course in cardiopulmonary resuscitation (CPR), or a basic first aid course that includes CPR, and demonstrated proficiency in the use of an AED (which should be in accordance with the standards of a nationally-recognized organization such as the American Heart Association or American Red Cross and must meet any applicable requirements of the Florida Department of Health);

2. instruction on the maintenance and operation of the specific AED model in the trainee's facility; and

3. information on the time period for which training will be valid, along with a recommendation for subsequent renewal. As a general principle, training is not a one-time event; formal refresher training should be conducted at least every two (2) years. Computer-based programs and video teaching materials may permit more frequent review. Advances in techniques and care should be incorporated into the training program. In addition to formal recertification, mock drills and practice sessions are suggested to maintain current knowledge and a reasonable comfort level by lay responders.

3. AED Purchases.-- To insure uniformity in the quality of AEDs installed and used in facilities, all AED unit purchases first must be reviewed by the AED Program Coordinator and AED Training Coordinator to ensure that the units meet necessary specifications.

4. AED Placement.-- Suggested factors to be considered by the AED Program Coordinator/designee in approving placement of AEDs within a facility include:

1. a secure location that prevents or minimizes the potential for tampering, theft, and/or misuse, and precludes access by unauthorized users;

2. an easily accessible position (e.g., placed at a height so those shorter individuals can reach and remove, unobstructed access);

3. a location that is well marked, publicized, and known among trained staff, and periodic "tours" of locations are recommended;

4. a nearby telephone that can be used to call backup, security, or 911; and

5. it is recommended that equipment stored in a manner whereby the removal of the AED automatically notifies security or EMS. If such automatic notification is not practical or feasible, emphasis should be placed on notification procedures and equipment placement in close proximity to a telephone.

5. AED Maintenance.-- All AED equipment must be in good repair and subject to regular maintenance inspections. The AED Program Coordinator, in exercising oversight over AED maintenance, shall take reasonable measures to ensure that:

1. AEDs are used only by those who have completed an approved AED training course;

2. AEDs are maintained and tested according to manufacturer's guidelines;

3. AEDs are installed according to manufacturer's specifications and procedures; and

4. all AED units receive monthly maintenance checks to insure that all equipment is in ready-to-use condition and that the AED battery and a replacement battery are fully operational and ready to use.

4. Disclaimer of Liability.-- Consistent with Fla. Stat. § 768.1325(5) this Policy shall not establish any cause of action.

1. Neither this Policy nor Fla. Stat. §§ or 401.2915 or 768.1325 require that an AED be placed in any building or other location; nor do any of these laws require the School Board to make available on its premises one or more employees or agents trained in the use of the device.

2. As stated in Fla. Stat. § 768.1325(3):

   "Notwithstanding any other provision of law to the contrary, and except as provided in [§ 768.1325](4), any person who uses or attempts to use an automated external defibrillator device on a victim of a perceived medical emergency, without objection of the victim of the perceived medical emergency, is immune from civil liability for any harm resulting from the use or attempted use of such device." Liability shall also be limited in accordance with Fla. Stat. § 768.1325(3)(c)1-2 and § 768.28.

3. Additionally, as acquirers of AEDs, the School Board and its employee and agents shall be immune from liability as provided by Fla. Stat. § 768.1325(3) and as further provided in § 768.28.