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The 2015 Wellness Promotion Policy Annual Report
The School District of Palm Beach County, Florida
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Risk Management - Automatic External Defibrillators (AEDs)

Over the past nine years the District has distributed and maintained Automatic External Defibrillators (AEDs) in each school site and in most facilities. During that time rescuers used the AEDs to save six adults and three students’ lives. Some of the adults were District employees however several were members of the general public that were on campus for a variety of reasons.

History

In 2004 the School Board approved the funding for the purchase an AED for each school site. In conjunction with this funding, they developed an AED policy that governed the use, maintenance and training requirements for AED use in the District.

Shortly thereafter the Health Services Specialist in collaboration with Risk Management reviewed the Board’s policy and initiated a program that would assist schools to become compliant with the policy. Compliance involved working with schools to designate AED site coordinators and develop and implement training for the AED site coordinators and emergency response teams. This was completed in the years 2006, 2007, and 2008.

Annually, Risk Management reevaluates the status of the current program to reflect changes in Florida’s laws and industry standards. As a result, it was determined that the number AEDs at each location was inadequate and did not meet the American Heart Association’s three minute recommendation. This recommendation states that a responder has three minutes to retrieve the AED and begin cardio-pulmonary resuscitation to afford successful results.

Safety Technicians from Risk Management and Facility Coordinators spent the next year evaluating each of the District’s 185 campuses and determined the need for hundreds of additional AEDs. Based on the evaluations conducted during the previous year it was determined in 2006 that the District would need 600 additional AEDs to meet current standards. The School Board approved the additional funding and the District purchased 600 Cardiac Science AEDs.

The increase of AEDs raised concerns in Risk Management about making sure they were properly maintained. An online program, AED Tracking Program (Database), developed by the District’s IT Department provides a system for tracking AED locations at each school as well as the status of its equipment. This has become an invaluable resource as both AED manufacturers have had several software updates during the past few years. The AED Tracking Program made it easy for District and manufacturer’s representatives to ensure that all AEDs were maintained in a state of readiness.

Impact
As stated earlier, District AEDs have saved eight lives. The people saved range in age from 15 – 72.

On April 15, 2009, a District AED helped save Claire Dunlap’s life. At that time, Claire was a 15 year old sophomore varsity softball player for the American Heritage-Delray Stallions. The Stallions had just finished a 5 – 4 win against West Boca Raton Community High and were huddled together after the win. Claire collapsed in the huddle and appeared to be having a seizure. Sarah Donner the trainer for West Boca Raton Community High at the time, came to Claire’s aide, assessed the situation and began to do CPR. Two paramedics were watching another game on a nearby field and came over to assist. One determined that she was in sudden cardiac arrest and that the CPR was not working. He told the trainer to get an AED and she retrieved one from a nearby golf cart. The paramedics put the pads on Claire and it delivered three shocks. The third shock put Claire’s heart back into rhythm.

Claire spent some time in the hospital undergoing a variety of tests and surgery. She emerged eleven days later with an implantable cardioverter defibrillator (ICD) in her chest. An ICD is a small battery operated device that is “implanted in patients who are at risk of sudden cardiac death due to ventricular fibrillation and ventricular tachycardia. The device is programmed to detect cardiac arrhythmia and correct it by delivering a brief electrical impulse to the heart.” Claire said she returned to high school and played softball her junior and senior years with no further incidents. However, since entering the University of Florida (UF) in 2011 the ICD has gone off 3 times, once in 2011, and again in 2012 and 2013.

Last fall, Claire entered her senior year at UF. She would like to become a manufacturer’s representative for an AED company like Physio Control (formerly Medtronic). Claire noted that she would really like to work with children that are recovering from sudden cardiac events.

The AEDs used throughout the District have a life expectancy of 8 - 10 years. As a result, in the past few years Safety Technicians and AED Coordinators started noticing that the Charge Paks for the Medtronic AEDs were only lasting 5 - 6 months vs. the 18 months designated by the expiration date. Our first suspicion was that this was a manufacturer’s defect. However, research has indicated that the reason for the premature expiration of the Charge-Paks is the aging components in the AEDs. In order to maintain an adequate charge the components are drawing additional power from the Charge Paks. This is causing the Charge Paks to last only a few months vs. the normal 16 - 18 months.

The manufacturer has indicated that this is not something that can be repaired. AEDs unfortunately are like any other electronic piece of equipment -- eventually they need to be replaced. Being that this is lifesaving technology, the Risk & Benefits Management Department is recommending that the aging AEDs be replaced over the next five years. Cost of replacement is approximately $1,000 per unit and we have 800 units. There is some potential trade in value for the old AEDs so the eventual cost may be less at the time a purchase agreement is negotiated.

To this end the Risk & Safety Department was able to procure a $5,000 grant from the Boca Rio Foundation, a philanthropic arm of the Boca Rio Golf Club in Boca Raton, Florida. This money was used to purchase and replace the aging defibrillators in Boca Raton Elementary (2 AEDs) and Hammock Point Elementary (3 AEDs).

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