Madison McCarthy Cardiac Care Coalition For Children

The Madison McCarthy Cardiac Care for Children is a not for profit organization that was started in honor of 5 year old, Madison Lee McCarthy. On September 27, 2001, Madison suffered a cardiac arrest while attending kindergarten at Southtowns Catholic School in Lakeview, New York When someone suffers a cardiac arrest and their heart goes into ventricular fibrillation, the only life saving remedy is an automated external defibrillator (AED). In order not to let Madison’s death be in vain, our organization was started. Her death made apparent the serious need for training of school personnel in the recognition and treatment of cardiac emergencies. With extensive media coverage surrounding Madison’s death, community members and local politicians rallied behind the McCarthy family and their cause. Madison helped pass a law requiring all schools in New York State to purchase an AED and become a Public Access Defibrillation (PAD) provider. The bill was passed as an unfunded mandate leaving schools scrambling for funding. There are scores of schools throughout Western New York that need help in generating funds in order to be in compliance with New York State Law. Through the diligent efforts of volunteers and partners in the business community, the Madison McCarthy Cardiac Care Coalition For Children had a remarkable beginning and continues to thrive today. Our organization has raised funds for the implementation of a comprehensive PAD program for over 100 Western New York schools. Each school receives an AED unit and the invaluable American Heart Association or American Red Cross CPR/AED training which when combined will enable school staff members to properly respond to a cardiac emergency. In the 2004 school year, two Western New York lives were saved in a school setting by trained staff members with an AED unit.

We know this program works.

Thank you,

Mike and Suzy McCarthy

Surviving Sudden Cardiac Arrest

 Key Words:

Automated External Defibrillator (A.E.D.)

Cardiopulmonary Resuscitation (C.P.R.)

Emergency Response Team (E.R.T.)

Emergency Response Team Plan (E.R.T. Plan)

Emergency Response Team Drill (E.R.T. Drill)

Public Access Defibrillation (P.A.D.) in Schools

Sudden Cardiac Arrest (S.C.A.)

What is Defibrillation
Defibrillation is the delivery of a specific electrical shock to the heart. This shock stops the uncoordinated electrical activity of the heart, and allows the return of the heart's regular rhythm and pulse. Defibrillation is the only definitive treatment for sudden cardiac arrest, and time is very critical.

Surviving SCA
Surviving SCA is largely dependent on how quickly the patient is defibrillated. For each minute that defibrillation is delayed, the victim's chance of survival decreases by seven to ten percent. The patient suffers irreversible brain damage within 4 to 6 minutes after cardiac arrest. After 10 minutes, few victims of SCA survive. The American Heart Association estimates that an additional 40,000 lives could be saved each year with widespread access to defibrillators.

Overview
Over the last 10 years, advances in technology and design have made defibrillators easy to operate for people with little training. Modern automated external defibrillators (AEDs) are safe, easy to use, effective, and reliable. The defibrillator will only permit a shock to be delivered if a specific, irregular heart rhythm is detected. It will not allow a shock to be delivered if one is not needed. No longer must one sit and wait for help to arrive as precious seconds pass. No longer must one rely on CPR, which can buy time for a sudden cardiac arrest victim, but alone cannot save a life.

Designed for the Layperson
AEDs are simple to use, and designed for rescuers with minimal training. Simple voice and/or text instructions guide the rescuer through the resuscitation.

Safe and Effective
AEDs are designed to permit a shock to be delivered only when needed. The AED quickly analyzes the victim's heart rhythm through adhesive pads placed on the chest and only allows a shock to be delivered when a shockable rhythm is present.

Defibrillation Programs

What is a Defibrillation Program Defibrillation programs bring together defibrillators, planning, training, and support to provide a reliable means of responding to a victim of sudden cardiac arrest within a response time goal.

More Than a Defibrillator
Having a defibrillator is only part of aiding a victim of sudden cardiac arrest. For a defibrillator to be most effective, it needs to be part of a response plan that recognizes an emergency and brings the defibrillator with a trained person to the side of a victim within three to four minutes. A defibrillator that arrives too late, or without a person trained to use it, is of no use at all.

Tips for a Successful Public Access Defibrillation(P.A.D.) in Schools Program  

By Beverly Ann Shipe,NP,

Sweet Home Central School District

P.A.D.Coordinator

Key Words:

Automated External Defibrillator (A.E.D.)

Cardiopulmonary Resuscitation (C.P.R.)

Emergency Response Team (E.R.T.)

Emergency Response Team Plan (E.R.T. Plan)

Emergency Response Team Drill (E.R.T. Drill)

Public Access Defibrillation (P.A.D.) in Schools

Sudden Cardiac Arrest (S.C.A.)

Since New York State public school facilities were required to have on premises at least one Automated External Defibrillator (A.E.D.) effective September 1, 2002, many have successfully accomplished this task. However, there are still districts that are searching for a model to guide them through the process. Perhaps the following suggestions can be a catalyst for those who are in the initial stages of providing A.E.D.s in their facility and establishing a P.A.D. Program.

Automated External Defibrillators (developed in the 1980s), are microcomputers in defibrillators that recognize certain abnormal heart rhythms and provides electric shocks to stimulate the heart to beat normal again. They are simple to use and easy to maintain.Your worksite should have A.E.D.s, but also need to have personnel certified in C.P.R./A.E.D. emergency measures who know how to use them. A.E.D.s should be placed so that they are accessible to school personnel and community members on all shifts.

Both students and adults can experience abnormal heart rhythms that can cause the heart to stop pumping adequately and properly [e.g.Ventricular Fibrillation (VF)]. Electrical impulses become chaotic, often without warning; causing victims to collapse, lose consciousness. Death can follow within 3-7 minutes. Your facility emergency plan should be based on the

Chain of Survival, the four crucial links in emergency treatment of sudden cardiac arrest:

1. Early access to care- calling 911

2. Early C.P.R.- providing limited blood flow to heart ‘buys’ minutes for successful defibrillation

3. Early Defibrillation- using an A.E.D. increases survival rate

4. Early Advanced Care- paramedics providing airway control, drugs  

Genetic Disorders [e.g. Long QT Syndrome (LQTS)], Sudden Death Syndrome, an asthma attack, or Commodio Cordis [hard impact to the chest from a ball or object that stops the heart from beating normally causing fibrillation] all can cause Sudden Cardiac Arrest (S.C.A.) leading to a near death incident or death. The notes below are based on the Sweet Home Central

School District , Amherst , New York Public Access Defibrillation (P.A.D.) in Schools Program. Sweet Home Central started their program before the mandate and currently has 25 A.E.D.s in 13 sites throughout their school district.  

I. Coordinating a P.A.D. Program

Your PAD Program needs support from top down, which means your Superintendent and administration. You need a medical provider for guidance and medical supervision [A.E.D.s are prescription medical devices], along with community support of EMS personnel. And, you need to have an Emergency Response Team and an Emergency Response Team Plan for each building or department site.

• Administration support

• Physician oversight for quality control

• Emergency Medical Services (E.M.S.) Support

• Emergency Response Team (E.R.T.)

• Emergency Response Team Plan

A. Emergency Response Team Plan

Each building/department area should have a plan to execute in the event someone needs medical emergency assistance. The plan should detail and list what needs to be done and who is assigned to completing tasks. All E.R.T. members should be listed in the E.R.T. Plan.

B. All School/Department Area Personnel

• Know identity of E.R.T. members

• Be familiar with E.R.T. Plan

• Know location of [A.E.D.]

• Know location of pocket masks/face masks in the building [they should be in public areas for easy access,    e.g. in gymnasium, cafeteria areas, faculty room]  

 

C. Emergency Response Team [E.R.T.]

All Emergency Response Team members should be identified in Emergency Response Team Plan. There are basically 3 groups:

 

1 Core Team/group- members report to all emergencies.

 

These Emergency Response Team members should:

• Responds immediately to emergency site

• Provides assistance

• Assist nurse or first responder

• Know where medical emergency bag (‘Go Bag’) is located and brings to site

• Brings [A.E.D.] and emergency kit to site

• Begins C.P.R./Applies A.E.D.

2 Support Team/group- members provide assistance)

 

These support team members should:

• Keep the halls clear of traffic

• Keep students away from the emergency area-help execute the ‘Hold in Place’

• Provide coverage to classes of adults reporting to emergency site

• Clear area of furniture from doorway to patient for 911 emergency personnel and equipment

• Meet and escort emergency personnel and parents to site

• Provide crowd control

3 Main Office Team/Personnel- usually the command

center, provides communication to district,community, parents.

These support team members should:

• Execute an ‘All Call’ Public Address announcement of emergency or notify through two-way radios in larger buildings

• Call 911 for emergency medical services

• Notify parent or next of kin

• Notify district administrator(s) of 911 emergency call

• Copy emergency card information for paramedic report and bring to nurse/paramedic(s)

• Provide an ‘all call’ announcement to end/clear ‘Code Blue’ emergency

• Placement/location

• Housing (A.E.D. Cabinet)

• Daily/monthly monitoring

• Third Party monitoring wiring/security

• Phone (near each cabinet)

• Signage

• Communication

• A.E.D. close enough to defibrillate within 3-7 minutes-allows 70- 80% chance of survival

• For every minute of delay, probability of successful defibrillation decreases 2-10%

• Advantage is time

• Cabinets wired to immediate EMS access

• Door pull-weight tab threaded through eye-ring and door handle

• A.E.D.

• A.E.D. wired to third party monitoring system

• Reporting and informational paperwork

• Telephone card- district and community emergency numbers

• Emergency phone if none in immediate vicinity of cabinet

• Other suggested A.E.D. cabinet items

• CPR/AED Guide

• Monthly Inspection/Maintenance Checklist Form

• 2 Automated External Defibrillation (A.E.D.) Incident

• 2 WREMS Quality Improvement postcards (buff colored 4 1/2" X 5 1/2")

• 2 Adult A.E.D. pad sets each in sealed package-(check for current expiration dates)

• 2 Pediatric AED pad sets each in sealed package -(check for current expiration dates)

• 2 One way valve face masks or face shields

• Absorbent Gauze Pads or Hand Towel (for diaphoresis/absorbing water in area)

• Disinfectant disposable pads

• 3 Pair non-latex gloves in a variety of sizes

• Razor or sandpaper (for shaving hair from chest area)

• Trauma scissors

• Black pen and Paper pad

• Daily checks, for example, for LCD panel ‘OK’ on handle for Medtronic LIFEPAK models

• Monthly checks of A.E.D. for checking functions, cabinet items, door alarm, third party monitoring wiring/ function, expiration dates (battery, electrode pads)

• Red pull-weight tab intact

• Cabinet clear of blockages for easy access

• Nearby phone functioning

G. A.E.D./Emergency Signage

• Ceiling/wall hall sign for A.E.D. location

• Info on A.E.D. cabinet door

• Direction to nearest telephone for 911 call [Phone can be next to or in the A.E.D. cabinet or in the local vicinity.]

• Number exit/entrance building doors in and outside for E.M.S. easy access

• Call 911 immediately if A.E.D is used

• Give information about the victim and entry to building

• Emergency personnel will respond when A.E.D is removed

• Nearest telephone: (state location)

• Tampering with emergency medical equipment or reporting a false alarm is a crime and subject to prosecution

• Letters informing community law enforcement, fire and rescue personnel of A.E.D. locations and drill schedule is recommended.

• Communication is crucial- Also telephone calling third party monitoring and local EMS/911 dispatch in planning a drill is key for success. Especially a call just prior to beginning a drill is helpful in clarifying any 911

practice calls.

• Pre-drill practice occurs with all mock patients.

• Parents/spouses love to play to and can be contacted to assist in the drill as if it were a real event.

• The First Responder activates the plan and alerts Main Office Personnel and the Emergency Response Team responds to the unconsciousness/unresponsive person.

• First Responder calls Main Office personnel

• Main Office personnel announces through Public Address System "Code Blue (with location)"

• A ‘Hold in Place’ begins

• Emergency Response Team members report to their assigned areas and implements assigned duties.

• A post critique with the group should always be arranged to review and modify plan.

Schools that received funding for an AED unit and CPR/AED training through the Madison McCarthy Cardiac Care Coalition For Children