Is Your Student Safe?

teacher-running-with-aedThe beginning of another school year means the beginning of school sports including football, soccer, cross country and swimming. All too often, school sports result in injuries to athletes and, in some cases, incidents of sudden cardiac arrest (SCA). Although SCA in athletes makes the headlines, it’s important to know that SCA can happen to anyone including a seemingly healthy child.

Sudden cardiac arrest in a young person usually stems from a structural defect in the heart or a problem with the heart’s electrical circuitry. The most frequent cause, accounting for about 40% of all cases, is hypertrophic cardiomyopathy or HCM.

HCM is a genetic heart condition that affects 1: 500 individuals, including men, women and children of all ages. HCM is characterized by a thickening of the heart muscle and can lead to sudden cardiac arrest.

sca incidenceApproximately 50% of individuals with HCM experience no symptoms, and don’t even know they have the condition, until tragically, sudden cardiac arrest occurs.  In 9:10 cases the outcome is fatal, resulting in unimaginable grief for families and fellow students.  Yet better outcomes can be achieved with early electrical stimulation of the heart – delivered by a small, fully automated, easy to use box.

Given that educational institutions house more than 20% of the American population every day, you’d think they would be fully prepared for this eventually. But sadly, they are not.

At the time of writing, only 19: 50 states in the U.S. require that at least some of their schools have automated external defibrillators [AED’s].  In some states, AEDs are required in public, but not private schools. In other states, AEDs are required in high schools, but not elementary schools. Some states require AEDs only in schools offering athletics. Only two states – Hawaii and Oregon – require AEDs in colleges.

To find out whether your state requires AEDs in schools, click here to view an interactive map.

Chain of Survival full sizeAlthough schools and colleges are ideal and obvious locations for AED deployment, concerns regarding legal liability and litigation have been perceived as a barrier to purchasing and deploying AEDs.  Fortunately this is slowly changing.  Recognition of the need to protect youth from sudden cardiac arrest is gaining momentum in many states:

In Pennsylvania, Sen. Andrew Dinniman has sponsored Senate Bill 606, Aidan’s Law, named for Aidan Silva, a seven-year-old Chester County resident who succumbed to SCA in September 2010.  Aidan had no symptoms of a heart condition prior to his death. Aidan’s Law will help ensure that every public school in Pennsylvania has an AED that is up to date and ready to use.

Rep. Connie Pillich, of Cincinnati, has introduced a bill focused on SCA in student athletes. House Bill 180 requires the Ohio Department of Health and the Ohio Department of Education to jointly develop guidelines and materials to educate students, parents and coaches about SCA. The measure bans a student from participating in a school-sponsored athletic activity until the student submits a signed form acknowledging receipt of the guidelines and materials created by the health and education departments. Individuals would not be allowed to coach a school-sponsored athletic activity unless the individual has completed, within the previous year, a sudden cardiac arrest training course approved by the health department.

John Ellsessar, whose son Michael died during an Oxford High School football game in 2010 from cardiac arrest, believes automated external defibrillators should be as readily available at school settings as fire extinguishers.

Ellsessar, is pushing for legislation to require all schools to have defibrillators, said he and his wife were horrified when they learned that at most schools that have the medical devices, but they are locked away in nurses’ offices, instead of being ready for emergencies.

CPR-AED-lgAnd in Rhode Island, high school seniors will be required to be trained in CPR and the use of a defibrillator before they can graduate. Under the legislation signed into law by Gov. Lincoln Chafee, students will receive training that includes a hands-on course in cardiopulmonary resuscitation and an overview of the use of an AED.

The National Parent Teacher Association has also adopted a resolution calling for public schools to develop emergency response plans that include summoning help, performing CPR and using automated external defibrillators to save lives. The PTA also called for ongoing CPR-AED training in schools and legislation that would fund placement of AEDs in every school, while providing immunity for people who use the lifesaving devices in good faith.

To learn more about sudden cardiac arrest and how you can help please visit http://www.sca-aware.org

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I Spy an AED

SRxA’s Word on Health loves a good challenge – and they don’t come much better than this.  A group of researchers from the University of Pennsylvania are set to save lives with cell phone cameras… and they need help.

The MyHeartMap Challenge, will be a month-long contest starting in mid January. It will invite Philadelphians to the streets and social media sites to locate as many automated external defibrillators (AEDs) as they can. AEDs are lifesaving devices used to deliver a controlled electric shock and restore normal cardiac rhythm following a heart attack.  AED’s are widely used in hospitals and by pre-hospital providers such as EMT’s; but they can also be used by people with no medical training since they provide audio instructions that talk users through the process of performing CPR and defibrillation.

There’s an estimated one million AEDs across the nation. Some are hung clearly on the walls in airports and casinos, but others are tucked away in restaurant closets and under cash registers in coffee shops. Since  AEDs are not subject to regulations that would allow their makers to know where or when their devices are being used there’s currently no uniform system to track their location.

The contest hopes to change that.  Furthermore, it’s just a first step in what the Penn team hopes will grow to become a nationwide AED registry project that will put the lifesaving devices in the hands of anyone, anywhere, anytime.

Armed with a free app on their mobile phones, contest participants will snap pictures of the lifesaving devices wherever they find them in public places around the city. Contestants will then use the app to geotag the photos with their location and details about the device and send them to the research team via the app itself or the project’s web site.

The data collected will be used to create an updated app linking locations of all public AEDs in the city with a person’s GPS coordinates to help them locate the nearest AED during an emergency.

Better still – the person or team who finds the most AEDs during the contest will win $10,000. Additionally, people who find various pre-located “golden AEDs” around the city will win $50.

More and more, scientists are learning that we can benefit from the wisdom of the crowd,” says MyHeartMap Challenge leader Raina Merchant, MD, Assistant Professor of Emergency Medicine. “Participation from ordinary citizens will allow us to answer questions and make the city safer than our team could ever do on its own.”

MyHeartMap Challenge participants can register as individuals or teams, and the Penn researchers suggest participants develop creative ways to maximize their chances of winning. If, for instance, a team can figure out how to use their social networks via Twitter and Facebook to engage people who work in public locations in Philadelphia to take photos of AEDs, the team could win $10,000 dollars without even leaving their desks. These “virtual teams” could prove to be faster and more efficient than any individual working alone. Participants can also organize AED scavenger hunts or mini-contests to locate all the AEDs in a workplace building, or compete against friends to see who can find the most devices. The researchers encourage participants to start strategizing and forming teams now so they can be first out of the gate to win.

What are you waiting for?

Emergency Epinephrine Act

SRxA’s Word on Health is pleased to start the week with some good news.  Last Friday a new federal bill known as the School Access to Emergency Epinephrine Act was introduced in the Senate.  The Bill encourages schools to prevent allergy-related deaths by allowing trained, qualified staff to give an injection of epinephrine to a student suffering from a severe allergic reaction.

The tragic deaths of teenagers in Georgia and Illinois, who did not have immediate access to epinephrine, underscores the importance of immediate treatment and the passage of this legislation. One, a 13-year-old student from Albany Park, IL who had previously suffered from only minor allergies died at her school because of a severe allergic reaction.

Following this, Illinois passed a law that allowed school nurses to administer epinephrine shots to any student suffering from a severe allergic reaction. The new legislation proposed by Illinois Senators Mark Kirk and Dick Durbin would expand the law by allowing all trained and authorized school personnel — not just school nurses — to administer the shot.

U.S. Senator Mark Kirk (R-IL) said, “For the millions of children suffering from serious, potentially fatal allergies, the safe and expedient administration of epinephrine can mean the difference between life and death. Something as seemingly harmless as a bee sting during recess or a peanut butter and jelly sandwich during lunch can quickly become a tragedy.”

For about 1 in every 13 children, school lunchtime or a classmate’s school birthday party can risk exposure to foods that can cause a severe and life-threatening reaction. For these children, the consequences of exposure to the wrong food can be fatal.  However, if epinephrine is available such consequences are preventable.

The legislation would reward states that require schools to maintain a supply of epinephrine auto-injectors, such as EpiPen, and train authorized school personnel to administer an epinephrine injection if a student experiences an anaphylactic reaction. The bill also contains a provision that requires those states to have Good Samaritan laws in place to protect school employees who administer an epinephrine injector to any student believed to be experiencing anaphylaxis.

Although students with severe allergies are allowed to self-administer epinephrine if they have a serious allergic reaction, a quarter of anaphylaxis cases at schools involve young people with no previous allergy who are unlikely to carry a personal epinephrine injector.

Attorney General Lisa Madigan applauded Durbin and Kirk on their push for federal legislation. “Growing numbers of children suffer from life-threatening food allergies,” Madigan said. “In Illinois, we were able to eliminate bureaucratic barriers that previously prevented schools from acting when a child could be suffering from a severe allergic reaction but whose medical records didn’t reflect an allergy diagnosis.”

Word on Health also applauds the introduction of a law that could save children’s lives and raise awareness that in anaphylaxis every second counts. We also hope it will stimulate a wider dialog that could eventually lead to epinephrine autoinjectors becoming available in airports and on airplanes, in restaurants, sports stadiums and other public places…much as automated external defibrillators (AED’s) are today.