Kayla Malecek
5012 Highview Drive SW
Montevideo, MN 56265
(320) 226-3473
February 8, 2005
Dr. Michael McCord
207 Weld Hall
Minnesota State University Moorhead
Moorhead, MN 56563
Dear Dr. McCord:
As an athletic training student from Minnesota State University Moorhead working at Horizon Middle School for my clinical rotation, I recommend considering my proposal for moving the schools automated external defibrillator (AED) from the athletic training room to a more accessible area of the school. In the event of an individual suffering sudden cardiac arrest (SCA) the AED is virtually unattainable for a majority of the day. I can provide Moorhead Independent School District 152 with a complete analysis of the problem and a wide array of appropriate solutions.
I propose to find a more appropriate location for the AED and inform ISD 152 of the immense need for a change in it’s location based on medical research of SCA and AED usage.
I feel this proposal is a phenomenal starting point for my feasibility study. This project is close to my heart and is something I am very passionate about. Working toward my degree in an allied health profession, I am obviously very concerned with human well-being. This is an excellent opportunity to possibly save a life.
Thank you for considering this proposal. Please do not hesitate to contact me if you have any questions or concerns.
Sincerely,
Kayla Malecek
A Proposal to Investigate
AED Necessity and Availability
in Horizon Middle School
February 8, 2005
Prepared for:
Dr. Michael McCord
Director of First-Year English, Department Webmaster
207 Weld Hall
Minnesota State University Moorhead
Moorhead, MN 56563
Submitted by:
Kayla Malecek
5012 Highview Drive SW
Montevideo, MN 56265
(320) 226-3473
Table of Contents
Summary
What is an AED?
An Overview of this Proposal
Automated External Defibrillators Save Lives
Cardiac Chain of Survival
Some Real-Life Examples
A Problem for Many
What the Study Will Do
Possible Solutions to Investigate
Action Plan
Budget
References
Summary
Cardiovascular disease, specifically sudden cardiac arrest, is the most prevalent cause of death in the United States. Though children can suffer SCA, a majority of the victims are adults. Those misfortunate enough to suffer from SCA have little chance of survival if an AED is not readily available and used.
I propose to study the problem of availability of the AED in Horizon Middle School. Through extensive online and published research, along with interviews of medical professionals and HMS staff, I will provide the information that will move the school district to relocate the AED.
What is an AED?
An AED is a device about the size of a laptop computer that analyzes the heart's rhythm for any abnormalities and, if necessary, directs the rescuer to deliver an electrical shock to the victim. This shock, called defibrillation, may help the heart to reestablish an effective rhythm of its own.1
An Overview of this Proposal
Hundreds of thousands of citizens die yearly from SCA. The AED is a vital step in the chain of survival. Currently, the AED at Horizon Middle School is located in the Athletic Training Room, which is open for mere hours each day. In the event of an individual suffering SCA, the AED is not readily available, not to mention that few people know of its current location.
As an athletic training student I am worried by the current situation. I know of the immense importance an AED is to a victim’s survival. Currently on my clinical rotation at Horizon Middle School I am familiar with its facilities and staff members.
I plan to research the criticality of AED use in the event of SCA and why AEDs need to be easily accessible in the event of an emergency.
Automated External Defibrillators Save Lives
The leading cause of death in the United States is cardiovascular disease, which takes the lives of approximately 950,000 of our friends and family members. 250,000 of these victims die from sudden cardiac arrest before they even reach a hospital.2 Evidence suggests as many as 7,000 children die of SCA each year.3
Most often, SCA is caused by an abnormal heart rhythm called ventricular fibrillation (VF) that prevents the heart from pumping blood. The treatment for VF is defibrillation, which is a delivery of an electric shock to the heart that stops VF and allows a normal heart rhythm to resume.2
Cardiac Chain of Survival
Early defibrillation is an important step in the cardiac "Chain of Survival" –a series of four critical steps for resuscitation:
Step 1: Early access to care (calling 9-1-1 or another emergency number)
Step 2: Early CPR
Step 3: Early defibrillation
Step 4: Early advanced medical care
Some Real-Life Examples
To illustrate a few of the endless examples of how AEDs have saved lives, here are some case reports:
Case #1. On September 12, 2003, 10-year-old Zubin Noorani collapsed suddenly at
Pflugerville Middle school due to a heart condition called cardiomyopathy. This is a
disease in which the heart becomes inflamed and cannot function properly, leading to
SCA. The school’s emergency action plan was activated and the school nurse and a
teacher immediately started cardiopulmonary resuscitation (CPR). EMS personnel,
armed with an AED, rushed to the scene and administered a shock to Zubin’s heart
with the defibrillator. Minutes later, Zubin’s pulse returned and his life was saved.4
Case #2. Exercise enthusiast, 76-year-old Bill Cecil of Libertyville, Illinois was
enjoying his 30-minute treadmill workout one day in May 2002. His workout was cut
short when his heart began beating irregularly, causing him to lose consciousness and
collapse to the floor. Immediately, the facilities head of Sports Medicine along with a
physician began CPR. Moments later, an AED was delivered as part of the facilities
emergency plan. After being hooked up, the abnormal rhythm of Cecil’s heart
prompted the AED to request a shock. Three weeks later Cecil was back on the same
treadmill working out, fit as ever.5
Case #3. On January 31, 1998, Mark Vollmar, a 41-year-old off-duty police officer
was driving his car when he suddenly went into cardiac arrest. His 9-year-old son,
unable to remove his father’s foot from the gas, turned of the car’s ignition. As
bystanders observed the car coasting safely to a stop, two off-duty nurses happened
upon the scene and began CPR. A bystander flagged down a police officer who had
just acquired an AED. After three shocks, Mark’s pulse returned.6
A Problem for Many
Unnecessary deaths resulting from sudden cardiac arrest are not only devastating to many, but are, to some extent, preventable. Though there is an AED located in Horizon Middle School’s Athletic Training Room, it is not good enough. It needs to be in a location accessible to the masses anytime during the day. The AED will save no lives if it is locked in a room that nobody can get into. Not only is it possible for any of the students, teachers, or staff at the school to succumb to SCA, it is possible for any of it’s visitors, especially during large athletic or artistic functions. Having a death occur on site would not only hurt the school’s insurance, but would put it in position for a possible lawsuit. Death affects everybody, especially children, and especially when the deceased is a child. If lives and potential in this world can be saved, all possible steps toward doing so should be taken.
Defibrillation is the only effective therapy for ventricular fibrillation. For each minute that passes without CPR and defibrillation, the chance of survival decreases 7% to 10%.2,7 Evidence suggests that the risk of a cardiac event is higher during or immediately following vigorous exercise, such as during a physical education class.3 Nationwide, SCA survival is only about 5%. When AEDs deliver a shock within 3-5 minutes by the first person on the scene, survival rates are as high as 48-74%.2,3
A study of AED use and necessity will show a need to relocate the AED in Horizon Middle School. Benefits may not be immediately noticeable or observable, but when a member of the community collapses of SCA in the school and their life is saved, the benefits will be all too clear. Numerous associations, including the American Heart Association, National Athletic Trainers Association, and the American College of Occupational and Environmental Medicine recommend AEDs be accessible in order for the maximum life saving benefits.
What the Study Will Do
I will conduct AED research in several aspects. Based on published and online information, alongside interviews with local medical professionals I will answer the following questions:
1. Why is an easily accessible AED vital in the event of sudden cardiac arrest?
2. Why would it be beneficial to relocate the AED at Horizon Middle School out of
the Athletic Training Room.
3. What changes made to staff training will maximize AED familiarization?
One might ask why not simply put the AED in a hallway or office. I do not believe this is the appropriate solution. An AED is an expensive piece of life saving equipment that needs to be in a protected area. Finding a balance between protection and availability is what I plan to do with this project. I understand that money is a factor and will find an economically reasonable resolution.
One may object to this proposal since, to date, AED location has not been an issue. Let’s not wait for an unnecessary death to make this an issue. Prevention is the key behind this proposal. If even one life is saved, the money and man-hours put into this project will be paid off.
Possible Solutions to Investigate
1. Relocate current AED
2. Purchase new AED for accessible area
3. Faculty and staff education
Action Plan
What Has Been Done So Far
- I have spoken to Tony Haneca, Certified Athletic Trainer (ATC) at Horizon Middle School and Chris Huot, ATC at Minnesota State University Moorhead.
- I have done web-based research determining the need of a publicly accessible AED.
- As an Athletic Training Student I have knowledge in SCA, CPR, and AED use.
What I Will Do
- I will review published and online literature, including medical literature, to explore the need of AEDs.
- I will examine records of SCA as they relate to AEDs.
- I will consult local ATCs to further explore the problem.
- I will interview a local physician to confirm the need for accessible AEDs.
Action / Projected Completion Date
Interview Horizon Middle School ATC / Feb. 19
Physician Interview / Feb. 19
Additional ATC interviews / Feb. 26
Internet research / Apr. 3
Gather and analyze collected information / Apr. 16
Analyze possible solutions / Apr. 23
Write final report / Apr. 30
Budget
Fully believing in the importance of relocating the Horizon Middle School AED I will not be including a budget in this proposal. Money spent on this project will depend on the action route taken. However, can a price be put on a human life?
References
1 American Red Cross: Health and Safety Services. Accessed online at
redcross.org/services/hss/courses/aed.html#whatisit
2 American Heart Association: Automated External Defibrillation, September, 2004.
Accessed online at
702272%20AED% 20ImplementGuide.pdf.
3 National Athletic Trainers Association: Official Statement – Automated External
Defibrillators. Accessed online at
officialstatement.pdf.
4 American Heart Association, Learn and Live: Every Minute Counts – AED Saves
Pflugerville Student’s Life. Accessed online at
presenter.jhtml?identifier=3015578.
5 Condell Health Network: Saved by an AED. Accessed online at
org/health-information/stories/aed.php.
6 National Center for Early Defibrillation: Angel with an AED. Accessed online at
7 American College of Occupational and Environmental Medicine. Accessed online at