AIBU to disagree with PTA buying defibrillator for primary school?

[Babylon1]

That's it really.

I'm on the governing body at local primary school and the PTA have decided they are going to purchase a defibrillator for the first aid kit.

This is really down to one member of the PTA having suffered a terrible loss due to congenital heart defect which was undiagnosed in a child. NOT a child at this school I hasten to add.

Now, as a governing body, we have a wish list of what we would ideally like the PTA to help purchase, and at the moment we are prioritising interactive whiteboards, a new reading scheme and some new phonics materials - resources that will be used EVERY day by the pupils.

The PTA are insistent in buying the defibrillator ASAP, and I am equally insistent that we neither want/need it for the following reasons:

1. The likelihood of it EVER being used is hopefully very very slim

1. There is an ambulance station with trained medics less than 5 mins away at normal driving pace. On blues and twos an ambulance would/could be present inside of two mins.

1. There has been no consultation with staff, yet 5 of them would be expected to be happy to be trained to administer the defibrillator if it

was required.

1. There has been no consultation with parents to ascertain if they would be happy for their DCs to be defibrillated at school by a non-professional medic (I certainly wouldn't be)

Before I would be in the slightest happy about this, I want a demo from the company providing the equipment on how easy it is to use, bearing in mind it is a paediatric defibrillator.

I want to know who will make the decision that the defibrillator is required - ie who is going to diagnose the child with a failing heart?

What happens if/when it goes wrong? Will the administrator of the defibrillator be held responsible?

So am I being unreasonable?? Really appreciate your thoughts here as I need to feed back to governors at next meeting.

so if theyre extremely rare, is it cost effectve?
What about preventtive services, as I mentioend? What about sports equipment to prevent obesity? What about safety equipemtn to prevent accidnets?

well stealth, your local tescos, leasure centre, theme parks, large event centres, family fun outing places etc most likely all think they're worth having..

stealth do you watch the news?

footballers and rugby players can have heart attacks too, it's not just a weight related issue?

YANBU. The survival rate for out-of-hospital cardiac arrests has remained stubbornly at 7% for the last 30 years, despite the spread of defibrillators to shopping centres etc.

There are 3 types of cardiac arrest, two of which cannot be treated with defibrillation. Defibrillation only really works for brief disturbances in the electrical conduction of the heart.

Most people who have cardiac arrests in the community have them because the blood supply to their heart is blocked (a myocardial infarction/heart attack) or because they have had another catastrophic event such as a massive PE. You will not resuscitate these people with a defibrillator. (Defibrillation can work for the electrical disturbances that follow a heart attack but, if you have had a big enough heart attack to drop dead in the community, it is v unlikely to get you back).

People who want to raise money for defibrillators have been watching too much Casualty. They seem like a sexy bit of kit - who wouldn't want to reverse death? But sadly it's not that simple.

You are far more likely to save lives by investing the money in really good first aid training.

Turps (GP and ex-A&E doctor)

really? that is interesting (not disagreeing just interested in the difference in figures)

ALS teachers at 2 hospitals I've worked in told me it was 3% about 10 years ago (for outcome after 3 months) and is now a lot higher (again for outcome after 3 months not initial success) I wonder if its that the initial sucess rate is similar but longer term it's different? as in the ones tha ARE revived do better?

PS Defibrillation virtually never works for children because they have cardiac arrests for different reasons from adults and those reasons cannot be reversed with defibrillation.

I have had the misfortune to attend many children's cardiac arrests in A&E. Never once in 8 years did we have an arrest that could be defibrillated.

You are absolutely right that it would be particularly pointless if an ambulance can be on site in 2 minutes. Trust me, if you have never used a defibrillator before, it would take you longer than that to set it up.

Feel free to PM me if you need more info - you are right, they are wrong

Please listen to gasman & turps! It's not all like the telly.

My husband who has been trained in defibrillation (999 police), has just said that he was told on his training course that defibrillation machines in shopping centres etc were as much there to reassure the family of someone suffering a cardiac arrest that staff/people were trying to help/do something positive.

monkeymoma - see paper in New England Journal of Medicine last year [NEJM 2011; 365]. Overall survival figures vary by study depending on what you count as survival (how long? neurologically intact?) but there is no evidence that they are improving for out-of-hospital arrest. Indeed, a study in the JAMA earlier this year suggested that out-of-hospital adrenaline actually worsened outcomes, so maybe ambulances should go back to scooping & running?

Monkey: oh yes, "basic" sorry my bad, but I do disagree I think a good technique would be just as effective as when you shock someone you are already doing BLS, you stop briefly to assess whether they are shockable, then ypu woukd recommence CPR if not shockable or not responsive. - what I am trying to say is that you'd hope the people doing the CPR would be damn good at what they were doing. Also children's bodies are so good at compensating ? don't really want to write the rest but I'm sure you know what I mean.

Wow. Lots of x-posts really took too long to type out my reply!

I would have assumed that the overall decision lies with the Headteacher. They are the ones that normally ask for items for the PTA to purchase and normally sit in on the PTA meetings.

What has the headteacher suggested about this, at the end of the day they are responsible for the day to day running on the school and staff i.e. who gets trained on courses and in general take overall responsibility.

workshy Fri 01-Jun-12 21:04:13
stealth do you watch the news?

footballers and rugby players can have heart attacks too, it's not just a weight related issue?

I do realise that. Heart attacks are not the only cause of mortality. Diabetes, cancer, related to obesity. And that's only mortality. If we include morbidity, then the picture looks even more grim.

Add message | Report | Message poster monkeymoma Fri 01-Jun-12 21:00:59
well stealth, your local tescos, leasure centre, theme parks, large event centres, family fun outing places etc most likely all think they're worth having..

Yes but they have a lot of adults through. Teh ones the PTA are getting are for children only. Im questioning the likelihood of them being needed for a child.

Plus a really good first aid course could teach them to correctly manage as well burns, bites, choking, fractures etc. which are more likely to happen in a playground. That's my price anyway. Off to bed

This thread is really frustrating me. In 12 years of working in acute specialties including almost 5 years in exclusive paediatric practice (during which I covered children's cardiac icu) I have only defibrillated one child.

Children having cardiac arrests are rare. Those who have them in the community rarer still. Those who would benefit from a defibrillator even rarer still especially in the primary school age group.

If a paeds only model is being bought quite frankly I think it is a waste of money and pandering to the fears of a group of not-quite educated enough Mummies.

I would much rather my children's school had new reading books or some posh white boards at least they would be used.

For those who haven't got it yet I'm an Anaesthetist specializing in pediatric practice.

Oh flipping eck what did I start

Sorry to all those frustrated by this thread, but there is some really good, useful information coming through.

Babylon - really it's a good discussion to have

From my POV a defib is worth having in the community but school isn't the best place to have it and a paeds version (if such a thing exists) isn't going to be made best use of. YANBU in asking the question.

a very frustrating thread :o Still, I ahve discovered many people will happily fund a paramedic to be on guard full time at their child's school - if it saves just one life it will be worth it
Oh and that yabu to even ask a question about soething like this

x post saggar - not directed at you

And raising awareness is always a good thing. As is learning to do effective CPR.

I know Stealth - I think we're generally singing from the same hymn sheet so to speak.

Stealth you put your point across very poorly, asking silly pendantic questions.

ALSO, Anyone who has said 'good technique' of CPR is better/same as a defib is wrong. CPR just basically helps get oxygen to the person. It's not like films were they miraculously wake up. A few of my course teachers said in the event of having to administer CPR in public, people may expect you to perform miracles, it's true.

Also stealth, let's compare the point you have made

You saying that if people want a defib why not get a full time paramedic

Is like saying:

If people want a burglar alarm why not get a full time policeman.

How much of a paramedic would you get for £1000?

That was also a point I was going to make