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.

It's obviously not a decision that most people want to make using rational reasons (like cost benefit analysis). Maddening, but so much of the world works like that (sigh).

Someone at DC primary school is fund-raising to get an AED . Her choice, if she wants to work hard for it, so be it (not from PTA funds, though, our PTA would struggle very badly to find £1300 + annual maintenance costs, whatever they are, nobody has answered that??).

my considered medical opinion is that a paediatric only defibrillator in a primary school is not going to be of much use.

Especially if there is a paramedic crew 2 minutes away.

My oh was a paramedic. They were put on standby around their patch. They didn't wait around the station for a shout

saggar it depends on the type but you can certainly get paediatric pads to use with adult AEDs. From memory, I think they are licensed from the age 12 months up.

My oh was a paramedic. They were put on standby around their patch.

Ask him how often he successfully defibrillated a child.

I think this thread just proves that many people haven't a clue about how to calculate relative risks.

And again I think the thread is moving towards logic, no doubt someone will pop up in a sec to say yabu yabu yabu what cost a child's life?

Turps - I was thinking the reverse situation - from a personal POV if dd (18) required defib, would a paeds AED be of any use?

Iswym saggar. You'd imagine it couldn't hurt to try but I don't know.

thank you very much Turps and Gasman for posting from your professional perspective, your information has changed my views on this issue.

I actually thought YANBU.

But having read most of the thread I think YABU. It sounds like it's a airly easy but yet very effective piece of equipment which could potentially save a life.

I am also thinking from the information given there could be many children who may benefit - for example a child who has anaphylatic shock heart may stop despite using an epi-pen, a child having an asthma attack can have cardiac arrest. And I know there are often many children with allergies and asthma. (My DS is one of them)

So my answer now is YABU - but I agree more research needs to done be done first.

It's a moot point really isn't it....

The PTA have gone ahead and done it, which presumably means the majority of members of said PTA supported the idea.

Schools in general waste far more money on less worthwhile things.

Quite

Very surprising how Gasman's post several pages back was ignored by just about everyone. Anaesthetists (I'm assuming thats what you are by the user name) are the absolute experts in resuscitation - if I ever have an arrest, the one person I would want there would be an anaesthetist.

Surely a much better use of the PTA money would be to ensure that every member of staff and parent who help out in school is trained in paediatric CPR. Maybe they could even fund some classes for all parents? Now that would be a good use of the money.

Youarekidding, I think you miss the points that have been made about the type of collapses children are more likely to have (respiratory arrests rather than cardiac) and that even if they have a cardiac arrest, a defibrillator wont be of use in most cases.

wotnow - oh believe me that ground has been well covered; we get plenty of head-scratching and she's 'somewhat unusual' is about as good as it gets. It's more a question (for me) of whether a paeds AED is of any use whatsoever to an adult suffering a sudden cardiac event.

From a quick (unscientific) google it would appear that some paeds specific AEDs have ECG analysis specifically designed for children and reduced energy output.

Not sure why I am continuing with this as my opinion seems to be being discounted... But without disclosing too much information, in the last year my place of work had 3 children who collapsed at school, were successfully resuscitated (they all collapsed with VF ie needed defibrillating) and with appropriate treatment were eventually discharged home.

I have acknowledged that it is rare, but it can and does happen. If there is a child in your school with a known cardiac problem fund raise for an AED. They come with paediatric and adult paddles.

folly I think your right. I do admit to not reading the whole thread post by post as was 8 pages long when I joined it.

Just some back-of-fag-packet calculations (apologies if my maths is dodgy ).

According to gasman's figures approx 6.7% of children suffering a cardiac arrest will have a shockable rhythm.

If the incidence of paedeatric cardiac arrest is 3:100,000 then around 0.2 children in 100,000 will have a cardiac arrest that is shockable.

This means that you would need a paedeatric population of around 500,000 to encounter 1 child with a shockable rhythm. (Note: this doesn't mean that this child will survive, just that a defibrillator could potentially save them. It still might not)

Let's assume that the defibrillator will have a normal lifespan of 10, no, I'll be generous, 15 years. The start-up cost is £1800, which works out at £120 a year, plus additional costs of £200 a year giving a grand total of £320.

For the sake of argument this primary school has 300 children. This means that on average, the defibrillator will be used roughly once every 1,666 years.

Therefore the cost involved with defibrillating one child (and let's remember, not necessarily even saving his/her life) will be £533,333.

I'm sure to the family of that putative child that would be worth every single penny, but in healthcare terms there are a LOT of other things you could spend that money on.

Please feel free to pick apart my maths - I aint no mathematician

Stealth have you taken in any of the comments re the ambulance station?