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.

If the defib (sorry can't spell) was suitable for adults AND children, you need to add on all the adults who work at the school, Daisy, say 70 full-time equivalents (reality is 50 FT & 40 PT, of course). Plus visiting parents, inspectors, volunteers, which might add up to the equivalent of another 20 FT people.

Not allowing for weekend use (like our school hall doubles as a church hall on Sundays & is rented for evening classes, too). Suppose that's another equivalent of 10 FT adults + another 10 FT children.

Allowing for the fact that the premises are shut almost completely 8 weeks/yr, and the children themselves are only onsite 7 hours/day max.

Even with those complications I'm sure it's STILL not cost-effective, but since I am not following your maths, do you want to run them thru again, allowing for say... being available to treat 110 working-age adults, for 40x40 hours/yr?

I can't Adventures without the figures for incidence of cardiac arrest for adults and the proportion of those with shockable rhythms, and I don't know these off the top of my head (BTW, how many schools of 300 pupils has 70 FTE staff?! Ours certainly doesn't!)

I do think the cost:benefit profile is going to be significantly better for adults, which is why they are frequently found in public places as somebody up the thread pointed out. Presumably though, the whole point of the PTA fundraising it is because they want it to benefit their children - if they went for a combined paed/adult AED they need to know that it is far more likely that one of the teachers will benefit

Did anyone see my link further up the thread? It sort of got lost as fast moving thread. LINK TO MNETTERS DD

Sorry, eejit moment, maybe more like 30 FTE staff?
I was presuming the other numbers you needed were buried upthread!

Problem is we need cardiac arrest + shockable rhythm numbers for healhty working age population; gotta exclude people too old or ill to work.

This makes for fascinating reading, basically AEDs would have helped 75% of cardiac arrest incidents in about 1980, but are down to being useful in less than 50% of incidence now (& further decline is expected, OECD country data).

I put in some numbers here, for a 35yo smoking elevated cholesterol elevated untreated blood pressure female, and came up with a 4% of cardiac arrest in next 10 yrs (0.4% per yr).

But the adults in our hypothetical school are only onsite for 40 weeks x40 hours per year, or 18.3% of the time in a year.

If we said that 50% of adult cardiac arrest is vfib (shockable) & allow for 50 FTE people (30 FTE staff + 20 FTE other adults) with a 0.4% annual risk of such kind of cardiac arrest (so 0.2% chance of relevant type of cardiac arrest), is that enough for back of fag packet calculations, Daisy, just to find benefits to adults?

Small children fussing on my lap so I've probably got something very wrong there. I'm coming up with 1.83% chance that the defib would be useful each year for those 50 adults. Assuming that anyone has the presence of mind to get it, use it, and it's not locked up. After 15 years there's still a 72.5% chance that it won't have been any use at all to the adults.

Adventures with voles it is for children only

Mrsdv, yes, and the ramifications of an ambulance not being there in minutes are huge, but this is only one of the conditions which would need the ambulance. And probably not even the most likely. And for the majority of the time when children aren't in school, what do the parents do then? I believe they rely on the fact that such an event is comparatively rare!

But you are involving the ambulance station in the arguement and it's irrelevant.
It forms part of your reason not to have the equipment.

I did but I have accepted o am wrong on that - only point remains that if youbcant rely on an ambulance living next door to the station then that has implications for more than just rare conditions in children.

That doesn't make any sense. An ambulance station is not designed to serve just its neighbours.
It is a building that houses ambulances that serve the whole area.
It's not a failure of service. If they were always available to people 5 mins away they would be feck all use to the rest of us.

This has been an interesting discussion: initially I was against the idea for all the reasons/concerns that the OP outlined - but I've come to see that a case could be made for getting an AED.

However there are two important caveats:

1. That is suitable for use for both adults and children (if I've understood the discussion correctly, that is possible, with just the need to choose adult or child pads as appropriate

and

1. and most importantly the support of the school staff. They have to be prepared - no, have to want to use it should the occasion arise and to ensure that it is maintained. If they are too scared or apprehensive to do so, it would just be an expensive piece of scrap equipment plus added anguish if the worst were to happen and its services were required and it couldn't be used :(

I'm not saying they are. Don't think I'm explaining myself clearly. Ambulances cannot, apparently be relied on to get there within 10 mins. We've established that. School has a child defib. Brilliant. Is no one else nervous about all the times the children aren't at school, or all the conditions that don't respond to a defib - many of which will be more prevalent than the heart conditions that respond to a defib.

AnyoneForTurps - I have worked in the HCI, and this is exactly the reason why I say they are a good thing and a must for any public building!

It's exactly the same as the burglar alarm. It's there just in case isn't it? And we aren't just talking about children in this building. There's teachers and visitors too.

It's not just heart conditions that respond to defib is it?
The heart may stop for many reasons.
Can they not be used for heart failure caused by other things?
Genuine question.

It would be wonderful if we could get sn ambulance within a few minutes.
That would involve taking a few million cars off the road and stringing up the wankers who phone 999 for pathetic reasons.

No, they can't.
Only particular specific arrhythmias respond to defibrillation, as explained earlier by gasman.

The heart stopping is the final common pathway for a lot of processes. Still, only certain rhythms will be amenable to a shock.
Defibrillation is a treatment for a cardiac arrest rather than for heart failure (though heart failure may lead to a cardiac arrest)

I keep saying this but the onebthe Pta plans to buy is for children only

Mrsdv I'm thinking of common childhood issues, choking, bleeding, etc. Surprised the only conditions people seem to think need a fast response are heart related. But could be wrong. If more children die of heart disease out of the blue than say choking, then fine, a defib is a good idea.

No. Defibrillators work for ventricular fibrillation and pulseless ventricular tachycardia. Not PEA, not asystole, not choking from foreign body aspiration, not for respiratory arrest following traumatic head injury...

etc etc.

And anyway, if no-one's doing good quality CPR whilst the designated, trained individual is found, gets to site, gets AED out, shits self, applies pads, goes through instructions and then shocks....

....defibrillation will NOT work as the right ventricle will be too full and Starling's Law will fuck you right up the arse.

Small point - whoever mentioned Muamba upthread should remember that he was defibrillated within seconds/minutes of cardiac arrest, with immediate professional CPR to an athlete's heart....

and it didn't work. Nor did defibrillation work the next 20+ times they tried it. This is not uncommon. What saved Patrice Muamba was stunning physiological reserve and professional quality CPR.

I think gasmans posts are only actually visible to a select few. Maybe most people have blocked men :o

That explains why nobody is listening to her.
Or is it because she's talking sense?

But a defib will not put those without heart conditions at risk.
If there was an anti choking machine I am pretty sure thebota would want one of them as well

Excuses! Started reading earlier, got way laid and now haven't the time to catch up! (will do overnight ). What you need is a PAD. Public access defib. Idiot proof. The whole community can utilise. We are just fitting one on the outside of our cricket club. It's free. Anyone who calls 999 gets a code nd instructions. No training needed. It's life saver. Any one could use it. For goodness sake get one.

4. 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)

WOULD YOU RATHER SOMEBODY DIED WAITING ON AN AMBULANCE? just because the local station is 5 mins away doesnt mean an ambulance is!!!
Why don't you just ask that all those using it would be well trained?

YABU. Yes there is a very local ambo station BUT chances are the majority of the ambulances will be out on calls/way back or at the hospital. So could be a lot further away.

AEDs ARE fool proof. It is CPR that most importantly counts, however.

YABVVVVU
Haven't read all 17 pages but why on god'd green earth would you not want your child defibrillated.Without that, their chance of survival would be very very slim.