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.

Sigh
Yes if you have a need to use it you do. OF COURSE you do. What the people who have READ THE THREAD are debating are the chances of it ever being needed vs cost effectiveness against other interventions which may save MORE children lives

I repeat

The one the school plans to buy is for CHILDREN ONLY

my comments about one in every home are ironic posts to the people who say "you can't put any price on saving a child's life no matter how small the risk". The logical conclusion is that they are wiling to pay for anything, no matter how rare the condition.

Sigh
Yes if you have a need to use it you do. OF COURSE you do. What the people who have READ THE THREAD are debating are the chances of it ever being needed vs cost effectiveness against other interventions which may save MORE children lives

I repeat

The one the school plans to buy is for CHILDREN ONLY

my comments about one in every home are ironic posts to the people who say "you can't put any price on saving a child's life no matter how small the risk". The logical conclusion is that they are wiling to pay for anything, no matter how rare the condition.

The cost of an AED is roughly £1500. Plus batteries.

If it is never used, that's a sunk cost. You'll never see the benefit.

If it is used, it is invaluable.

As a percentage of a school's annual budget, particularly when amortised over the number of years of the life span of the AED, is quite minimal.

Claiming it costs half a million pounds per use is wildly inaccurate and inflammatory.

How much would it cost per use then?

If you are sole rescuer, then you're doing CPR until either a) someone else takes over b) you are too physically tired to continue or c) someone like a doctor or paramedic orders you to stop. Or d) the rarest occurrence, the person starts breathing again.

You bloody well don't, you phone 999 and then start CPR.

Have you actually ever done a first aid course? Or administered CPR? Or do you just read about it on the Internet?

I also have ALS, spent 10 years working in cardiology, yes I have done CPR, but not often because my job was to do the defibbing. In 10 years working with adult and pead cardiacc patients I never defibbed a child.

When I worked at a large teaching hospital I know of only one case where a child was defibbed - they were in AF, which is not a 'shockable' rhythm, in the sense it is not cardiac arrrest and a low voltage shock is all that is required.

I do remember a child arresting in the cathlab and not being ressucitated. Intrestigly it was a respiratory arrest. The consultant cardiologist didn't defib, or ask for a defib because it would have been useless.

A trained and equipped paramedic on full time standby in the staff room would be a lot more effective and would almost certainly be used a couple of times a year.

Arguably £1500, plus batteries, amortised over several years. If it isn't used, it isn't used.

But even if you want to go on Steiner's viewpoint, those are some pretty heavy assumptions.

Again, we don't have these debates over smoke alarms or fire alarms or school nurses.

"How much would it cost per use then?"

About half a million as has been pointed out several times, because on average the vast majority of paed defibs in schools will never be used.

Point I'm making here is why is 1k ok to spend but the cost of a paramedic not? I bet the cost effectiveness would actually be similar

Ssash, once you've started that CPR, when do you stop? And do you leave the patient to call 999? Of course you don't. You're doing CPR.

Or not, I have no idea. But I admit it whereas most people on this thread don't even realise cost effectiveness comes into it.

goannego

Going on your figures it would be £1500 if used once, which sounds fine. What are the chances of it being used once though? How many schools do you need to but an AED for before you have enough coverage that one of them will be used once? Daisey has some figures in her post on the incidence of shockable rhythms in children.

Saying that it would cost half a million per use is frankly ridiculous as the PTA in question has nothing to do with buying defibrillators for any other school. If it was a national initiative, then you could start banging on about national costs.

The point about the defibrulator is that you don't need specialist training to use it - the machine tells you what to do. The reason they are being used is that they do save lives in the vital seconds available. You are not wrong to prioritise financial resources, but you should be aware of how important these pieces of equipment are. Oh, and by the way, it's not just the children which could get heart problems. The staff too. It's well documented that they save lives, and you will have to stand by the decision not to have one. Couldn't you raise money charitably to buy it? I

So we are back around to 'who cares what it costs, or that the chances of it ever being used are virtually nil, buy it anyway because money is infinite'

Anne, as I said, I wont be debating with you any further. Particularly as you think I am too stupid to be able to tell the difference between a respiratory and cardiac arrest in a non- clinical setting

I dont think I need to prove to you that I know what to do with a child having a respiratory arrest - my employers and colleagues never complained about my responses in about 18 years, so presumably I'm OK on that front....

PS now I've read missced's post too, would it be OK to bang my head on the desk?

But my point is that for safety and first aid equipment you can make the same sort of argument. I've participated in a lot of fire drills and heard smoke alarms go off,etc but I've never, thankfully been in a fire or even known anyone who was apart from my friend's husband. Who is a firefighter. There's whole teams of firefighters so there must be a need somewhere. But we don't calculate whether or not we should have them. There are even laws saying we have to have them as the harm they prevent is substantial. Just like smoke alarms, fire alarms, etc. So why would we have such a debate about this piece of equipment, which will cost a school less than its even less likely to be used but more expensive to buy and maintain sprinkler system?

the op has said the one the school is buying is for use on children only

Can anyone read this?

We do actually. Cost effectiveness is calculated when people decide what measures to employ. Why have a fire alarm when you could have a fully staffed fire truck in the school yard - wouldnt that be safer?

Oh ffs

I think it's excellent that OP started this thread. Entirely appropriate.

If nothing else OP is in a good position to insist that any defib bought is suitable for adults AND children.

Smoke alarms cost £10 each & last 10 years.
Who actually has a school nurse??
Perhaps there is a case against future fire-safety measures in school, however they overlap with other safety procedures (like evac in case of other threats), and at least they would safeguard 100s of lives, not just one or 2.

I could be wrong, but I haven't come across an AED yet that is for use in kids only. There are some for adults only but even those are incredibly rare. The vast majority (and there's no substantial difference in price) are suitable for both, though as previously pointed out very young babies (up to a year or so) may be too small. But school aged kids would be big enough.

Given the OP was based on her own admission on a profound lack of information, I'd be really surprised if this turned out to be the case.

Smoke alarms in schools cost a lot more than £10 each. And you need far more than one and they must be tested, maintained, wired into the mains, and there is the cost in time and training in all those fire drills.