Current through Register Vol. 49, No. 9, September, 2024
1.00
PURPOSE
The purpose of this Rule is to establish the requirements and
procedures for Governing school-based Automated External Defibrillator (AED)
devices and Cardiopulmonary Resuscitation (CPR) programs in Arkansas Public
Schools.
2.00
REGULATORY AUTHORITY
This rule was promulgated pursuant to Ark. Code Ann.
§§
6-11-105,
6-10-122, and
6-10-123.
3.00
DEFINITIONS
For the purpose of this Rule, the following terms mean:
3.01 "Arkansas Public Schools" means all
public and charter schools;
3.02
"Automated External Defibrillator" means a device that:
3.02.1 Is used to administer an electric
shock through the chest wall to the heart;
3.02.2 Has built-in computers within the
device to assess the patient's heart rhythm and judge whether defibrillation is
needed;
3.02.3 Has audible or
visual prompts, or both, to guide the user through the process;
3.02.4 Has received approval from the United
States Food and Drug Administration of its pre-market modification, filed
pursuant to 21 U.S.C.
360(k);
3.02.5 Is capable of recognizing the presence
or absence of ventricular fibrillation and rapid ventricular tachycardia and is
capable of determining without intervention by an operator whether
defibrillation should be performed; and
3.02.6 Upon determining if the defibrillation
should be performed, the AED either automatically charges and delivers an
electrical impulse to an individual's heart or charges and delivers an
electrical impulse at the command of the operator.
3.03 "CPR/AED Provider" means a member or
employee of a campus who has completed training in CPR in addition to knowledge
and understanding of an AED's operation and use under the requirements set
forth in this rule.
3.04 "Cardiac
arrest" means a condition, often sudden, that is due to abnormal heart rhythms
called arrhythmias. It is generally the result of some underlying form of heart
disease.
3.05 "Cardiopulmonary
Resuscitation (CPR)" means a combination of rescue breathing, chest
compressions, and external cardiac massage used to sustain a person's life
until advanced assistance arrives.
3.06 "Defibrillation" means administering the
electrical impulse to an individual's heart in order to stop ventricular
fibrillation or rapid ventricular tachycardia.
3.07 "Department" means Arkansas Department
of Education
3.08 "Emergency
Medical Services" means the transportation and medical care provided the ill or
injured prior to arrival at a medical facility by a licensed emergency medical
technician or other health care provider and continuation of the initial
emergency care within a medical facility subject to the approval of the medical
staff and governing board of that facility.
3.09 "Extra-curricular event" means any
school sponsored program or voluntary activity sponsored by the school, local
education agency, or an organization sanctioned by the local education agency
where students are competing for the purpose of receiving an award, rating,
recognition, or criticism, or qualification for additional competition or
including preparation for and involvement in public performances, contests,
athletic competitions, demonstrations, displays and club activities.
3.10 "FDA" means the Federal Food and Drug
Administration
3.11
"School-Personnel" means School Board approved/contract employee of the
district that is required to follow school policy and procedures.
3.12 "Program Coordinator" means an
individual, appointed by the school district, who is responsible for
administration of the Automated External Defibrillation program for their
respective campus.
3.13 "Protocol"
means currently approved and accepted procedures describing specific steps a
provider must follow in assessing and treating a patient.
3.14 "Renewal" means the period training and
demonstration of competence in the application and use of automated
defibrillation equipment.
3.15
"School campus" means any public school building or cluster of buildings,
including grounds, with a Department of Education-issued LEA number, that is
used for any purpose, including, without limitation: an extracurricular
activity, organized physical activity course defined in Ark. Code Ann. §
6-16-137, pre-kindergarten
education, or district administration.
3.16 "School sponsored event" means any event
or activity sponsored by the school or school system which includes but is not
limited to athletic events, booster clubs, parent-teacher organizations, or any
activity designed to enhance the school curriculum whether on school-campus or
not.
3.17 "Sudden Cardiac Arrest"
means a sudden or unexpected cessation of heart function, most often caused by
a sudden arrhythmia, such as ventricular fibrillation (VF). When this occurs,
the heart's electrical impulses suddenly become chaotic and ineffective. Blood
flow to the brain abruptly stops and the victim collapses and quickly loses
consciousness. Death usually follows unless a normal heart rhythm is restored
within minutes.
3.18 "Ventricular
Fibrillation" means the most common arrhythmia that causes cardiac arrest. It
is a condition in which the heart's electrical impulses suddenly become
chaotic, often without warning, causing the heart's pumping action to stop
abruptly.
4.00
REQUIREMENTS
4.01 Each school
campus must have an Automated External Defibrillator, and appropriate school
personnel must be adequately trained on an ongoing basis as outlined in Section
9.0 of this Rule
5.00
AUTOMATED EXTERNAL DEFIBRILLATOR MODEL
5.01 Defibrillators acceptable for use in
Arkansas public schools are:
5.01.1 FDA
approved;
5.01.2 Automated type
requiring provider intervention to initiate a defibrillation shock;
and
5.01.3 Capable of automatically
collecting data.
5.02 No
modifications will be made to defibrillation equipment, by the provider or the
service, which results in:
5.02.1 Deviation
from the original manufacturer's specifications, or
5.02.2 Deviation from AED protocols which
are: Early access- calling 911; Early CPR - starting CPR immediately; Early
Defibrillation - utilizing the onsite AED within three (3)-five (5) minutes of
onset; and Early Advanced Care - trained health care providers arriving to
provide advanced care.
6.00
DEFIBRILLATOR PREVENTATIVE
MAINTENANCE/REPAIR
6.01 Each school
district shall designate appropriate personnel to be responsible for the
maintenance of the AED(s).
6.02 All
components of the AED and integrated data recording system shall be inspected
by a qualified service technician at least one (1) time per calendar year or as
recommended by the manufacturer to ensure:
6.02.1 The equipment meets original
manufacturer's specifications;
6.02.2 The equipment maintains the currently
approved treatment protocols based on the current American Heart Association
scientific guidelines, standards, and recommendations for the use of the
AED.
6.02.3 The battery of the AED
shall be maintained and replaced in accordance with manufacturer's
specifications.
6.02.4 All
maintenance and repairs shall be performed by a qualified service technician
recognized by the manufacturer.
6.02.5 Written records shall be maintained
for all maintenance, repairs, and inspections performed on all components for
mandated annual state reporting purposes.
7.00
AVAILABILITY OF AUTOMATED EXTERNAL
DEFIBRILLATOR
7.01 Each school shall
designate appropriate personnel to be responsible for ensuring the availability
of the AED.
7.02 The location of
AEDs shall be based on the following:
7.02.1.
Size and physical layout of the buildings;
7.02.2 Number and ages of individuals in the
building;
7.02.3 Types and
locations of curricular, extracurricular, and school-sponsored
events;
7.02.4 Design features that
might be unique to the building; and
7.02.5 Each school shall report, in a format
approved by the Division, maintenance records and any use of an AED.
7.03 During school hours, the AED
will be placed at designated locations.
7.03.1
These locations shall be specific to each school but should allow the device to
be easily seen and accessed by staff.
7.03.2 The locations should allow staff
members to retrieve the device outside of normal school hours.
7.04 AEDs shall not be located or
stored in a locked office or room.
7.05 Each school-sponsored sporting event for
grades seven through twelve (7-12) shall have an automated external
defibrillator at the school sponsored sporting event.
8.00
SCHOOL APPOINTED PROGRAM
COORDINATOR
8.01 The school appointed
program coordinator shall:
8.01.1 Maintain
current provider status in CPR and AED;
8.01.2 Assure that the CPR and AED providers
on campus receive appropriate training in the use and maintenance of the
school's AED(s);
8.01.3 Oversee
training operations for the school and maintain organizational training
reports;
8.01.4 Ensure AED
equipment is maintained according to manufacturer and treatment protocol
specifications based on the current American Heart Association scientific
guidelines, standards, and recommendations for the use of the AED;
8.01.4.1 This includes, but is not limited
to, ensuring that AED pads and batteries have not expired;
8.01.5 Provide professional development
opportunities annually for AED providers and all school employees, if
applicable;
8.01.6 Verify
credentials of personnel functioning as an AED provider within the school;
and
8.01.7 Review each use of the
AED.
8.02 If the Program
Coordinator is not a healthcare provider, a healthcare provider must oversee
these activities.
9.00
QUALITY TRAINING
9.01 Appropriate
training of anticipated rescuers in the use of the AED and in CPR will
incorporate at least the following:
9.01.1
Testing of psychomotor skills based on the American Heart Association
scientific guidelines, standards, and recommendations for the use of the AED,
as they existed on January 1, 2021; and
9.01.2 Providing CPR as published by the
American Heart Association or the American Red Cross, or equivalent course
materials, as they existed on January 1, 2021;
9.01.3 Coordination with the emergency
medical services system; and
9.01.4
An ongoing quality improvement program to monitor training and evaluate
response with each use of an AED.
10.00
PROFESSIONAL DEVELOPMENT
REQUIREMENTS
10.01 Automated external
defibrillator and cardiopulmonary resuscitation training shall count fully
toward the existing professional development requirements for teachers and
school personnel as noted in the Division of Elementary and Secondary Education
Rules Governing Professional Development.
11.00
REPORTING
11.01 The Commissioner of Elementary and
Secondary Education shall provide a report to the Senate Committee on Public
Health, Welfare, and Labor and the House committee on Public Health, Welfare,
and Labor on or before July 1 of each year.
11.02 Schools shall annually report to the
Division of Elementary and Secondary Education the implementation of these
Rules and status of AED availability on each school campus by May 1.
11.03 An AED Incident Report Form shall be
completed and submitted to the School Health Services Director within thirty
(30) days following an event. This form shall include relevant information
regarding the incidence and use of the AED and the client
outcome.
12.00
OPIOID OVERDOSE RESCUE KIT
12.01
The Division of Elementary and Secondary Education shall consult and
collaborate with the Criminal Justice Institute and the office of the Arkansas
Drug Director to ensure that each public high school campus in the State of
Arkansas has an opioid overdose rescue kit that is clearly visible and labeled
with the words "Overdose Rescue Kit - Naloxone Nasal Spray" or other language
approved by the division.
12.02 The
location of each opioid overdose rescue kit required under 12.01 shall be
registered with the school nurse and school resource officer.
12.03 At all times while present on school
property, a school nurse and a school resource officer shall carry on their
person at all times:
12.03.1 Narcan;
12.03.2 Naloxone; or
12.03.3 Another medication approved by the
Department of Health and the FDA that, when administered, negates or
neutralizes, in whole or in part, the pharmacological effects of an opioid in
the human body.
12.04 An
opioid overdose rescue kit required under section 12.01 shall:
12.04.1 Be:
12.04.1.1 Located where it is readily
available for public use; and
12.04.1.2 Placed within all storage locations
that currently contain an automated external defibrillator for public
use;
12.04.2 Be visually
free of advertisement; and
12.04.3
Include without limitation:
12.04.3.1
Narcan;
12.04.3.2 Naloxone;
or
12.04.3.3 Another medication
approved by the Department of Health and the FDA that, when administered,
negates or neutralizes, in whole or in part, the pharmacological effects of an
opioid in the human body.
12.05 A school resource officer or school
nurse, as appropriate, shall report through the Criminal Justice Institute to
the office of the Arkansas Drug Director within the Department of Human
Services immediately following the use of an opioid overdose rescue kit
required under this section.