Pennsylvania State University

With 80,000 students and 18,000 employees at multiple campuses, the Pennsylvania State University (PSU) has a population about the size of West Palm Beach, Fla. Developing and executing an effective medical emergency response plan for SCA was no small task, especially when this was just one of many responsibilities of PSU’s Department of Environmental Health and Safety (EHS). But Maurine Claver, EHS Director, was up for the challenge.

In the early 2000s, Claver spearheaded a campus-wide initiative to develop an emergency action plan that included deployment of AEDs. She worked with university police and EMS, staff and many others throughout the university.

When they started planning, there were no models to follow, so they created one. “We did not encounter any obstacles—none related to funding, liability concerns, culture or politics,” says Claver. “Everyone was on board because they knew it was the right thing to do.”

The program expanded rapidly in the ensuing years. The plan is standardized for all campuses. To the extent practical, the selection of lifesaving devices and signage is consistent at each campus. “It just doesn’t make any sense to have multiple brands with different batteries and pads, and to have to watch for recalls from several companies. It’s just more efficient and effective,” she says.

Before an AED is deployed, a minimum number of likely responders must be trained. More than 1,000 people have undergone CPR-AED training to date, according to Claver, including professional rescuers, employees and students. “We do everything we can to make training simple, streamlined and readily accessible.”

Today, 247 AEDs are strategically placed university wide.

On average, there are two cardiac arrests a year on all campuses—excluding those occurring at the football stadium. All victims to date have been employees or visitors.

“We’ve had many successes, many saves,” says Claver, thanks in large part to “amazingly quick recognition and response” by employees, students and other bystanders who call 9-1-1, and university police who carry AEDs and typically arrive at the scene within three to four minutes. If they are on bikes, response times are even quicker. Survival rates are well above the national average of 8%.

Allan Braslow, PhD, an emergency care and systems expert who attended PSU and worked on campus as an EMT, has the highest regard for Claver’s program. “I like the fact that Penn State looks at sudden cardiac arrest as a public health problem,” says Braslow. “They have a comprehensive systems perspective that considers the health and safety of the entire community, not only students. Their emergency response plan is active, dynamic, reviewed and adjusted on a regular basis.”

The primary reason for the success of the PSU program, according to Claver, is that all players understand their roles and work as a team. The other reason for its success? As Claver admits, “It’s hard to argue with me when I am passionate about something—especially something as important as AEDs, which can mean the difference between life and death.”

Richard Huff NREMT-B, works as a volunteer EMT for Atlantic Heights in New Jersey and is the executive news director for CBS. Contact him via e-mail at richardmhuff [at] gmail.com.

Mary Newman, MS, is the president and co-founder of the Sudden Cardiac Arrest Foundation.

Model programs that place AEDs on campus

By Richard Huff, NREMT-B, Mary Newman, MS

One key to successfully fighting sudden cardiac arrest (SCA) on campus is having an automated external defibrillator (AED) program in place that makes AEDs as accessible as possible to campus students, staff and visitors. The following article chronicles different programs across the U.S.—big and small—that have made AED access a priority for their campus, a realistic and achievable goal that resulted in saving lives.

Harvard

Harvard University is known for having some of the brightest students. But what many may not know is that helping protect these bright students is one of the best model AED programs in the country.

With 200 AED units deployed across the Cambridge, Massachusetts campus, the school is well covered. This strategy to have units strategically placed has already paid off.

“If we save one person, in my mind, it would be worth it,” says Francis Wang, MD, medical director of the program and a clinical instructor in medicine and director of sports medicine at Harvard’s Department of Athletics.

The school’s AED program began in 2002 with the acquisition of 25 units, which were mounted in every police car, on each floor of the health center and in a handful of satellite health centers around the campus. Currently, Harvard has more than 200 units in service around the campus.

“The initial strategy when we first started this was to cover the athletic teams with defibrillators,” Wang says. “Then we got a nice grant to put them in the highest risk areas, and we put them in many public areas.”

So far, the system has proven successful. In 2007, a 67-year-old professor collapsed on a sidewalk. Someone called for help, and within three minutes, three AEDs were on the scene, and the man was saved. In 2008, a 20-year-old student suffered an SCA and was revived; although the student didn’t survive. And in 2010, a 44-year-old visitor was playing soccer on campus when he went down. He was saved.

Wang credits Harvard’s administration with understanding the need for AEDs on campus and supporting efforts to increase the number of units spread around campus. “AEDs are like a life insurance policy. You need to have them, but you hope you don’t need to use them.”

Under the current system, AEDs are available at every sports practice and game. Each stand-alone unit is locally alarmed to an internal emergency response system. Students are also offered CPR training throughout the year.

“What we did is geographically spread them out a bit,” he says. “We keep identifying areas without looking at specific yardage [apart].”

The next step in the program, says Wang, is getting AEDs into the dorms. “We plan to get AEDs into each of the 13 undergraduate residences in the yard by fall 2012. We will have a clear-cut emergency plan for each location. Houses will then promote training to student residents.”

Once the units are in place, students will be trained to use them. “This is not something we’ve done in a vacuum,” he says. “It’s part of a campus-wide initiative, and that, plus good leadership that sees the need.”

Maricopa County Community Colleges District

Maricopa County Community Colleges District (MCCCD), a collection of community colleges in Arizona, not only pumps out educated students, but it also makes sure it keeps their hearts pumping with a successful, widespread AED program.

The mission, says Bentley J. Bobrow, MD, FACEP, program medical director, is to make sure the school maximizes survival rates from SCA by having AEDs with working batteries and pads available to everyone. Moreover, says Bobrow, the medical director for the Arizona Department of Health Services Bureau of EMS and Trauma Systems, the goal is to have people trained to perform early defibrillation.

“Public Access Defibrillation [PAD] programs are an important means for providing defibrillation in settings where large numbers of people congregate,” says Ruth Unks, ARM, director of Enterprise Risk Management at MCCCD. “With over 275,000 students and more than 11,000 employees, the MCCCD was well suited to implement a PAD program.”

Although folks commonly think of colleges as places for younger people, they’re microcosms of the larger community, and having an AED plan in place is critical, says Bobrow.

“SCA can occur in any age group and many older students and teachers are frequently on college campuses, and there are frequently other events—performing arts, sporting, and fairs associated with colleges,” Bobrow says.

The MCCCD AED program began in 2002. There are approximately 100 AEDs in place today in 20 locations throughout the 10 community colleges and 10 other educational skill centers, according to Bobrow.

Unks says she measures the success of the program by the number of AEDs that the school has purchased, the number of people trained to use them, and the number of people saved.

The plan is part of a larger Bureau of EMS and Trauma System and the University of Arizona Sarver Heart Center program, Save Hearts in Arizona Registry and Education (SHARE), says Bobrow. SHARE is designed to educate the public about SCA and the need for CPR and AED use.

Just placing AEDs in public buildings isn’t enough. Training is a key component, Bobrow says. “It is a tragedy when someone dies from SCA, especially when they collapse in a public location where we have the opportunity to save them,” Bobrow says.

“The SHARE program has over 1,000 survivors to date,” added Bobrow. AZ SHARE is an affiliate of the Sudden Cardiac Arrest Foundation.

Unks says the program also sends a message to the MCCCD community. “Every time that I get an e-mail about a ‘save,’ it reinforces why we invested more than $200,000 over 10 years ago and were one of the first educational institutions to do so.”