The recent proposal by politicians for AEDs (automated external defibrillators) to be installed in all schools across Scotland has sparked a necessary debate. And whilst in principle, this would deliver more defibrillators into communities, the reality is complex.
The UK Government successfully delivered AEDs to every school in England, with the support of £19 million Government funding. This followed a campaign from Mark King of the Oliver King Foundation, who tragically lost his son to an Out of Hospital Cardiac Arrest (OHCA) during a school swimming lesson.
The Scottish Government is now being encouraged to follow in England’s footsteps.
As Scotland’s only dedicated first aid charity, we welcome the news and are encouraged to witness Government action. However, a significant number of the AEDs installed in England are indoors and remain inaccessible to the public outside school hours.
Cardiac arrest is rare in young people, with the mean age of sufferers in Scotland currently 64. To increase the likelihood of a public access defibrillator (PAD) being available for use following OHCA, they must be installed and registered in sufficient numbers and placed in optimal locations. The work of Edinburgh University’s Resuscitation Research Group (RRG) and its data-driven PAD placement technology is vital here. The "PADmap" is dedicated to identifying the prime location for AEDs, having regard to risk, for example, ambulance response times and frequency of cardiac events.
Schools sit at the heart of communities. This should make them an ideal location, but only if the devices are accessible 24/7. With education budgets under mounting pressure, the Department for Education advises that without additional insurance, schools who locate an AED outside their grounds will be “solely responsible for repair or replacement costs in the event of theft or vandalism”, with a similar approach adopted by Scottish local authorities. There is also an important question of how to pay for the significant costs of replacing electrode pads and batteries.
Figures indicate that the incidence of AED theft is generally low, but these responsibilities could make schools reluctant to install a device and even less likely to leave the cabinet unlocked.
In a situation where seconds count, locked cabinets waste valuable time.
While I am in favour of installing more defibrillators across Scotland, I encourage Scotland’s political parties, the Government and local authorities to consult more widely with industry experts. For these proposals to work, it is vital that every effort is made to ensure AEDs in schools are accessible and informed by RRG’s PADmap. There have been a number of tragic cases - such as the death of Jamie Rees - where locked devices in schools prevented early defibrillation.
Local authorities should ensure that there are adequate resources set aside for ongoing maintenance and that Resuscitation Council UK guidelines are followed so that the nearest AED can be found quickly in an emergency, and is "rescue ready".
In Scotland, we have the opportunity not just to follow examples, but to set them, ensuring the best possible implementation of this life-saving technology. Let’s make Scotland an international leader in OHCA outcomes.
Stuart Callison is Chief Executive of St Andrew’s First Aid
Agenda is a column for outside contributors. Contact: agenda@theherald.co.uk
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