Element 1: Screening/Risk Assessment

1. ALL students- Students will take home an assessment form to their parents/guardians. It will consist of questions specific to student’s cardiac history and family history of any heart problems.
2. School will provide a copy of the screening/assessment form used.
3. School will provide documentation of Policy and Procedures fro annual distribution of screening/risk assessment form.

Element 2 : Care Plans

1. All students with a cardiac diagnosis will have a plan of care in the student’s school record. This should be in collaboration with the student’s family.
2. School will provide a template of the care plan(s) used.
3. School will provide documentation of Policy and Procedures for annual care plan updates for all students with a cardiac diagnosis.

Element 3: Emergency Medical Response Drills

1. School will conduct medical emergency response drills at least three times per year.
   1. "Victim" must be defibrillated in under 3 minutes.
   2. School will provide documentation of drills that include date and staff invovled.
   3. School will provide video evidence of one drill.
      
   4. Strongly Recommended: School will hold a debriefing after drill to discuss what went well nad how to improve.
2. School will provide documentation of Policy and Procedures for conducting Emergency Medical Response drills at least 3 times per year.

Element 4: Automatic External Defibrillators (AEDs)

1. AED will be no further than 90 seconds from any point in the building (from scene to AED and back). If so, additional AEDs will be necessary.
   1. School will provide location of AEDs and travel times to furthest part of the building. 
   2. School to provide floor plan or a copy of the school policy if it does not allow floor plan to be distributed.
2. AEDs to be kept in an unlocked open area.

Element 5: CPR Training for Staff

1. School will provide documentation of number of CPR trained staff.
   1. School must meet a ratio of 1:50 CPR trained staff to students.
      • CPR training to be either full certification or Hands On certification from approved CPR instructor.
2. School will provide documentation of Policy and Procedures for maintaining a 1:50 ratio of CPR trained staff to students.

Element 6: CPR Training for Students

1. CPR training offered to students as part of curriculum.
   • Training can be offered to any of the grades in the building. Training needs to be offered to all students at some point as they pass through the building (example: all 4^th graders for K-6; all 8^th graders for Jr. high).
2. Documentation of CPR training and participation.
   1. List the ratio of students trained to students offered training (75 out of 100 students).
   2. CPR training to be either full certification or Hands On certification from approved CPR instructor.
3. School will provide documentation of Policy and Procedures for ensuring all students are offered CPR training by the time they graduate from the building.

Element 7: Sudden Cardiac Awareness Activity/Event/Fundraiser

1. School will conduct an awareness event of sudden cardiac arrest on a yearly basis. This can be in conjunction with a fundraiser. It can be a community based or family event.
   1. Must provide documentation of awareness event.
2. School will provide documentation of Policy and Procedures for conducting an annual Sudden Cardiac Awareness Activity/Event/Fundraiser.