The NSW Premier, Mike Baird, has voiced support for legislative changes to make defibrillators compulsory in schools.

Mr Baird's feedback comes in response to 7news media reports publicising an online change.org petition calling for mandatory CPR training and defibrillators in all NSW public schools.

Currently in NSW, like other States and Territories, non-government schools have the discretion to purchase a defibrillator

While the petition focuses on government schools, the issue of having adequate first aid training and equipment on school premises as part of a school meeting its duty of care obligations to students is one that affects all schools across Australia.

What does a defibrillator do?

A defibrillator is an electrical device that provides a shock to the heart when there is a life-threatening arrhythmia (a condition in which the heart beats with an irregular or abnormal rhythm) present or it has stopped beating.

In a school first aid situation, defibrillation using an Automatic External Defibrillator (AED) may be required if a student is in cardiac arrest caused by:

• drowning or choking;
• receiving an electric shock;
• respiratory related medical conditions such as asthma and anaphylaxis;
• trauma;
• poison; or
• congenital abnormality.

A defibrillator can be used in a situation where CPR has commenced and an ambulance has been called, but a student remains unconscious.

According to the petition, 'four young people die every week in Australia from sudden cardiac death. Their best chance for survival is early defibrillation and CPR, and every minute that passes the survival rate drops by about 10%.'

What is the law?

Each State and Territory has different work health and safety or occupational health and safety laws and for government schools, first aid guidance plans, which prescribe a school's obligations to ensure the safety of students.

These include having first aid, asthma and anaphylaxis management plans and procedures in place. As part of meeting with their obligations, schools must ensure that staff are educated and trained on their student health and safety requirements.

Federal anti-discrimination law under the Disability Discrimination Act 1992 (Cth) is relevant as its provisions make it unlawful for schools to discriminate against students on the grounds of 'disability', the definitions of which can be broad enough to cover students who must take prescribed medication and/or who need health care procedures administered either on an ongoing or emergency basis. It is, however, legal to discriminate if a school would face 'unjustifiable hardship' in doing so - for example, financial circumstances. Although State and Territory anti-discrimination legislation also exists, in some jurisdictions such as NSW, there are exemptions for non-government schools.

A school's common law duty of care to protect and ensure the safety of students requires it to exercise special care towards students that have a known health condition such as asthma or anaphylactic shock. In these cases, students will have individual health care plans which staff need to be aware of and take responsibility for, managing.

Currently, defibrillators are not legally prescribed pieces of medical equipment in schools.

Funding is key

A general internet search for the cost of a EAD revealed that the cheapest EAD model starts from around $2,000 - in addition to the cost of extras such as EAD signage and an EAD cabinet (see www.optomo.com.au).

Staff must also be trained how to use an EAD.

And herein lies the fundamental issue with the supply of defibrillators to all schools - funding.

Although non-government schools may have greater resources available to them than government schools to purchase defibrillators themselves - they are not legally required to do so.

This means that it's still a cost-based decision to purchase based on discretion for non-government schools.

For government schools, a lack of resources can prevent them from even considering the idea - and this is the nexus for the change.org petition and the emotional debate from parents and community members that surrounds the issue. In a government school context, it will often be a parent driving a fund-raising campaign to purchase an EAD, normally in relation to their child's heart condition, while in a non-government school, the decision to purchase an EAD may be initiated by the members of the school's executive team who have identified the benefit of this equipment.

The supply of government funding for defibrillators in schools is not a novel concept and in the United Kingdom, the government has recently pledged funding towards them.

While the issue remains a question of policy in Australia, there are other options available to schools. The importance of having defibrillators in schools and the challenge they face of having inadequate financial resources has been recognised by the Australian Red Cross which has extended its 'Project Defib' campaign to make defibrillators and related training and support, accessible to all sporting clubs and public schools across Australia.

Does schools need defibrillators?