Automated External Defibrillators, Bleed Kits and

First Aid Kits

How to Use Your School’s Emergency Resources

Disclosure

• The information provided in this presentation does not, and is not intended to, constitute legal advice.
• All information and content is for general informational purposes only.​
• There are no relevant financial relationships with ineligible companies for planners, presenters, reviewers, or others in control of content for this activity.​

Learning Intentions

• Evaluate the legal frameworks and compliance mandates governing emergency response and liability in Utah schools
• Coordinate systematic scene assessments and emergency protocols while implementing protective measures
• Demonstrate proficiency in differentiated cardiopulmonary resuscitation (CPR) techniques and the rapid integration of automated external defibrillator (AED) technology
• Analyze physiological indicators of hemorrhage to determine and execute critical bleeding control interventions
• Assess penetrating thoracic trauma and perform advanced stabilization using occlusive dressings

Local Education Agency Requirements

Mandatory Staff Certification (1)

Administrative Rule R392-200-6 requires:

• At least two onsite individuals that have current certification from a First Aid and CPR training program.
• Schools with AEDs to provide AED training
• Teachers in high risk areas or who supervise high risk activities and all bus drivers must receive First Aid and CPR principles trainings annually

Mandatory Staff Certification (2)

• Athletic department: all head coaches, assistant coaches, and athletic trainers must maintain active CPR certification
• Health services: advanced training enables school nurses to manage medical responses and train unlicensed staff
• Education: physical education (P.E.) and driver’s education teachers require specialized emergency response training, while school guardians require basic trauma care

Utah Senate Bill 244 (2026): Cardiac Emergency Response Plans in Schools

180 Seconds to Shock

From any point on the school premises, the following three actions must occur within 3 minutes:

• Retrieve the AED
• Transport the AED to the victim
• Apply the AED pads to the victim’s chest

CERPs

A CERP is required in Utah each school before the beginning of the 2026-2027 school year. Plans must contain the following evidence-based core elements.

• Designation of appropriate staff to be training in first aid, CPR and AEDs
• School nurses, athletic trainers, teachers
• Implementation of emergency response protocols
• Placement of AEDs and other requirements
• Annual CERP review, drills and local education agency (LEA) education

Other CERP Requirements

• AED maintenance: includes regular testing, visual checks and replacing single-use pads
• Monitoring expiration dates: ensure first aid kits and bleed kits have up-to-date supplies
• Emergency services notification: each school within an LEA must inform the appropriate first aid, ambulance, rescue squad or other emergency medical service provider about the type and location of the AED within 14 days, per Utah Code Section 53-2d-803

CERP Grant Implementation

Utah State Board of Education (USBE) grant requirements:

• First-come, first-served basis with priority given to “High Needs” and “Rural” schools
• Utah Grants reimbursement: July 1, 2026 through June 30, 2027
• Eligible costs include AEDs, staff training (including training kits) and supplies to implement CERP plans
• LEAs must submit CERP plans for each participating school in order to be eligible for the grant funding

School First Aid and Bleed Kits

First Aid and Bleed Kits

As detailed in Administrative Rule R698-13, schools must comply with the following requirements immediately for new school building construction projects and before the 2029-2030 school year for existing school buildings.

• Bleed kits in each classroom and large gathering areas
• First aid kits in school's office and gymnasium or anywhere school administrators deem as appropriate

Personal Protective Equipment

Personal Protective Equipment (PPE)

When giving care in schools, always use PPE and report exposures to blood or other bodily fluids.

• Eye protection
• Face shields or masks for CPR
• Gloves for everything else
• Wash hands after taking gloves off
• Take gloves off safely to reduce exposure to bloodborne pathogens

Know Your School Resources

• LEA stock supply of naloxone, glucagon and albuterol
• Stock epinephrine (injectable epinephrine rescue medication) is required at each school
• Ask questions
• Who is trained to administer medications? Are they a qualified adult?
• Ensure you know where the closest first aid kit, bleed kit, AED, where stock medications are kept and who can administer them

CPR Basics and AEDs

Liability Protections

Utah’s Good Samaritan Law (Utah Code Section 78B-4-501) protects bystanders who voluntarily provide emergency care from civil liability for ordinary negligence (e.g., unintentionally cracking a rib during CPR).

The authority to administer CPR (Utah Code Section 53-2d-801) authorizes anyone to perform CPR or use an AED without a license or certification, provided they reasonably believe the victim is in sudden cardiac arrest.

Check Call Care

1. Check the scene for safety and obtain consent
2. Form an initial impression (unresponsive, breathing, life-threatening bleeding)
3. Put on gloves
4. Ask a bystander to call 9-1-1 and retrieve the AED and first aid kit
5. Give care according to the conditions that you find and your level of knowledge and training
1. Administer thirty compressions and two breaths until you are too tired to continue or help arrives

Key Differences with Children

Adults

• Correct hand placement
• Thirty compressions: at least two inches (100-120 compressions)
• Two breaths: open the airway past neutral and pinch the nose

Children

• One-hand technique for smaller children
• Thirty compressions: about two inches
• Two breaths: open the airway to a position slightly past neutral

Operating Your School’s AED

• Power:
• Open the lid or press the button. Follow voice prompts.
• Apply:
• Place pads on bare skin (upper right/lower left).
• Analyze:
• Stand clear while the AED checks the heart. “Clear”.
• Shock:
• Press the button ONLY if the AED tells you to. “Clear”.

After completing this process, begin CPR immediately. Limit interruptions to less than 10 seconds.

Using Bleed Kit Resources

Inside Your Bleed Kit (1)

A bleed kit shall include:

• four Combat Application Tourniquets (C-A-Ts) and two permanent markers
• four compressed gauzes and a two-inch roll of surgical tape
• four four-inch emergency trauma dressings
• two Z-fold hemostatic gauzes or equivalent
• one abdominal emergency trauma dressing

Inside Your Bleed Kit (2)

A bleed kit shall include (continued):

• four HyFin-style vent chest seals (twin pack)
• two CPR microshields
• five pairs of large nitrile gloves
• one 5.25 inch (or larger) pair of trauma shears
• two survival blankets

Initial Response and Safety

• Scene safety: PPE (gloves, eye protection)
• Call for help, activate emergency response and obtain consent
• Positioning the patient
• Rapid primary assessment (circulation, airway, breathing (CAB), with emphasis on circulation)
• Speed and decisiveness

Recognizing Life-Threatening Bleeding

Visual cues:

• spurting and pulsatile bleeding
• pooling blood
• soaked clothing and/or bandages
• partial or complete amputation

Patient signs:

• altered level of consciousness
• tachycardia, hypotension

Life-Threatening Bleeding

• Internal vs. external bleeding (focus on external control)
• Must cut clothing to see the entire injury
• There are three ways to control bleeding:
• Apply pressure with hands
• Pack the wound and press
• Apply a tourniquet

Using Direct Pressure with Hands

1. Place the dressing on the wound
1. Use a hemostatic dressing (if available)
2. Apply steady, firm pressure directly over the wound until bleeding stops, a tourniquet is applied, another person relieves you or you are too exhausted to continue
3. Hold the direct pressure
4. If the bleeding stops before EMS arrive, apply a roller bandage

Wound Packing

Junctional wounds (groin, axilla, neck):

1. Locate the source
2. Pack tightly with gauze (hemostatic if available, i.e. QuickClot)
3. Maintain pressure (≥3 minutes or per product guidelines)

Using Tourniquets (1)

• Indications: severe extremity bleeding not controlled by pressure
• Placement: two to three inches above the wound (if unsure, do not place over joints - always go higher on the limb)
• Documentation: time of placement

Never use a generic tourniquet (from Amazon). They will break.�Blue tourniquets are trainers. Do not use them during an emergency.

Using Tourniquets (2)

Tourniquet placement is very painful. Remember a screaming patient is a patient with an open airway.

• There should be no distal pulse (below the tourniquet)
• Consider adding an additional or 2nd tourniquet
• These can be applied to all limbs in adults and children
• Stays in place

Never use a generic tourniquet. They will break. They do not work.

Special Considerations (1)

• Pediatric patients compensate well - until they don't
• Multiple casualties (triage mindset)
• Doing the greatest good for the greatest number of people with the resources available
• Immediate interventions taking less than 30 seconds
• Do not: bandage or splints
• Do: apply a tourniquet for catastrophic bleeding

Special Considerations (2)

Multiple casualties (triage mindset, continued)

• Strict, rapid categorization of patients into “immediate”, “delayed”, “minor” and “expectant” categories
• Assessing for “immediate” distress:
• Respirations (>30 breaths/min for adults, may be more for children)
• Perfusion (radial pulse absent)
• Mentation (cannot follow commands)

Chest Seals

Open Chest Wounds

• Open chest wounds can lead to tension pneumothorax: a chest pressure change that causes the lungs to not expand
• Air entering the chest + impaired lung expansion = rapid deterioration
• Goal: seal the wound and prevent air entry

When to Use Chest Seals

• Penetrating trauma to chest, back, or side
• “Sucking” chest wound (audible air movement)
• Bubbling blood at wound site
• Signs of respiratory distress:
• Shortness of breath
• Decreased breath sounds
• Cyanosis, a.k.a. turning blue (late sign)

How to Use Chest Seals

1. Prepare:
1. Use PPE (gloves), expose the chest fully and identify entry/exit wounds
2. Apply the seal:
• Wipe away blood (quickly, don’t delay)
• Apply seal directly over wound
• Press firmly to create an airtight seal
3. If an exit wound is present, apply a second seal. You must check to see if there is an exit wound.

Special Considerations

• Chest seals are NOT for bleeding control. Use when:
• Massive hemorrhage: control first, then address airway/breathing (chest seal)
• Think: “hole in the chest → seal it” and always check for exit wounds
• Monitor continuously after placement

First Aid Kits

First Aid Kit Components (1)

What’s inside:

• eyewash with eye pads and strip
• bandages, alcohol wipes and hand sanitizer packets
• burn dressing
• cold pack
• conforming gauze roll
• one CPR face shield
• first aid tape

First Aid Kit Components (2)

What’s inside (continued):

• petroleum jelly, scissors and tweezers
• nitrile exam gloves
• sterile gauze pads
• trauma pads
• ammonia inhalant
• appendage splint
• electrolyte liquid or glucose gel

Be Empowered to Save Lives

Training and equipment are only effective when utilized with confidence.

Hands-on Skills Practice

Skill stations: AEDs, bleed kits and first aid kits

• Practice direct pressure, wound packing trainers and tourniquet application (self and partner)
• Place AED pads on the manikin and use the trainers
• See up close what is inside the state-issued bleed and first aid kits

Resources

North American Rescue. (2019, June 14). Bleeding control kits walkthrough [Videos]. Vimeo. https://vimeo.com/342301416

STOP THE BLEED. American College of Surgeons, https://www.stopthebleed.org/. Accessed 12 May 2026.

Granger video

Contact Information

Kendra Muir, MHL, BSN, RN, NCSN

kendra.muir@schools.utah.gov

Sami Bushnell, BSN, RN, NCSN samanthabushnell@utah.gov

Shauna Rawlinson, BSN, RN, AEMT

srawlinson@nsanpete.org