Defibrillators in Schools: Requirements and Pediatric Pads

Schools, middle schools and high schools fall under the classification of buildings open to the public, known in France as ERP (établissement recevant du public), with a category that depends on the number of people they accommodate. ERP categories 1 to 3 have been required to have a defibrillator since 1 January 2020, category 4 since 2021, and part of category 5 since 2022, under the French loi 2018-527 (law) and its décret 2018-1186 (implementing decree). Many primary schools, for lack of sufficient headcount, fall into category 5: they can still choose to equip themselves, especially when they run a before or after school club, a canteen or extracurricular activities that increase actual attendance.

The head of the establishment, whether run by a town, a department, a region or a private body, is responsible for checking the ERP category and applying the resulting requirement. Town councils and local authorities that run primary schools have every interest in folding this into their overall safety policy, alongside the fire evacuation drills already held every term.

A child's heart responds differently to an electric shock than an adult's, owing to lower body mass and different chest resistance. An automated external defibrillator, or DAE (AED), delivers an energy level calibrated for an adult by default. Used without adjustment on a child under eight years old or under 25 kilograms, that energy can be excessive, though this does not rule out using the device when no alternative is on hand.

Manufacturers have addressed this with pediatric pads or energy attenuator keys, which automatically reduce the shock delivered. Some devices use a single pair of universal pads for adults and children, others need a dedicated pair or a specific key inserted before use. A school that equips itself should therefore check that its defibrillator has this option and that the pediatric pair stays accessible, stored near the device and within its expiry date.

The current catalogue offers pediatric pads or attenuator keys ranging from about 65 to 174 euros including tax, depending on the brand and the defibrillator model already installed, with a spare pair added to the one supplied at purchase. For a first turnkey setup including the defibrillator, first aid kit, wall cabinet, signage and training, the available packs range from 1090 to 1499 euros including tax. A school that prefers to limit the initial outlay can also choose rental, available from 50 euros excl. VAT per month with maintenance included, backed by a 5 year warranty and delivery within 2 to 5 working days.

Having a defibrillator on site does not remove the need to train the adults present in the school. Teachers, canteen staff, after school activity leaders and maintenance staff are all people who might step in before help arrives. Basic life saving training, or a fuller first aid course for safety officers, helps remove the hesitation to use the device on a child.

An automated external defibrillator guides the user by voice at every step, including the choice of pediatric pads where the device allows it. That guidance does not lessen the value of regular sessions, ideally repeated every school year, so that chest compressions and switching the device on become reflexes shared among several adults in the school rather than resting on a single person.

Like any defibrillator, a school's unit remains the operator's responsibility for maintenance, under article R. 5212-25 (French public health code) of the Code de la santé publique. Pads need replacing every 2 to 5 years depending on the model, the battery every 3 to 5 years, and the device itself stays usable for 8 to 10 years or more as long as the self test light stays green. A designated staff member should check that light regularly, especially after school holidays when the building stays closed for several weeks.

Registering with Géo'DAE remains compulsory for any defibrillator installed in a place open to the public, schools included, so that emergency services can locate the nearest device when a call comes in. The signage posted at the entrance and in corridors must follow the model set by the arrêté du 29 novembre 2018 (French ministerial order), visible to staff as well as to parents or outside visitors.

The chosen spot needs to stay accessible at all times, including outside class hours if the school runs a morning club or an evening study group. The entrance hall, near the head teacher's office or the caretaker's lodge, is often a good compromise between visibility and protection against vandalism. An outdoor heated cabinet makes sense if the nearest permanently accessible point sits outside the buildings, for instance near the covered playground or the gate onto the yard.

In a school spread across several buildings or floors, it is better to equip each zone rather than rely on too long a round trip in an emergency. Time lost crossing a yard or climbing a floor can cancel out the benefit of an otherwise well chosen device.