With these 10 essential steps, any school can start an AED program.

1 Pick a program coordinator and a medical consultant. A physician's prescription is necessary to buy an AED. The prescription can come from any licensed M.D. or D.O. (such as the school physician, a volunteer parent or even your own doctor). In the case of an event involving the AED, the physician and program coordinator should review the incident and response, and assess whether any quality-improvement adjustments could be made to the emergency response plan.

2 Review state laws and regulations. All U.S. states have Good Samaritan laws that provide immunity from legal liability when using an AED to help someone. Some states also have laws that mandate the presence of an AED in schools or at school events. Laws vary from state to state. (See www.early-defib.org.)

3 Conduct a needs assessment and build a budget. Before you determine what you'll need to buy and the related costs, consider these points:

* It would be ideal to have an AED at every sports event, keeping in mind that different teams may be playing or practicing simultaneously in different locations. Do an assessment of the average number of sports events on any given day to determine how many portable devices your school may need.

* Are phones readily available for anyone in the school to call 9-1-1 at any time, day and evening? If not, consider budgeting for phones as part of the AED program.

* An AED should be placed on the victim within 3 to 5 minutes of collapse. Therefore, the unit should be placed where it can be reached within 90 seconds while walking at a fast clip. This will allow you to return to the victim, with the device, within the recommended time frame.

* Public-access AEDs are often mounted in cases similar to fire extinguisher cabinets. Cases can be equipped with various features, such as an alarm or auto-dial system that alerts 9-1-1 or security when the door is opened or the device is removed. Basic cabinets start at about $200.

* Advertising the AED's location is important. If the building layout is complicated, you may need extra signs. You can reproduce the universal AED symbol for free. (Download it from www.early-defib.org).

* Along with each AED, the following items are necessary: a battery; 2 sets of adult electrode pads (additional pediatric pads if desired); and an ancillary equipment pouch holding a towel, scissors, razor, pocket CPR mask, and a pair of non-latex gloves.

4 Seek funding. For ideas and funding sources in your area, see "Dollars for Defibrillators" at left, or visit www.early-defib.org.

5 Select a device. There are a number of different companies that manufacture AEDs and a variety of models available. Devices vary slightly in design and price, but they all are reliable and have been cleared by the FDA. For a comprehensive listing of devices on the market, see www.early-defib.org/aeds.html.

6 Select a location. The device should not be locked up in an office; choose a visible location that can be reached whenever people are at the school. Some suggestions: the auditorium, gym, front entry, and outside the nurse's office on the wall.

7 Develop a response plan. Procedures should be written and drills performed. Also, a copy of the plan should be kept with the AED. The procedures manual should address:

* How and when to call 9-1-1

* Location of AEDs

* Simple diagram and steps for using the AED

* Emergency contact numbers and procedures

* Post-event review forms

8 Coordinate with EMS. Your local emergency medical services should be made aware of the location of all AEDs in the building, and the program should be registered with the state EMS authority.

9 Conduct training. Ideally, all faculty, staff, students, and users of the school should be trained in CPR and AED use. If this is not possible, identify people such as athletic directors, health teachers, janitorial staff who are around after hours, student leaders and coaches to be trained first. You can use in-house or outside instructors. Tip: Try your local fire department, hospital or ambulance service. For a list of national training organizations, visit www.early-defib.org.

10 Create public awareness. Install signs indicating that an AED is available. Conduct assemblies and drills for occupants of the building. Send letters to parents and groups that use the school facilities (e.g., community sports teams, voting commissions, social programs) to convey:

* The location of all AEDs

* How to contact 9-1-1

* That they are allowed to use the AEDs

* That AEDs are simple and safe to use

* That when an AED is turned on, the voice prompts will guide the user through the rescue