FIRST REGULAR SESSION
SENATE BILL NO. 166
103RD GENERAL ASSEMBLY
INTRODUCED BY SENATOR GREGORY (21).
0979S.01I KRISTINA MARTIN, Secretary
AN ACT
To amend chapter 160, RSMo, by adding thereto one new section relating to cardiac emergency
response plans.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Chapter 160, RSMo, is amended by adding t hereto 1
one new section, to be known as section 160.482, to read as 2
follows:3
160.482. 1. As used in this section, the following 1
terms mean: 2
(1) "Automated external defibrillator" or "AED", a 3
lightweight, portable device that: 4
(a) Is used to administer an electric shock through 5
the chest wall to the heart; 6
(b) Has built-in computers within the device to assess 7
the patient's heart rhythm, determine whether defibrillation 8
is needed, and administer the shock; 9
(c) Has audible or visual prompts, or both, to guide 10
the user through the process; 11
(d) Has received approval from the U.S. Food and Drug 12
Administration of its pre -market modification filed under 21 13
U.S.C. Section 360(k), as amended; 14
(e) Is capable of recogn izing the presence or absence 15
of ventricular fibrillation and rapid ventricular 16
tachycardia and is capable of determining without 17 SB 166 2
intervention by an operator whether defibrillation should be 18
performed; and 19
(f) Upon determining defibrillation shou ld be 20
performed, either automatically charges and delivers an 21
electrical impulse to an individual's heart or charges and 22
delivers an electrical impulse at the command of the 23
operator; 24
(2) "Cardiopulmonary resuscitation" or "CPR", a 25
combination of rescue breathing, chest compressions, and 26
external cardiac massage used to sustain an individual's 27
life until advanced assistance arrives; 28
(3) "Defibrillation", administering an electrical 29
impulse to an individual's heart in order to stop 30
ventricular fibrillation or rapid ventricular tachycardia; 31
(4) "Emergency services provider", any public 32
employer, or ground or air ambulance service as those terms 33
are used in chapter 190, that employs persons to provide 34
fire fighting, dispatching ser vices, and emergency medical 35
services; 36
(5) "Extracurricular event", any school -sponsored 37
program or voluntary activity sponsored by the school, local 38
education agency, or an organization sanctioned by the local 39
education agency at which students compete for the purpose 40
of: 41
(a) Receiving an award, rating, recognition, or 42
criticism; 43
(b) Qualifying for additional competition; or 44
(c) Preparing for and involvement in public 45
performances, contests, athletic competitions, 46
demonstrations, displays, and club activities; 47
(6) "Project ADAM (Automated Defibrillators in Adam's 48
Memory)", a national, nonprofit organization focused on 49 SB 166 3
education around preventing and planning to respond to 50
cardiac arrest; 51
(7) "Protocol", currently approved and accepted 52
procedures describing specific steps a provider is required 53
to follow in assessing and treating a patient; 54
(8) "Public school", the same definition as in section 55
160.011; 56
(9) "School campus", any public school buildi ng or 57
cluster of buildings, and grounds around such public school 58
building or cluster of buildings, used for any public school 59
purpose including, but not limited to, an extracurricular 60
activity, organized physical activity courses, early 61
childhood education programs, or school district 62
administration; 63
(10) "School personnel", a school district employee 64
approved by the school board or a contract employee of the 65
school district who is required to follow school policy and 66
procedures; 67
(11) "School-sponsored event", any event or activity 68
sponsored by the public school or school district including, 69
but not limited to, athletic events, booster clubs, parent - 70
teacher organizations, or any activity designed to enhance 71
the school curriculum whe ther on the school campus or not; 72
(12) "Sudden cardiac arrest", a condition that occurs 73
when the heart malfunctions and stops beating unexpectedly, 74
is due to abnormal heart rhythms called arrhythmias, and is 75
generally the result of some underlying form of heart 76
disease; 77
(13) "Ventricular fibrillation", the most common 78
arrhythmia that causes cardiac arrest and a condition in 79
which the heart's electrical impulses suddenly become 80 SB 166 4
chaotic, often without warning, causing the heart's pumping 81
action to stop abruptly. 82
2. For the 2026-27 school year and all subsequent 83
school years, each public school shall develop and implement 84
a cardiac emergency response plan that addresses the 85
appropriate use of school personnel to respond to incidents 86
involving an individual experiencing sudden cardiac arrest 87
or a similar life-threatening emergency while on a school 88
campus. 89
3. Members of each public school's administration 90
shall coordinate directly with local emergency services 91
providers to integrate the public school's cardiac emergency 92
response plan into the local emergency services providers' 93
protocols. A cardiac emergency response plan shall 94
integrate evidence-based core elements, such as those 95
recommended by the American Heart Assoc iation guidelines, 96
Project ADAM, or another set of nationally recognized, 97
evidence-based standards or core elements. 98
4. The cardiac emergency response plan shall 99
integrate, at a minimum, the following core elements: 100
(1) Establishment of a ca rdiac emergency response team; 101
(2) Activation of the team in response to a sudden 102
cardiac arrest; 103
(3) Implementation of AED placement and routine 104
maintenance throughout the school campus; 105
(4) Dissemination of the plan throughout the sch ool 106
campus; 107
(5) Maintenance of ongoing staff training in CPR and 108
AED use; 109
(6) Practice of the cardiac emergency response plan 110
using drills annually; 111 SB 166 5
(7) Integration of the plan into the local emergency 112
services providers' protocols; a nd 113
(8) Both annual and continuous reviews and evaluations 114
of the plan. 115
5. Appropriate AED placement shall be dictated by the 116
cardiac emergency response plan and in accordance with 117
guidelines set by the American Heart Association or 118
nationally recognized guidelines focused on emergency 119
cardiovascular care. An AED should be identified with 120
appropriate signage and be on -site or placed and made 121
available in an unlocked location on school property. 122
6. For schools with an athletic depart ment or 123
organized school athletic program, an automated external 124
defibrillator shall be clearly marked and easily accessible 125
in an unlocked location at each school athletic venue and 126
event. The AED shall be accessible during the school day 127
and any school-sponsored athletic event or team practice in 128
which pupils of the school are participating. An AED should 129
be placed on a person experiencing cardiac arrest within 130
three minutes. 131
7. Appropriate school personnel shall be certified in 132
first aid, CPR, and AED use following guidelines set forth 133
by the American Heart Association or nationally recognized 134
guidelines focused on emergency cardiovascular care. The 135
school personnel required to be certified shall be 136
determined by the cardiac emergenc y response plan and shall 137
include, but shall not be limited to, athletic coaches, 138
school nurses, and athletic trainers. 139