Automated External Defibrillators in Schools

Sherrid MV, Aagaard P, Serrato S, et al.
State Requirements for Automated External Defibrillators in American Schools: Framing the Debate About Legislative Action. J Am Coll Cardiol 2017;69:1735-1743.

The following are 10 points to remember from this article dealing with the importance of universal placement of automated external defibrillators (AEDs) in schools:

  1. Estimates of the incidence of sudden cardiac arrest (SCA) in school-age individuals range from 2.1-6.3/100,000 per year.
  2. Two in fifty high schools in the United States can expect a SCA event each year.
  3. The hospital survival rate of students after SCA in schools with AEDs is approximately 70%, compared with only approximately 8% in the overall population of school-age children.
  4. Only 17 of 50 states (34%) have some type of legislation dealing with AEDs in schools, most commonly a requirement for AEDs in public grade schools or in both public grade schools and colleges.
  5. Nine of these seventeen states provide funding for the AEDs.
  6. The American Heart Association provides no specific guidance or recommendations on the placement of AEDs in schools.
  7. The placement of AEDs in schools should be accompanied by training of the staff.
  8. A simulator study has demonstrated that students without prior training can accurately employ an AED as directed by prompts from the AED.
  9. All states have Good Samaritan laws that protect bystanders who use an AED to resuscitate a victim of SCA.
  10. The main impediment to the universal placement of AEDs in schools is cost. However, the cost of two AEDs plus a training program is approximately $3,300 per school, which is much lower than the annual expenditures of $11,000-12,000 per student in the United States.

Keywords: Arrhythmias, Cardiac, Cardiopulmonary Resuscitation, Child, Death, Sudden, Cardiac, Defibrillators, Health Expenditures, Heart Arrest, Schools, Students, Survival Rate, Secondary Prevention

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