ORIGINAL ARTICLE

Automated external defibrillators in Washington State high schools

Justin D Rothmier¹, Jonathan A Drezner¹, Kimberly G Harmon¹

¹ Department of Family Medicine, University of Washington, Seattle, Washington, USA

Correspondence to:
Dr J A Drezner
Department of Family Medicine, University of Washington, Box 354775, 4245 Roosevelt Way NE, Seattle, WA 98105, USA; jdrezner{at}fammed.washington.edu

Background: The placement of automated external defibrillators (AEDs) in schools and public sporting venues is a growing national trend.

Objective: To determine the prevalence and use of AEDs in Washington State high schools and to examine the existing emergency preparedness for sudden cardiac arrest (SCA).

Design: Cross-sectional survey.

Setting: High schools in Washington State.

Participants: The principal at each high school in the Washington Interscholastic Activities Association (n = 407) was invited to complete a web-based questionnaire using the National Registry for AED Use in Sports (http://www.AEDSPORTS.com).

Main outcome measurements: The primary outcome measures studied included AED prevalence and location, funding for AEDs, AED training of school personnel, coordination of AED placement with local emergency response agencies, and prior AED use.

Results: 118 schools completed the survey (29% response rate). 64 (54%) of the schools have at least one AED on school grounds (mean 1.6, range 1–4). The likelihood of AED placement increased with larger school size (p = 0.044). 60% of AEDs were funded by donations, 27% by the school district and 11% by the school or athletic department itself. Coaches (78%) were the most likely to receive AED training, followed by administrators (72%), school nurses (70%) and teachers (48%). Only 25% of schools coordinated the implementation of AEDs with an outside medical agency and only 6% of schools coordinated with the local emergency medical system. One school reported having used an AED previously to treat SCA in a basketball official who survived after a single shock. The estimated probability of AED use to treat SCA was 1 in 154 schools per year.

Conclusions: Over half of Washington State high schools have an AED on school grounds. AED use occurred in <1% of schools annually and was effective in the treatment of SCA. Funding of AED programmes was mostly through private donations, with little coordination with local emergency response teams. Significant improvement is needed in structuring emergency response plans and training targeted rescuers for an SCA in the high-school setting.

Abbreviations: AED, automated external defibrillator; AHA, American Heart Association; CPR, cardiopulmonary resuscitation; EAP, emergency action plan; EMS, emergency medical system; SCA, sudden cardiac arrest; SCD, sudden cardiac death

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COMMENTARY

Constance LeBrun²

² Fowler Kennedy Sport Medicine Clinic, UWO, London, Canada; clebrun{at}uwo.ca

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• Drezner, J A (2009). Preparing for sudden cardiac arrest--the essential role of automated external defibrillators in athletic medicine: a critical review. Br. J. Sports. Med. 43: 702-707 [Abstract] [Full Text]  
• Drezner, J. A., Rao, A. L., Heistand, J., Bloomingdale, M. K., Harmon, K. G. (2009). Effectiveness of Emergency Response Planning for Sudden Cardiac Arrest in United States High Schools With Automated External Defibrillators. Circulation 120: 518-525 [Abstract] [Full Text]  
• Bernhardt, D. (2007). AEDs in High Schools. AAP Grand Rounds 18: 9-10 [Full Text]