AEDs Do Belong in Schools

During the school year, 20 percent of America's population spends at least part of their day on a school property. Common sense would conclude that automated external defibrillators should be deployed on school campuses to provide protection from the risk of sudden cardiac arrest for all age groups. Parents, teachers, administrators, coaches, parents, grandparents, neighbors and students can all be found on a school campus at any given part of the day. Adults can be attending sporting events or attending a concert, teachers can be in the classroom or on the playground, coaches can be in the gym or on the athletic fields, and parents, grandparents or neighbors can be picking up or delivering kids to school. Therefore, having AEDs located on school grounds gives the sudden cardiac arrest (SCA) victim a second chance at life that they might not have some place else. How many people die each year from sudden cardiac arrest in this country? No one knows. The estimates range from 250,000 to 450,000 people, of which somewhere between 7,000 to 10,000 are children, depending on the source. However, there is no state or federal database or registry that tracks the frequency of sudden cardiac arrest in the United States; this includes the Center for Disease Control, which groups SCA deaths under heart attack. In addition, most studies focus on athletes, and not the eleven-year-old kid who collapsed and died while walking into school one morning. The coroners and medical examiners that I have spoken with say funds eliminate their ability to always determine an exact cause of death. Their major concern is to rule out homicide. As a result, the parents that are not given a specific cause of death are broken. It is difficult enough to accept the fact that your child is dead, but not to be given a cause of death is a nightmare. When a 17-year-old from North Carolina died in his first period English class, his cause of death was listed as natural causes on his death certificate. It was not until I spoke to the family about being tested for Long QT Syndrome that all of his family was tested. His father and two brothers later tested positive for Long QT. It was concluded that this was the probable cause of death for their son who died. No AED was available at their son s school. Since the conception of Parent Heart Watch, parents who have lost a child or children to sudden cardiac arrest, survivors of SCA and advocates for the decrease of sudden cardiac arrest have worked tirelessly to place AEDs in schools and public places, pass legislation requiring AEDs in schools and at athletic events, health clubs, government buildings and golf courses. Then, a terrible error occurred when a reporter recently interpreted an article in newspapers across the country questioning the need for AEDs on school properties. This conclusion was made after the reporter reviewed an AED study that took place in Seattle, and seemed to place a spin on the statistics. This was horribly misleading to the general public, and distorted the meaning and conclusion of the study. After reading the story written by Associated Press reporter Donna Gordon Blankinship, entitled Schools may not need defibrillators, study finds,² I concluded that she must have read a different abstract than the one I had read in Circulation, because what I read stated that School cardiac arrest victims were also more likely to survive to hospital discharge.¹ I spoke with Philip J. Goscienski, MD, a retired pediatric infectious diseases specialist whose son died at the age of 37 from SCA, about this concern. He is a CPR/AED instructor and Director of a Public Access Defibrillator (PAD) program in his church community. Dr. Goscienski lives in Oceanside, California and is a strong supporter of AEDs in public places. Dr. Goscienski s response to Blankinship s view was I am concerned that the reporter's seriously misguided opinion will adversely affect community efforts to place defibrillators in schools. In a recent commentary, Dr. Goscienski wrote that The Circulation article states that only 12 students suffered a cardiac arrest in 16 years. Given the out-of-hospital survival figures, I will assume that 11 died. If the four children with known cardiac defects could not have been saved by an AED (a premise that is not certain but which I will grant to Ms. Blankinship), four of the remaining eight children without such defects might have recovered with timely defibrillation. This reflects a survival rate of 50 percent if an AED is applied within four minutes.³ In addition, he goes on to write that the authors of the Circulation study conclude that school-based CPR and AED programs would benefit faculty and staff members as well as visitors to the school.³

Future Initiatives

The state of Texas has taken the initiative with a new law mandating AEDs in all schools and on all playing fields, as well as a cardiac screening test for students in grade 7. We hope that other states will follow this initiative, which was brought about by the sudden cardiac deaths of 16 kids in Texas schools, as well as the amazing save of 17-year-old Matt Nader of Austin during a football game. I would also like to thank Laura Friend, PHW member and sponsor administrator, for her phone calls and her many visits to the University Interscholastic League and the Governor and Lt. Governor s office. Every time I speak to an administrator who tells me that he or she doesn t need an automated external defibrillator in their school, I have to ask why. The usual response is that their fire company is across the street, that they can see it from their office window and it takes them no longer than two minutes to be anywhere in their building. It amazes me that they are not considering that the volunteer fire company will need time to be dispatched to even get to the firehouse or they could be out on another call if there is a sudden cardiac arrest emergency in their school. If a school can afford one laptop computer, they can afford an AED. If they have fire extinguishers, water sprinklers, or even strobe lights with their fire alarms, they can afford an AED. According to the Centers for Disease Control, there are approximately 10 deaths per day that are caused by fires versus the approximate 1,000 that die per day from sudden cardiac death. The number of fire-related deaths is low because fire safety is a priority. When will SCA become a priority? AEDs should be in schools to save lives, whether it is for the life of a child or adult, since sudden cardiac arrest can happen anytime to anyone. I would have rather had an AED in the $70 million dollar school where my 15-year-old died playing basketball, but these life-saving devices were cut from the budget. The school board apparently thought that the $50,000 scoreboard was worth more than one person s life. Parent Heart Watch will be sponsoring a CME event with the University of Washington in Seattle on January 18, 2008; the event will focus on "Prevention of Sudden Cardiac Death in Young Athletes. Online registration, brochure, and course programs are now available at: https://depts.washington.edu/cme/live/course/MJ0818. This conference, under the leadership of Dr. Jonathan Drezner, will focus on cardiovascular disease in athletes, screening methods and controversies, and strategies to prevent sudden cardiac death. Many of the most esteemed leaders in the field of cardiology and electrophysiology will be presenting; our keynote speaker will be Dr. Domenico Corrado from Padova, Italy. I sincerely hope that Donna Gordon Blankinship can make it as well.

For more information about Parent Heart Watch, please visit: www.parentheartwatch.org