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Policy
Statement Addresses AEDs in School
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Numerous organizations
lead by the American Heart Association co-developed a policy statement
on how schools should respond to cardiac arrest and selected life-threatening
medical emergencies. The American Academy of Pediatrics, the National
Association of School Nurses, and a number of associations of emergency
response professionals helped to author and disseminate this statement.
Cardiac arrests in
school age children are caused by ventricular fibrillation or pulseless
ventricular tachycardia. Excepting for exceedingly rare cases where these
heart rhythm problems are caused by a blow to the chest, these are caused
by inherited/congenital problems or acute medical problems such as: Q-T
Syndrome, cardiomyopathies, abnormal coronary arteries, and aortic dissection.
Hypertrophic cardiomyopathy is the most common. On average, one may expect
an incidence of 1/100,000 to 1/200,000 students per year to have a sudden
cardiac arrest. This number is higher among secondary school students
who are also athletes and lower among elementary school students.
All schools are recommended to have effective communication systems (i.e.,
cannot rely on 'runners' from the field to the school telephone), coordinated
plans (e.g., a plan that outlines how to achieve less than one-minute
elapsed time between the "collapse" and the 911 call), risk
reduction (injury prevention plans in place), and first-aid and CPR training
for staff and students. Once these have been established, schools may
also choose to have an AED - particularly large schools with many adolescent
and adult attendees or many community events and schools distant from
community-based emergency response systems. A mathematical formula is
provided to estimate the risk of sudden cardiac arrest in any one school.
The policy statement warns that unfunded mandates for AEDs in school and
funding only for AEDs and not the systems to support this piece of equipment
will limit the effectiveness of AEDs and place substantial limits on their
effectiveness.
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