Placement of automated external defibrillators (AEDs) in schools is an efficient way to curb out-of-hospital sudden cardiac arrest (OHCA) deaths if a recent study carried out by researchers at New York University College of Nursing is to go by. Schools represent one of the most important frontiers in the fight against (OHCA).
In the US, health organizations and state authorities recommend or mandate public establishments such as hotels, airports and schools to provide at least one AED on their premises. Because SCA is often linked to physical activity, student athletes are particularly targeted in the public access defibrillation push. Teachers and other adult staff also benefit greatly because they are more prone to SCA than the average student. SCA is the leading cause of natural death in the USA, killing more than 350,000 people annually.
The researchers received correspondence from a total of 876 respondents from the state of New York State Association of School Nurses. Of these, 8.2% (71) reported having witnessed one or more SCAs in the school(s) they served. In 84.3% (59) of these cases, an AED was applied, with 40 individuals attaining long-term survival and a further 10 achieving short-term survival. Long-term survival means surviving long beyond hospitalization, while short-term survival is where the victim only makes it to the ambulance or hospital.
The availability of AEDs in New York schools was quite impressive with over half of the responding nurses indicating that their schools had between two and four functioning AEDs, and nearly 96% of schools having at least one AED. Only a small minority (5.4%) did not have an AED. Additionally, despite NYS laws not requiring AEDs in private schools, respondents indicated that a majority of private schools have at least one.
Another instructive finding is that the majority of SCA cases affected adults working in the schools including teachers and support staff. This is not surprising given that SCA risk increases with age.
Given the apparent efficacy of AEDs, it is unfortunate that only 17 states require schools to have AEDs on their grounds. The researchers recommend that AED policies be more inclusive rather than preferentially targeting student athletes because only a minority of students play sports school. Additionally, it should target all levels of schooling. Currently, most literature on SCA is focused on high school athletes but in the current study, most of the SCA cases occurred among middle schoolers. The researchers recommended further research on use of AED in schools, with particular interest in disparities of outcomes between states with AED mandates and those without them.
Overall, this study is an affirmation of what medical experts have known for a long time: public access defibrillation works. Future efforts should now be concentrated on streamlining policies on AED placement and awareness to ensure that it is targeted towards an optimal cross-section of the population.