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Sudden Cardiac Arrests, Automated External Defibrillators, and Medical Emergency Response Plans in Tennessee High Schools

Meredith, Mark L. MD*†; Watson, Andrew M. MD, MS*; Gregory, Andrew MD*‡; Givens, Timothy G. MD§; Abramo, Thomas J. MD*†; Kannankeril, Prince J. MD, MSCI*∥

doi: 10.1097/PEC.0b013e31828530c1
Original Articles

Objectives Schools are important public locations of sudden cardiac arrest (SCA), and the American Heart Association (AHA) recommends medical emergency response plans (MERPs), which may include an automated external defibrillator (AED) in schools. The objective of this study was to determine the incidence of SCA and the prevalence of AEDs and MERPs in Tennessee high schools.

Methods Tennessee Secondary School Athletic Association member schools were surveyed regarding SCA on campus within 5 years, AED presence, and MERP characteristics.

Results Of 378 schools, 257 (68%) completed the survey. There were 21 (5 student and 16 adult) SCAs on school grounds, yielding a 5-year incidence of 1 SCA per 12 high schools. An AED was present at 11 of 21 schools with SCA, and 6 SCA victims were treated with an AED shock. A linear increase in SCA frequency was noted with increasing school size (<500 students: 3.3% incidence, 500–1000: 6.5%, 1000–1500: 12.5%, ≥1500: 18.2%; P = 0.003). Of 257 schools, 71% had an MERP, 48% had an AED, and only 4% were fully compliant with AHA recommendations. Schools with a history of SCA were more likely to be compliant (19% vs 3%, P = 0.011).

Conclusions The 5-year incidence of SCA in Tennessee high schools is 1 in 12, but increases to 1 in 7 for schools with more than 1000 students. Compliance with AHA guidelines for MERPs is poor, but improved in schools with recent SCA. Future recommendations should encourage the inclusion of AED placement in schools with more than 1000 students.

From the *Department of Pediatrics, Divisions of †Pediatric Emergency Medicine, and ‡Pediatric Orthopedics, The Monroe Carell Jr Children’s Hospital at Vanderbilt, and Vanderbilt University School of Medicine, Nashville, TN; §Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO; and ∥Division of Pediatric Cardiology, The Monroe Carell Jr Children’s Hospital at Vanderbilt, and Vanderbilt University School of Medicine, Nashville, TN.

Disclosure: The authors declare no conflict of interest.

Reprints: Mark L. Meredith, MD, Monroe Carell Jr Children’s Hospital at Vanderbilt, 2200 Children’s Way, VCH 1014, Nashville, TN 37232 (e-mail:

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© 2013 Lippincott Williams & Wilkins, Inc.