6407 Saving lives in schools: the history of the automated external defibrillator (AED) and its implementation in UK schools

Objectives Since the introduction of new legislation by the Department for Education, all state-funded schools are required to have an Automated External Defibrillator (AED) in place by the end of the 2023 academic year.¹ External defibrillators have been in evolution since 1899 and now their value in reversing preventable paediatric cardiac arrest in schools is being recognised. The term to 'defibrillate' means to 'reverse the action' of the Latin 'fibra', relating to the cardiac fibres beating in an abnormal way.² Objective to review the history of the AED and the impact of school AED implementation. Methods Method Literature Review Results Results The first demonstration that electrical shocks could alter electrical activity of the heart was shown by Prévost and Batelli in 1899, with the induction and reversal of ventricular fibrillation (VF) in dogs. Following this, Electrical Engineer Kouwenhoven in 1930 experimented on the human heart but it was not until 1947 during thoracic surgery in a 14-year-old boy that Claude Beck performed the first defibrillation.³ Professor Frank Pantridge is heralded as the creator of the portable external debrillator in 1965, which initially weighed over 70kg and was powered by a car battery.⁴ Survival rates for cardiac arrest reduce by 7–10% for every minute delay in receiving treatment.¹ The value of early intervention was recognised by Pantridge, who installed his device into a first responder ambulance. Portable defibrillators were born! More recently, studies into the value of AEDs in public places, including schools, has evolved. Japanese SPIRITS trial evaluated that 71% of out-of-hospital paediatric arrests were cardiac in origin; 65% occurred during exercise.⁵ New legislation recommends schools consider locating AEDs in sports facilities, particularly if publicly accessible, with a recognised 100-fold potential benefit.¹ In the UK, it is expected that around 20,000 defibrillators will be supplied to schools, as the result of legislation and campaigning by the Oliver King Foundation.⁶ Studies evaluating AED use in school children highlight the need for school education programmes – in one study 20% of school age children were able to follow AED prompts effectively, although only one fifth used the device satisfactorily.⁷ Conclusion Conclusion AEDs have evolved to become accessible and life saving devices demonstrating clear benefit in the case of arrest in the school setting. To optimise effectiveness, emphasis should be placed on education programmes to enhance confidence in bystander use. References Automated External Defibrillators (AEDs) Guidance for schools, Department for Education August 2023. Online Etymology Dictionary, Douglas Harper October 2023. Defibrillators A Brief History, The Community Heartbeat Trust October 2023. Evans A. Frank Pantridge. BMJ 2 April 2005. Kiyohara K, Sado J, Kitamura T, et al. Epidemiology of pediatric out-of-hospital cardiac arrest at school – an investigation of a Nationwide Registry in Japan. Circulation Journal 2018. Defibrillators: All state schools now have lifesaving equipment, The Education Hub, Department for Education 25 July 2023. C Jorge-Soto, C Abelairas-Gómez R Resuscitation et al. Automated external defibrillation skills by naive schoolchildren 2016.