Key result
The 5-year incidence of sudden cardiac arrest in Tennessee high schools was 1 in 12, and schools with a history of SCA had higher compliance with AHA recommendations (19% vs 3%, P=0.011).
Cross-Sectional (n=257)
Yes
Absolute Event Rate: 19% vs 3%
p-value: p=0.011
Despite a 5-year incidence of 1 SCA per 12 high schools, compliance with AHA guidelines for medical emergency response plans and AED placement is poor.
SCA events may boost school compliance; observational data leave open whether mandated adherence reduces incidence.
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.
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Meredith et al. (2013) conducted a cross-sectional in Sudden cardiac arrest (n=257). History of sudden cardiac arrest vs. No history of sudden cardiac arrest was evaluated on Full compliance with AHA recommendations (p=0.011). The 5-year incidence of sudden cardiac arrest in Tennessee high schools was 1 in 12, and schools with a history of SCA had higher compliance with AHA recommendations (19% vs 3%, P=0.011).
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