Differences in school preparedness for sudden cardiac arrest based on automated external defibrillator availability and staff training between schools of different enrollment size

Background

A school has a 1–2 % chance of having a sudden cardiac arrest (SCA) on its campus in any given year. Schools can be prepared by having automated external defibrillators (AEDs) readily accessible with staff trained in their use. The overall survival rate of SCA is less than 10 %. However, those who suffer SCA at a school that has an AED on-site have more than a 60 % chance of surviving to discharge. Currently, AEDs are not required in schools across all 50 states in the US.

Objective

Investigate the availability of AEDs in high schools across a state prior to any formal mandate and explore discrepancies among schools of varying enrollment sizes.

Methods

A 16-question survey about AED availability, accessibility, and percentage of staff trained for its use was distributed to every high school in Nebraska in July 2022.

Results

Schools with smaller enrollments were more likely to have AEDs accessible to the public (p = 0.047), available at all events (p = 0.0002), and over 50 % of staff trained for its use (p = 0.00019) than schools with larger enrollments. There was no correlation between number of AEDs and enrollment (R² = 0.172).

Conclusions

Most high schools have automated external defibrillators (AEDs), even without statewide mandates; however, continuing efforts are needed to ensure that AEDs at all schools are accessible to the public and that staff are appropriately trained. This study highlights the need for increased advocacy and targeted resource allocation, particularly for larger schools, to ensure appropriate/adequate AED distribution and emergency preparedness across all high schools.