In a survey of high schools that had an AED program and had had a cardiac arrest within the preceding six months, 64% of cases — students and nonstudents alike — survived to hospital discharge, according to Jonathan Drezner, MD, of the University of Washington in Seattle, and colleagues.
Most of the schools (83.5%) had an emergency action plan in place for responding to sudden cardiac arrest, the researchers reported online in Circulation: Journal of the American Heart Association.
More than 92% of individuals suffering an out-of-hospital cardiac arrest do not survive to hospital discharge, and survival declines 7% to 10% for each minute defibrillation is delayed, according to Dr. Drezner and colleagues.
One study found that survival after exercise-related cardiac arrest in particular was only 11%.
Responding to the low survival rate, many schools have implemented AED programs and emergency response plans for sudden cardiac arrest.
However, it had remained unclear how effective early defibrillation was for treating cardiac arrest among student-athletes and others in schools.
To explore the issue, Dr. Drezner and colleagues identified 1,710 U.S. high schools that had at least one AED using the National Registry for AED Use in Sports.
According to a survey completed by school representatives, 83.5% of the schools had an established emergency action plan for sudden cardiac arrest; 60% of those with a plan developed it in collaboration with local EMS.
However, only 40% practiced and reviewed the plans at least once a year, and only 18% posted a written emergency plan at each athletic venue.
Of the respondents, 2.1% of the schools had had a sudden cardiac arrest occur on premises within the preceding six months.
Almost all (97%) were witnessed, 94% received CPR from a bystander, and 83% received an AED shock.
The average time from arrest to first shock was 3.6 minutes for students (mean age 16) and 1.8 minutes for nonstudents, including teachers, coaches, visitors, and other adults (mean age 57).
Nearly two-thirds (64%) of cases survived to hospital discharge, including nine of 14 student-athletes and 14 of 22 nonstudents.
“Although some deficiencies in emergency response planning were identified, a high survival rate for both student athletes and older nonstudents with sudden cardiac arrest was reported in high schools with on-site AED programs,” the researchers said.
“The need for ongoing CPR training, fully developed and executed emergency plans, and links to EMS are vital to the immediate and long-term outcomes of shock delivery,” Dianne Atkins, MD, of the University of Iowa in Iowa City said.
“The tragic death of an adolescent has a profound effect on the community, and the desire to protect this population may outweigh financial considerations,” she said.
Dr. Drezner and colleagues acknowledged some limitations of the study, including the low response rate (11%), the inclusion of schools that already had AED programs, the use of self-reported data, and the possibility that some cases of sudden cardiac arrest may have been missed.