Do schools need emergency response equipment to deal with heart attacks?

Aug 29 2007

A study by researchers in the U.S. has found that the incidence of heart attacks on school property is rare, and when it does occur most of the victims are adults.

In view of pending policies with regard to the setting up of emergency response systems in schools, the study comes at an opportune moment.

After conducting a review of 16 years of emergency medical service calls in the Seattle area, researchers found that faculty and staff were 25 times more likely than students to suffer cardiac arrest.

The researchers from the University of Washington School of Medicine found cardiac arrest is quite uncommon in schools and is much more likely to occur in adults than in young athletes or students.

Lead researcher Dr. Tom Rea, an associate professor of medicine at Harborview Medical Center and the University says the study should help policymakers and schools make the decision of how much priority they are going to give to cardiac arrest, especially when implementing automated external defibrillator (AED) programs.

The study aims to provide data for those considering the setting up of emergency response systems in schools.

In the study, the researchers examined data on 3,773 cardiac arrests in King County, Washington, which occurred between January 1990 and December 2005.

Of these, 97 occurred in the 641 schools that ranged from preschools to colleges, in seven of the cases, the affiliation between the victim and the school was unknown but it was found in the remaining 90 cases, that only 12 students suffered cardiac arrest and eight of those were 18 or younger.

Of the eight younger students who suffered cardiac arrest, four had known heart or lung disease or were severely developmentally disabled.

Thirty three cardiac arrests occurred among faculty and staff while another 45 adults who had no connection to the school had cardiac arrest while on school property that included sports fields and tracks.

The question remains - what level of emergency response, if any, should a school be expected to provide in such circumstances?

Of course the most popular idea appears to be training school personnel in cardiopulmonary resuscitation (CPR) and early defibrillation using AEDs, which are used to restart the heart after cardiac arrest.

But the second question is do such rare events warrant the expense involved in both the training and equipment which would then be needed?

These events are extremely uncommon, so individual schools or school districts have to decide if they want to be prepared for even the most uncommon event.

Experts are divided over the issue with some saying improved cardiac arrest recognition and emergency activation, early CPR, and early defibrillation, including the use of AEDs, can significantly increase the chances of surviving sudden cardiac arrest.

Others disagree and say the rarity of cardiac arrests at schools makes having AEDs available unnecessary and not cost-effective.

The study found that half of the student cardiac arrests were not associated with physical exertion or sports participation, and student risk was similar for elementary school, middle school, high school and college.

The report is published in the September issue of Circulation.