Automated External Defibrillators and Emergency Planning for Sudden Cardiac Arrest in Vermont High Schools: A Rural State’s Perspective

BACKGROUND: Sudden cardiac death (SCD) events are tragic. Secondary prevention of SCD depends on availability of automated external defibrillators (AEDs). High school athletes represent a high-risk group for SCD, and current efforts aim to place AEDs in all high schools. HYPOTHESIS: The prevalence of AEDs and emergency planning for sudden cardiac arrest (SCA) in Vermont high schools is similar to other states. Understanding specific needs and limitations in rural states may prevent SCD in rural high schools. STUDY DESIGN: Cross-sectional survey. METHODS: A survey was distributed to all 74 Vermont high school athletic directors. Outcome measures included AED prevalence, AED location, individuals trained in cardiopulmonary resuscitation (CPR) and AED utilization, funding methods for AED attainment, and the establishment of an emergency action plan (EAP) for response to SCA. RESULTS: All schools (100%, 74 of 74) completed the survey. Of those, 60 (81%) schools have at least 1 AED on school premises, with the most common location for AED placement being the main office or lobby (50%). Larger sized schools were more likely to have an AED on the premises than smaller sized schools (P = 0.00). School nurses (77%) were the most likely individuals to receive formal AED training. Forty-one schools (55%) had an EAP in place for response to SCA, and 71% of schools coordinated AED placement with local emergency medical services (EMS) responders. CONCLUSION: In Vermont, more than two-thirds of high schools have at least 1 AED on school premises. However, significant improvement in the establishment of EAPs for SCA and training in CPR and AED utilization is essential given the rural demography of the state of Vermont. CLINICAL RELEVANCE: Rural high schools inherently have longer EMS response times. In addition to obtaining AEDs, high schools must develop a public access to defibrillation program to maximize the chance of survival following cardiac arrest, especially in rural settings.