Abstract 148: Installation and Deployment of Automated External Defibrillators in New York State Schools

Abstract

Introduction: AHA recommends that automated external defibrillators (AEDs) be made available in public areas with high likelihood of a sudden cardiac arrest (SCA). Only 18 US states have regulations requiring AEDs in schools and the legislation varies. There is no comprehensive evaluation of the epidemiology of sudden death in schools. School nurses are often the only healthcare providers within a school. New York State (NYS) enrolls almost 3.5 million students with New York City (NYC) being the largest school system in the US; legislation requires AEDs in all public but not in private schools. Purpose: Our aims were threefold: to gain epidemiologic data on SCAs in NYS schools, to evaluate the availability and utilization of AEDs, and to identify factors affecting deployment of AEDs. Methods: Electronic surveys were sent to school nurse members of the NYS Association of School Nurses and NYC school nurses. We also conducted structured interviews with a representative sample of NYS school nurses. Results: Nurses representing 750 public schools and 116 private schools responded, a response rate of 36.4%. There were 71 SCA events, with majority affecting adults on school grounds 41 (58%). AEDs were deployed in 59 (73%). Short term survival occurred in 50 (69%) with 40 (56%) returning to regular activity. While not required to have AEDs available, most private schools had them 69(60%). There were 21 (30%) SCA events in private schools with 8 (11%) occurring in private schools with no AEDs. Of these, 6 (75%) had a negative outcome. Interviews revealed that staff attitude, fear, and training adequacy were factors influencing AED utilization. Conclusions: AEDs in schools improve survival outcomes. There has been no comprehensive evaluation of SCA events in US schools and no uniformity in AED legislation among states. While focus is on students, NYS data suggests that attention should also encompass adult SCAs in schools. Comparisons of AED utilization and SCA outcomes in states with and without AED legislation will be of interest, and may have health policy implications.