title: Sudden cardiac arrests, automated external defibrillators, and medical emergency response plans in Tennessee high schools.
abstract: OBJECTIVE
  Schools are important public locations of sudden cardiac arrest (SCA), and the American Heart Association (AHA) recommends medical emergency response plans (MERPs), which may include an automated external defibrillator (AED) in schools. The objective of this study was to determine the incidence of SCA and the prevalence of AEDs and MERPs in Tennessee high schools.
  
  
  METHODS
  Tennessee Secondary School Athletic Association member schools were surveyed regarding SCA on campus within 5 years, AED presence, and MERP characteristics.
  
  
  RESULTS
  Of 378 schools, 257 (68%) completed the survey. There were 21 (5 student and 16 adult) SCAs on school grounds, yielding a 5-year incidence of 1 SCA per 12 high schools. An AED was present at 11 of 21 schools with SCA, and 6 SCA victims were treated with an AED shock. A linear increase in SCA frequency was noted with increasing school size (<500 students: 3.3% incidence, 500-1000: 6.5%, 1000-1500: 12.5%, ≥1500: 18.2%; P = 0.003). Of 257 schools, 71% had an MERP, 48% had an AED, and only 4% were fully compliant with AHA recommendations. Schools with a history of SCA were more likely to be compliant (19% vs. 3%, P = 0.011).
  
  
  CONCLUSIONS
  The 5-year incidence of SCA in Tennessee high schools is 1 in 12, but increases to 1 in 7 for schools with more than 1000 students. Compliance with AHA guidelines for MERPs is poor, but improved in schools with recent SCA. Future recommendations should encourage the inclusion of AED placement in schools with more than 1000 students.
authors: Department of Pediatrics, Division of Pediatric Emergency Medicine, The Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, TN 37232, USA. Mark.Meredith@Vanderbilt.edu
authors: Mark L
authors: ML
authors: Meredith
authors: Andrew M
authors: AM
authors: Watson
authors: Andrew
authors: A
authors: Gregory
authors: Timothy G
authors: TG
authors: Givens
authors: Thomas J
authors: TJ
authors: Abramo
authors: Prince J
authors: PJ
authors: Kannankeril
mesh_terms: D000293:Adolescent; D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D016009:Chi-Square Distribution; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D047548:Defibrillators / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000458:organization & administration*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D015995:Prevalence; D012574:Schools; D011795:Surveys and Questionnaires; D015996:Survival Rate; D013714:Tennessee / Q000453:epidemiology