title: High school automated external defibrillator programs as markers of emergency preparedness for sudden cardiac arrest.
abstract: BACKGROUND
  School-based automated external defibrillator (AED) programs have demonstrated a high survival rate for individuals suffering sudden cardiac arrest (SCA) in US high schools.
  
  
  OBJECTIVE
  To examine the relationship between high schools having an AED on campus and other measures of emergency preparedness for SCA.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  United States high schools, December 2006 to September 2009.
  
  
  METHODS
  Principals, athletic directors, school nurses, and certified athletic trainers represented 3371 high schools.
  
  
  METHODS
  Comprehensive surveys on emergency planning for SCA submitted by high school representatives to the National Registry for AED Use in Sports from December 2006 to September 2009. Schools with and without AEDs were compared to assess other elements of emergency preparedness for SCA.
  
  
  RESULTS
  A total of 2784 schools (82.6%) reported having 1 or more AEDs on campus, with an average of 2.8 AEDs per school; 587 schools (17.4%) had no AEDs. Schools with an enrollment of more than 500 students were more likely to have an AED (relative risk [RR] = 1.12, 95% confidence interval [CI] = 1.08, 1.16, P < .01). Suburban schools were more likely to have an AED than were rural (RR = 1.08, 95% CI = 1.04, 1.11, P < .01), urban (RR = 1.13, 95% CI = 1.04, 1.16, P < .01), or inner-city schools (RR = 1.10, 95% CI = 1.04, 1.23, P < .01). Schools with 1 or more AEDs were more likely to ensure access to early defibrillation (RR = 3.45, 95% CI = 2.97, 3.99, P < .01), establish an emergency action plan for SCA (RR = 1.83, 95% CI = 1.67, 2.00, P < .01), review the emergency action plan at least annually (RR = 1.99, 95% CI = 1.58, 2.50, P < .01), consult emergency medical services to develop the emergency action plan (RR = 1.18, 95% CI = 1.05, 1.32, P < .01), and establish a communication system to activate emergency responders (RR = 1.06, 95% CI = 1.01, 1.08, P < .01).
  
  
  CONCLUSIONS
  High schools with AED programs were more likely to establish a comprehensive emergency response plan for SCA. Implementing school-based AED programs is a key step associated with emergency planning for young athletes with SCA.
authors.affiliation: Department of Family Medicine, University of Washington, Seattle 98195, USA.
authors.forename: Brett G
authors.initials: BG
authors.lastname: Toresdahl
authors.forename: Kimberly G
authors.initials: KG
authors.lastname: Harmon
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Drezner
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D002959:Civil Defense; D003430:Cross-Sectional Studies; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D047548:Defibrillators; D005260:Female; D006801:Humans; D007318:Inservice Training; D008297:Male; D012042:Registries; D012572:School Health Services / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D014481:United States