title: High School Cardiac Emergency Response Plans and Sudden Cardiac Death in the Young.
abstract: Introduction Sudden cardiac death (SCD) is responsible for 5%-10% of all deaths among children 5-19 years-of-age. The incidence of SCD in youth in Michigan (USA) and nationwide is higher in racial/ethnic minorities and in certain geographic areas. School cardiac emergency response plans (CERPs) increase survival after cardiac arrest. However, school cardiac emergency preparedness remains variable. Studying population-level factors associated with school cardiac emergency preparedness and incidence of SCD in the young may improve understanding of disparities in the incidence of SCD. Hypothesis/Problem The objective of this pilot study was to determine the association of elements of high school cardiac emergency preparedness, including Automated External Defibrillator (AED) distribution and the presence of CERPs with county sociodemographic characteristics and county incidence of SCD in the young.
  
  
  METHODS
  Surveys were sent to representatives from all public high schools in 30 randomly selected Michigan counties. Counties with greater than 50% response rate were included (n=19). Association of county-level sociodemographic characteristics with incidence of SCD in the young and existence of CERPs were evaluated using Spearman correlation coefficient.
  
  
  RESULTS
  Factors related to the presence of AEDs were similar across counties. Schools in counties of lower socioeconomic status (SES; lower-median income, lower per capita income, and higher population below poverty level) were less likely to have a CERP than those with higher SES (all P<.01). Lack of a CERP was associated with a higher incidence of SCD in youth (r=-0.71; P=.001). Overall incidence of SCD in youth was higher in lower SES counties (r=-0.62 in median income and r=0.51 in population below poverty level; both P<.05).
  
  
  CONCLUSIONS
  County SES is associated with the presence of CERPs in schools, suggesting a link between school cardiac emergency preparedness and county financial resources. Additionally, counties of lower SES demonstrated higher incidence of SCD in the young. Statewide and national studies are required to further explore the factors relating to geographic and socioeconomic differences in cardiac emergency preparedness and the incidence of SCD in the young. White MJ , Loccoh EC , Goble MM , Yu S , Odetola FO , Russell MW . High school cardiac emergency response plans and sudden cardiac death in the young. Prehosp Disaster Med. 2017;32(3):269-272.
authors.affiliation: 1Division of Pediatric Cardiology,Department of Pediatrics and Communicable Diseases,University of Michigan Congenital Heart Center,C.S. Mott Children's Hospital,Ann Arbor,MichiganUSA.
authors.forename: Michelle J
authors.initials: MJ
authors.lastname: White
authors.affiliation: 1Division of Pediatric Cardiology,Department of Pediatrics and Communicable Diseases,University of Michigan Congenital Heart Center,C.S. Mott Children's Hospital,Ann Arbor,MichiganUSA.
authors.forename: Emefah C
authors.initials: EC
authors.lastname: Loccoh
authors.affiliation: 1Division of Pediatric Cardiology,Department of Pediatrics and Communicable Diseases,University of Michigan Congenital Heart Center,C.S. Mott Children's Hospital,Ann Arbor,MichiganUSA.
authors.forename: Monica M
authors.initials: MM
authors.lastname: Goble
authors.affiliation: 1Division of Pediatric Cardiology,Department of Pediatrics and Communicable Diseases,University of Michigan Congenital Heart Center,C.S. Mott Children's Hospital,Ann Arbor,MichiganUSA.
authors.forename: Sunkyung
authors.initials: S
authors.lastname: Yu
authors.affiliation: 2Division of Critical Care Medicine,Department of Pediatrics and Communicable Diseases,University of Michigan,C.S. Mott Children's Hospital,Ann Arbor,MichiganUSA.
authors.forename: Folafoluwa O
authors.initials: FO
authors.lastname: Odetola
authors.affiliation: 1Division of Pediatric Cardiology,Department of Pediatrics and Communicable Diseases,University of Michigan Congenital Heart Center,C.S. Mott Children's Hospital,Ann Arbor,MichiganUSA.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Russell
mesh_terms: D000293:Adolescent; D002648:Child; D002662:Child Health Services; D002675:Child, Preschool; D002959:Civil Defense; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D047548:Defibrillators; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D008297:Male; D008824:Michigan / Q000453:epidemiology; D010865:Pilot Projects; D012572:School Health Services; D012574:Schools; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords:  AED Automated External Defibrillator;  CERP cardiac emergency response plan;  SCD sudden cardiac death;  SES socioeconomic status; automated external defibrillator; school health; sudden cardiac death