School-Based CPR-AED Programs Save Lives

ACEP News
April 2011

BY BRUCE JANCIN

Elsevier Global Medical News

CHICAGO - Programs that assist schools in implementing comprehensive cardiopulmonary resuscitation and automated external defibrillator use are resulting in markedly higher survival rates for sudden cardiac arrests occurring on school grounds, according to a new report from Project ADAM.

In Georgia, where a 2008 statewide survey showed comprehensive CPR-AED programs were in place in 32% of schools, survival to hospital discharge occurred in 10 of 26 students and 12 of 23 adults with sudden cardiac arrest at participating schools. This 45% survival rate for out-of-hospital cardiac arrest is far superior to rates reported in the literature, which are typically 5% or less, Dr. Stuart Berger noted at the annual scientific sessions of the American Heart Association.

Eight of the 26 affected Georgia students were in elementary or junior high school, underscoring the point that sudden cardiac arrest in pediatric patients is not a problem confined to high school athletes, as is often assumed to be the case, added Dr. Berger, professor of pediatrics at the Medical College of Wisconsin, Milwaukee, and medical director of cardiology at Children's Hospital of Wisconsin, where Project ADAM is based.

The Georgia students who survived sudden cardiac arrest included individuals with long QT syndrome, Kawasaki disease, aortic stenosis, hypertrophic cardiomyopathy, Wolff-Parkinson-White syndrome, lightning strike, commotio cordis, and coronary artery from the opposite sinus of Valsalva.

Project ADAM's Georgia affiliate, Project S.A.V.E., based at Children's Healthcare of Atlanta since 2004, has provided information on comprehensive school CPR-AED programs to all 180 school districts in the state.

A quarter of all schools in Wisconsin and 90% of the state's high schools now have CPR-AED programs. So do all traditional schools in the Milwaukee public school system. A statewide survey found a 36% rate of survival to hospital discharge in schools where an AED was utilized during sudden cardiac arrest, Dr. Berger continued.

Project ADAM is a not-for-profit organization. ADAM stands for Automated Defibrillators in Adam's Memory, in tribute to a 17-year-old Wisconsin youth who collapsed and died while playing basketball. Project ADAM staff has developed a CPR-AED training manual with an instructional DVD and other no-cost materials for schools. The staff works with parents, administrators, school nurses, teachers, coaches, and athletic trainers to develop an emergency response plan and first-responder teams trained in CPR-AED. Project ADAM provides training grants to schools to support these efforts.

Dr. Berger said schools are a logical place to locate secondary prevention programs as part of a public access defibrillation strategy. Not only do many of the estimated 3,000 sudden cardiac deaths per year in children and adolescents happen during school or after-school activities, but 20% of U.S. adults spend time in schools each week for their jobs, to attend programs, or in visiting students.

"Increased student CPR education will also put a new cadre of first responders into the communities. As future collaboration is carried forward, endeavors such as Project ADAM and other educational public access defibrillation programs will continue to improve outcomes to a level that has not yet been realized," the pediatrician predicted.

Georgia and Wisconsin are among at least 17 states with laws requiring or supporting AED placement in schools.