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Published on: February 28, 2012
Automated external defibrillator deployment in high schools and senior centers
Elizabeth Jones1, Sandeep Vijan, A Mark Fendrick
1Iowa City Veterans Affairs Medical, Center, Division of General Medicine, Department of Internal, Medicine, University of Iowa College of Medicine, Iowa City, Iowa 52242, USA.
Insights
Automated external defibrillators (AEDs) are not always placed in high-risk locations. This study found AED availability did not directly correlate with cardiac arrest risk in schools versus senior centers.
Area of Science:
- Public Health
- Emergency Medicine
- Medical Devices
Background:
- Limited funding necessitates strategic allocation of automated external defibrillators (AEDs).
- Guidelines recommend placing AEDs at high-risk venues based on sudden cardiac death (cardiac arrest) risk.
- Data on AED placement relative to site-specific risk are limited.
Purpose of the Study:
- To assess the availability of AEDs in low-risk (schools) and high-risk (senior centers) venues.
- To compare AED distribution with the incidence of cardiac arrest at these sites.
Main Methods:
- Surveyed a random sample of 188 high schools regarding student/teacher numbers, AED availability, and cardiac arrests (2001-02).
- Surveyed 20 licensed senior centers for AED availability and cardiac arrest data.
- Calculated annual incidence of cardiac arrest for both venue types.
Main Results:
- Schools had a low annual cardiac arrest incidence (2.1%); 25% had AEDs, 27% planned to purchase them.
- Senior centers had a higher annual cardiac arrest incidence (20%); only 10% had AEDs.
- AED availability did not align with the observed cardiac arrest rates between schools and senior centers.
Conclusions:
- The current placement of AEDs may not accurately reflect the actual risk of cardiac arrest at different venues.
- Site-specific cardiac arrest incidence should be a primary consideration for AED allocation to optimize public safety.
Background:
Policymakers with limited funds have been forced to make difficult decisions regarding which sites merit automated external defibrillators (AEDs). Guidelines have recommended that the allocation of AEDs be based largely on the site-specific risk of sudden cardiac death (cardiac arrest), with devices preferentially located at high-risk venues. However, there are limited data on whether such a strategy is being followed. The authors surveyed low-risk (schools) and high-risk (senior centers) venues to assess the availability of AEDs.
Methods:
A random sample of 200 high schools was identified; 12 were excluded, resulting in a final sample of 188. Each was contacted to determine the number of students, number of teachers, availability of AEDs, and number of cardiac arrests during the 2001-02 academic year. For comparison, 20 licensed senior centers were surveyed to assess the availability of AEDs.
Results:
Among 147 schools that responded to the survey, the mean student enrollment was 1,117 and the mean number of teachers was 58. There were three reported cases of cardiac arrest (2 students, 1 teacher), resulting in an annual incidence of cardiac arrest in a school of 2.1% (95% confidence interval [CI] 0.4%-5.7%). Thirty-seven schools (25%; 95% CI 18%-33%) reported having AEDs and 35 (27%) intended to purchase them. In contrast, among 20 senior centers, AEDs were available at two (10%; 95% CI 1%-32%), and the and there were four reported cardiac arrests (annual incidence 20%).
Conclusion:
The availability of AEDs across different sites may not correspond directly to the risk of cardiac arrest at these sites.
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