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Numerous organizations lead by the American Heart Association co-developed a policy statement on how schools should respond to cardiac arrest and selected life-threatening medical emergencies. The American Academy of Pediatrics, the National Association of School Nurses, and a number of associations of emergency response professionals helped to author and disseminate this statement.
Cardiac arrests in school age children are caused by ventricular fibrillation or pulseless ventricular tachycardia. Excepting for exceedingly rare cases where these heart rhythm problems are caused by a blow to the chest, these are caused by inherited/congenital problems or acute medical problems such as: Q-T Syndrome, cardiomyopathies, abnormal coronary arteries, and aortic dissection. Hypertrophic cardiomyopathy is the most common. On average, one may expect an incidence of 1/100,000 to 1/200,000 students per year to have a sudden cardiac arrest. This number is higher among secondary school students who are also athletes and lower among elementary school students. All schools are recommended to have effective communication systems (i.e., cannot rely on ‘runners’ from the field to the school telephone), coordinated plans (e.g., a plan that outlines how to achieve less than one-minute elapsed time between the “collapse” and the 911 call), risk reduction (injury prevention plans in place), and first-aid and CPR training for staff and students. Once these have been established, schools may also choose to have an AED – particularly large schools with many adolescent and adult attendees or many community events and schools distant from community-based emergency response systems. A mathematical formula is provided to estimate the risk of sudden cardiac arrest in any one school. (Hazinski MF, et al. Pediatrics 2004; 113(1):155-168) -- H.T.
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