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Evans S, Legg M. Cardiac Emergency Response Plan: Is Your School Prepared? NASN Sch Nurse 2024; 39:175-180. [PMID: 37753822 DOI: 10.1177/1942602x231201087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
School nurses play a major role in school readiness and emergency management, collaborating in safety assessment of schools and leading efforts to ensure the overall wellness of each child. Sudden cardiac arrest is a growing concern among students, and schools are a place of gathering, not only of our students and educators but also for the community, as family and friends support children in performances, sporting events, and religious or cultural activities. Implementing a school Cardiac Emergency Response Plan (CERP) provides a lifesaving resource for the entire community. This article will review the incidence of sudden cardiac arrest, discuss the latest guidance regarding preventive cardiac screening questions for all children, and share how one school district implemented a CERP using readily available resources.
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Dineen EH, Lawrence M, Husaini M, Danielian A, Dean P, Davis L, Edmonds K, Chung EH, Kim JH, Phelan DM. Advocacy in Sports Cardiology: A Call to Arms. JACC. ADVANCES 2024; 3:100985. [PMID: 38938857 PMCID: PMC11198313 DOI: 10.1016/j.jacadv.2024.100985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Affiliation(s)
- Elizabeth H. Dineen
- Mayo Clinic, Department of Cardiovascular Medicine, Jacksonville, Florida, USA
| | - Michael Lawrence
- American College of Cardiology, Washington, District of Columbia, USA
| | - Mustafa Husaini
- Division of Cardiology, Washington University in St. Louis, St. Louis, Missouri, USA
| | | | - Peter Dean
- Division of Pediatric Cardiology, Department of Pediatrics, University of Virginia, Charlottesville, Virginia, USA
| | | | | | - Eugene H. Chung
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jonathan H. Kim
- Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Dermot M. Phelan
- Gragg Center for Cardiovascular Performance, Sanger Heart & Vascular Institute, Atrium Health, Charlotte, North Carolina, USA
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Scarneo-Miller SE, Hosokawa Y, Drezner JA, Hirschhorn RM, Conway DP, Elkins GA, Hopper MN, Strapp EJ. National Athletic Trainers' Association Position Statement: Emergency Action Plan Development and Implementation in Sport. J Athl Train 2024; 59:570-583. [PMID: 38918009 PMCID: PMC11220767 DOI: 10.4085/1062-6050-0521.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
OBJECTIVE An emergency action plan (EAP) is a written document detailing the preparations and on-site emergency response of health care professionals and other stakeholders to medical emergencies in the prehospital setting. The EAP is developed to address any type of catastrophic injury response and should not be condition specific. The objective of this National Athletic Trainers' Association position statement is to provide evidence-based and consensus-based recommendations for developing and implementing an EAP for sports settings. METHODS These recommendations were developed by a multidisciplinary expert panel that performed (1) a comprehensive review of existing EAP evidence, (2) a modified Delphi process to define consensus recommendations, and (3) a strength of recommendation taxonomy determination for each recommendation. RESULTS An EAP is an essential tool designed to facilitate emergency preparedness and an efficient, coordinated emergency response during an athletic event. A comprehensive EAP should consider modes to optimize patient outcomes, the various stakeholders needed to develop the plan, the factors influencing effective implementation of the EAP, and the roles and responsibilities to ensure a structured response to a catastrophic injury. CONCLUSIONS These evidence-informed recommendations outline the necessary steps for emergency planning and provide considerations for the immediate management of patients with catastrophic injuries. Increasing knowledge and implementation of the EAP to manage patients with catastrophic injuries improves the overall response and decreases errors during an emergency.
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Tamirisa K, Patel H, Karim S, Mehta NK. Current landscape in US schools for bystander CPR training and AED requirements. J Interv Card Electrophysiol 2023; 66:2177-2182. [PMID: 37347384 DOI: 10.1007/s10840-023-01579-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 05/25/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Out-of-hospital cardiac arrest is a public health crisis affecting about 356,000 adults and 23,000 children annually in the US with 90% fatality. Early bystander CPR and AED application improve survival. Less than 3% of the US population is CPR trained annually. Since 20% of the US population is at school daily, these represent ideal places to target CPR training. Having standardized state school CPR and AED laws will help with training. METHODS We performed a systemic search of the state-specific laws for school AED and CPR requirements within the US. We used PubMed and Google search using keywords: school CPR mandates, US laws for CPR in schools, US state laws for AED implementation, and gaps in US school CPR and AED. We searched for mandates for schools in other countries for comparison. RESULTS The state laws for CPR training for high school graduation and AED requirements in US. schools are highly variable, and funding for AEDs is inadequate, especially in schools in lower socio-economic zip codes. Recent AED legislative efforts focus mainly on athletic areas and don't adequately address school size, number of buildings, non-athletic areas, and engagement of student-led advocacy efforts. CONCLUSION To improve OHCA survival, we identified potential solutions to consolidate efforts and overcome the barriers-standardize state laws, involve student bodies, increase funding, and allocate appropriate resources. The CPR/AED education needs to start earlier in schools and be part of the standard curriculum rather than implemented as a stopgap check-box mandate.
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Affiliation(s)
| | - Hiren Patel
- Division of Cardiovascular Medicine, St. Louis University School of Medicine, St. Louis, MO, USA
| | - Saima Karim
- Heart and Vascular Institute, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Nishaki Kiran Mehta
- Department of Cardiovascular Medicine, Corewell William Beaumont University Hospital, Royal Oak, MI, USA.
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5
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Sooy-Mossey M, DeRusso M, Green CL, Best DL. Sudden cardiac arrest response preparedness in Durham County schools. Cardiol Young 2023; 33:1561-1568. [PMID: 36047061 DOI: 10.1017/s1047951122002815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Sudden cardiac arrest is an uncommon event with high morbidity and mortality. There are improved outcomes with early access to an automated external defibrillator and cardiopulmonary resuscitation. We assessed the availability of automated external defibrillators and emergency cardiac arrest plans in schools. A cross-sectional electronic survey was conducted to determine the status of emergency cardiac arrest plans and automated external defibrillator presence. Most schools (88%) had access to an automated external defibrillator; however, trained staff and maintenance plans were highly variable. Automated external defibrillator availability did not differ by racial/ethnic or socio-economic composition; however, there was a relationship between number of automated external defibrillators and student population (p = 0.0030). The majority of schools either did not have (28%) or did not know if they had (36%) an emergency cardiac arrest plan. Even without state legislation, automated external defibrillators were largely available in schools. However, there remains a paucity of emergency cardiac arrest plans and automated external defibrillator maintenance plans.
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Affiliation(s)
- Meredith Sooy-Mossey
- Division of Pediatric Cardiology, Department of Pediatrics, Duke University School of Medicine, 2301 Erwin Road, DUMC Box 3127, Durham, NC 27710, USA
| | - Michelle DeRusso
- Department of Pediatrics, Duke University, 2301 Erwin Road, DUMC Box 3046, Durham, NC 27710, USA
| | - Cynthia L Green
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Duke Clinical Research Institute, 200 Morris St, Durham, NC 27701, USA
| | - Debra L Best
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, Duke University, 2301 Erwin Rd. DUMC Box 3675, Durham, NC 27710, USA
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Malik A, Hanson J, Han J, Dolezal B, Bradfield JS, Boyle NG, Hsu JJ. Sudden cardiac arrest in athletes and strategies to optimize preparedness. Clin Cardiol 2023; 46:1059-1071. [PMID: 37493125 PMCID: PMC10540019 DOI: 10.1002/clc.24095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/07/2023] [Accepted: 07/11/2023] [Indexed: 07/27/2023] Open
Abstract
Sudden cardiac arrest (SCA) is the leading cause of death in young athletes. Despite efforts to improve preparedness for cardiac emergencies, the incidence of out-of-hospital cardiac arrests in athletes remains high, and bystander awareness and readiness for SCA support are inadequate. Initiatives such as designing an emergency action plan (EAP) and mandating training in cardiopulmonary resuscitation (CPR) and automated external defibrillator use (AED) for team members and personnel can contribute to improved survival rates in SCA cases. This review provides an overview of SCA in athletes, focusing on identifying populations at the highest risk and evaluating the effectiveness of different screening practices in detecting conditions that may lead to SCA. We summarize current practices and recommendations for improving the response to SCA events, and we highlight the need for ongoing efforts to optimize preparedness through the implementation of EAPs and the training of individuals in CPR and AED use. Additionally, we propose a call to action to increase awareness and training in EAP development, CPR, and AED use for team members and personnel. To improve outcomes of SCA cases in athletes, it is crucial to enhance bystander awareness and preparedness for cardiac emergencies. Implementing EAPs and providing training in CPR and AED use for team members and personnel are essential steps toward improving survival rates in SCA cases.
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Affiliation(s)
- Aneeq Malik
- Department of MedicineOlive View‐UCLA Medical CenterLos AngelesCaliforniaUSA
| | - Justin Hanson
- Department of Medicine, Division of CardiologyDavid Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
| | - Janet Han
- Department of Medicine, Division of CardiologyVeterans Affairs Greater Los Angeles Healthcare System and UCLALos AngelesCaliforniaUSA
| | - Brett Dolezal
- Exercise Physiology Research Laboratory, Departments of Medicine and PhysiologyDavid Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
| | - Jason S. Bradfield
- UCLA Cardiac Arrhythmia CenterDavid Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
| | - Noel G. Boyle
- UCLA Cardiac Arrhythmia CenterDavid Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
| | - Jeffrey J. Hsu
- Department of Medicine, Division of CardiologyDavid Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
- Department of Medicine, Division of CardiologyVeterans Affairs Greater Los Angeles Healthcare System and UCLALos AngelesCaliforniaUSA
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7
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Khanji MY, Chahal CAA, Ricci F, Akhter MW, Patel RS. Cardiopulmonary resuscitation training to improve out-of-hospital cardiac arrest survival: addressing potential health inequalities. Eur J Prev Cardiol 2022; 29:2275-2277. [PMID: 34907418 DOI: 10.1093/eurjpc/zwab214] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/28/2021] [Accepted: 12/01/2021] [Indexed: 01/11/2023]
Affiliation(s)
- Mohammed Y Khanji
- Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK.,NIHR Biomedical Research Unit, William Harvey Research Institute, Queen Mary University of London, London, UK.,Department of Cardiology, Newham University Hospital, Glen Road, London E13 8SL, UK
| | - C Anwar A Chahal
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55902, USA.,Department of Cardiac Electrophysiology, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.,Department of Cardiology, WellSpan Center for Inherited Cardiovascular Diseases, WellSpan Health, York, PA, USA
| | - Fabrizio Ricci
- Department of Neuroscience, Imaging and Clinical Sciences, Institute of Advanced Biomedical Technologies, "G.d'Annunzio" University, 66100 Chieti, Italy.,Department of Clinical Sciences, Lund University, Jan Waldenströms gata 35, 205 02 Malmö, Sweden.,Department of Cardiology, Casa di Cura Villa Serena, Città Sant'Angelo, Pescara, Italy
| | | | - Riyaz S Patel
- Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK.,Institute of Cardiovascular Sciences, University College London, London, UK
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Abela M, Grech V, Sammut MA. Automated external defibrillators and basic life support practices in secondary schools: a nationwide study. Cardiol Young 2022; 33:1-4. [PMID: 36373237 DOI: 10.1017/s1047951122003572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIM Cardiac arrest prevention in schools has recently gained momentum. The survival benefit in schools who have access to defibrillators is clear, with far better survival outcomes in children or adults who sustain a cardiac arrest on school grounds. The main objectives of this study were to assess sudden cardiac arrest prevention in Maltese schools, specifically the availability of defibrillators and staff competence in delivering resuscitation. METHODOLOGY AND RESULTS An online-based questionnaire was distributed to all secondary schools across the Maltese archipelago. Data were collected, tabulated, and analysed using SPSS V.23. Most schools (n = 40, 74.1%) completed the questionnaire. Two schools documented a cardiac arrest in the past 10 years. 87.5% agreed that cardiac arrest prevention is an important health topic. Most have a defibrillator on the premises (n = 37, 92.5%). Only one defibrillator is usually available (n = 27, 75.0%). Despite the majority claiming its ease of accessibility (n = 35, 97.2%), most were not available on every floor (n = 37, 97.2%). Only one-third were close to a sporting facility (n = 11, 30.6%). Schools do not organise regular resuscitation courses (n = 21, 58.3%), with eight schools having five or more certified staff members (23.5%). The number of defibrillators did not influence the frequency of resuscitation courses at school (p = 0.607), and there was no association with the number of certified individuals (p = 0.860). CONCLUSION Defibrillators are not readily available at secondary schools and are often installed in low-risk areas. Most schools have only one staff member certified in resuscitation. These factors should be addressed with urgency.
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Affiliation(s)
- Mark Abela
- Department of Cardiology, Mater Dei Hospital, Malta
- Cardiology, University of Malta, Malta
| | - Victor Grech
- Depatment of Paediatrics, Mater Dei Hospital, Malta
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Gereige RS, Gross T, Jastaniah E. Individual Medical Emergencies Occurring at School. Pediatrics 2022; 150:188345. [PMID: 35757966 DOI: 10.1542/peds.2022-057987] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/28/2022] [Indexed: 11/24/2022] Open
Abstract
Children and adults may face emergency medical situations because of injuries, complications of chronic health conditions, or unexpected major illnesses that occur in schools. The American Academy of Pediatrics published a policy statement in 2001 titled "Guidelines for Emergency Medical Care in Schools," and in 2008, published its revision, "Medical Emergencies Occurring at School." Those statements focused on the preparedness of schools to address individual student emergencies. The increase in the number of children with special health care needs and chronic medical conditions attending schools, together with the added challenges faced by school districts to ensure that schools have access to on-site, licensed health care professionals on an ongoing basis, have contributed to added risks that medical and nonmedical personnel face in dealing with medical emergencies in schools. This newly revised policy statement serves as an update of the statement published in 2008 and reaffirmed in 2017, and intends to increase pediatricians' awareness of schools' roles in preparing for individual student emergencies and provide recommendations for the medical home and school physicians on how to assist and support school personnel. This statement does not address schoolwide or communitywide emergencies that might occur as a result of natural or man-made disasters.
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Affiliation(s)
- Rani S Gereige
- Director of Medical Education, Department of Medical Education, Nicklaus Children's Hospital, Miami, Florida
| | - Toni Gross
- Emergency Medicine, Children's Hospital New Orleans, New Orleans, Louisiana
| | - Ebaa Jastaniah
- Department of Pediatrics, Section of Pediatric Emergency Medicine, Arkansas Children's Hospital/UAMS, Little Rock, Arkansas.,Department of Emergency Medicine, Section of Pediatric Emergency Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia
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Brooks SC, Clegg GR, Bray J, Deakin CD, Perkins GD, Ringh M, Smith CM, Link MS, Merchant RM, Pezo-Morales J, Parr M, Morrison LJ, Wang TL, Koster RW, Ong MEH. Optimizing Outcomes After Out-of-Hospital Cardiac Arrest With Innovative Approaches to Public-Access Defibrillation: A Scientific Statement From the International Liaison Committee on Resuscitation. Circulation 2022; 145:e776-e801. [PMID: 35164535 DOI: 10.1161/cir.0000000000001013] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Out-of-hospital cardiac arrest is a global public health issue experienced by ≈3.8 million people annually. Only 8% to 12% survive to hospital discharge. Early defibrillation of shockable rhythms is associated with improved survival, but ensuring timely access to defibrillators has been a significant challenge. To date, the development of public-access defibrillation programs, involving the deployment of automated external defibrillators into the public space, has been the main strategy to address this challenge. Public-access defibrillator programs have been associated with improved outcomes for out-of-hospital cardiac arrest; however, the devices are used in <3% of episodes of out-of-hospital cardiac arrest. This scientific statement was commissioned by the International Liaison Committee on Resuscitation with 3 objectives: (1) identify known barriers to public-access defibrillator use and early defibrillation, (2) discuss established and novel strategies to address those barriers, and (3) identify high-priority knowledge gaps for future research to address. The writing group undertook systematic searches of the literature to inform this statement. Innovative strategies were identified that relate to enhanced public outreach, behavior change approaches, optimization of static public-access defibrillator deployment and housing, evolved automated external defibrillator technology and functionality, improved integration of public-access defibrillation with existing emergency dispatch protocols, and exploration of novel automated external defibrillator delivery vectors. We provide evidence- and consensus-based policy suggestions to enhance public-access defibrillation and guidance for future research in this area.
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Brooks SC, Clegg GR, Bray J, Deakin CD, Perkins GD, Ringh M, Smith CM, Link MS, Merchant RM, Pezo-Morales J, Parr M, Morrison LJ, Wang TL, Koster RW, Ong MEH. Optimizing outcomes after out-of-hospital cardiac arrest with innovative approaches to public-access defibrillation: A scientific statement from the International Liaison Committee on Resuscitation. Resuscitation 2022; 172:204-228. [PMID: 35181376 DOI: 10.1016/j.resuscitation.2021.11.032] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Out-of-hospital cardiac arrest is a global public health issue experienced by ≈3.8 million people annually. Only 8% to 12% survive to hospital discharge. Early defibrillation of shockable rhythms is associated with improved survival, but ensuring timely access to defibrillators has been a significant challenge. To date, the development of public-access defibrillation programs, involving the deployment of automated external defibrillators into the public space, has been the main strategy to address this challenge. Public-access defibrillator programs have been associated with improved outcomes for out-of-hospital cardiac arrest; however, the devices are used in <3% of episodes of out-of-hospital cardiac arrest. This scientific statement was commissioned by the International Liaison Committee on Resuscitation with 3 objectives: (1) identify known barriers to public-access defibrillator use and early defibrillation, (2) discuss established and novel strategies to address those barriers, and (3) identify high-priority knowledge gaps for future research to address. The writing group undertook systematic searches of the literature to inform this statement. Innovative strategies were identified that relate to enhanced public outreach, behavior change approaches, optimization of static public-access defibrillator deployment and housing, evolved automated external defibrillator technology and functionality, improved integration of public-access defibrillation with existing emergency dispatch protocols, and exploration of novel automated external defibrillator delivery vectors. We provide evidence- and consensus-based policy suggestions to enhance public-access defibrillation and guidance for future research in this area.
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Blanchard PG, Graham JM, Gauvin V, Lanoue MP, Péloquin F, Bertrand I, Ulrich Singbo MN, Poirier P, Émond M, Mercier E. Reducing Barriers to Optimal Automated External Defibrillator Use: An Elementary School Intervention Study. CJC PEDIATRIC AND CONGENITAL HEART DISEASE 2022; 1:30-36. [PMID: 37969560 PMCID: PMC10642092 DOI: 10.1016/j.cjcpc.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 12/27/2021] [Indexed: 11/17/2023]
Abstract
Background Timely use of an automated external defibrillator (AED) improves outcomes in sudden cardiopulmonary arrest (SCA). Our project aims were to: 1) identify the barriers to optimal AED use in the Québec City area elementary schools; 2) create targeted educational material regarding AEDs; and 3) measure the impact of the teaching module. Methods Using a quality improvement in health-care framework, a survey exploring the barriers to AED use was sent to 139 elementary schools. We then developed a video teaching module on using AEDs to address these barriers. A convenience sample of 92 elementary school professionals participated in a mock scenario. Metrics related to AED use were assessed at baseline and after completing the post-teaching module. The primary outcome was the time to first shock and secondary outcomes consisted of evaluating the completion of each step required for safe and effective AED use. Results The barrier analysis survey received a response rate of 52.5%. Most schools reported having an AED (95%), but 48.6% indicated that no formal training was offered. After the teaching module, the appropriate use of the AED in an SCA simulation improved from 53% to 92% (P < 0.001). The average time elapsed before first shock was 66 (95% confidence interval [CI], 63-70) seconds at baseline compared with 47 (95% CI, 45-49) seconds post-teaching module (P < 0.001). Conclusions Lack of training, the main barrier to optimal use of AEDs in elementary schools, can be addressed through a brief video teaching module, thus improving the ability to deliver timely and effective defibrillation.
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Affiliation(s)
- Pierre-Gilles Blanchard
- Département de médecine familiale et médecine d’urgence, Faculté de médecine, Université Laval, Québec City, Québec, Canada
- Centre de recherche du CHU de Québec–Université Laval, Québec City, Québec, Canada
- VITAM---entre de recherche en santé durable de l’Université Laval, Québec City, Québec, Canada
| | - Johann M.I. Graham
- Département de médecine familiale et médecine d’urgence, Faculté de médecine, Université Laval, Québec City, Québec, Canada
- Centre de Recherche du CISSS de Lanaudière, Québec, Canada
| | - Vincent Gauvin
- Département de médecine familiale et médecine d’urgence, Faculté de médecine, Université Laval, Québec City, Québec, Canada
| | - Marie-Pier Lanoue
- Département de médecine familiale et médecine d’urgence, Faculté de médecine, Université Laval, Québec City, Québec, Canada
| | - Fannie Péloquin
- Département de médecine familiale et médecine d’urgence, Faculté de médecine, Université Laval, Québec City, Québec, Canada
| | - Isabelle Bertrand
- Département de médecine familiale et médecine d’urgence, Faculté de médecine, Université Laval, Québec City, Québec, Canada
| | | | - Paul Poirier
- Faculté de pharmacie, Université Laval, Québec, Canada
- Institut universitaire de cardiologie et de pneumologie de Québec, Québec City, Québec, Canada
| | - Marcel Émond
- Département de médecine familiale et médecine d’urgence, Faculté de médecine, Université Laval, Québec City, Québec, Canada
- Centre de recherche du CHU de Québec–Université Laval, Québec City, Québec, Canada
- VITAM---entre de recherche en santé durable de l’Université Laval, Québec City, Québec, Canada
| | - Eric Mercier
- Département de médecine familiale et médecine d’urgence, Faculté de médecine, Université Laval, Québec City, Québec, Canada
- Centre de recherche du CHU de Québec–Université Laval, Québec City, Québec, Canada
- VITAM---entre de recherche en santé durable de l’Université Laval, Québec City, Québec, Canada
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Hedberg R, Messamore W, Poppe T, Tarakemeh A, Burkholder R, Carter T, Vopat B, Darche JP. Emergency Action Planning in School-Based Athletics: A Systematic Review. Kans J Med 2021; 14:282-286. [PMID: 34868470 PMCID: PMC8641435 DOI: 10.17161/kjm.vol14.15299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 07/30/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction A significant number of preventable catastrophic injuries occur in secondary school athletics. Compliance to Emergency Action Plan (EAP) recommendations is not well documented. The purpose of this systematic review was to identify compliance to EAP recommendations, access to an athletic trainer (AT) and automated external defibrillator (AED), and current legislative mandates in school-based athletics. Methods Electronic databases were searched to identify articles that met criteria for inclusion. Studies in English that focused on adoption, implementation, or compliance with EAPs or other national guidelines pertaining to athlete health were eligible for inclusion. Quality and validity were examined in each article and data were grouped based on outcome measures. Results Of 12,906 studies, 21 met the criteria for inclusion and full text review. Nine studies demonstrated EAP adoption rates ranging from 55% - 100%. Five studies found that EAPs were rehearsed and reviewed annually in 18.2% - 91.6% of schools that have an EAP. At total of 9.9% of schools were compliant with all 12 National Athletic Trainers Association (NATA) EAP guidelines. A total of 2.5% - 27.5% of schools followed NATA exertional heat illness guidelines and 50% - 81% of schools had access to an athletic trainer. In addition, 61% - 94.4% of schools had an AED available at their athletic venues. Four of 51 state high school athletic association member schools were required to meet best practice standards for EAP implementation, 7 of 51 for AED access, 8 of 51 for heat acclimation, and 3 of 51 for concussion management. Conclusions There was a wide range of EAP adoption and a low rate of compliance to EAP guidelines in U.S. schools. Barriers to EAP adoption and compliance were not well documented and additional research should aim to identify impeding and facilitating factors.
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Affiliation(s)
- Riley Hedberg
- Department of Orthopedic Surgery, Orthopedic Sports Medicine, University of Kansas Medical Center, Kansas City, KS
| | - William Messamore
- Department of Orthopedic Surgery, Orthopedic Sports Medicine, University of Kansas Medical Center, Kansas City, KS
| | - Tanner Poppe
- Department of Orthopedic Surgery, Orthopedic Sports Medicine, University of Kansas Medical Center, Kansas City, KS
| | - Armin Tarakemeh
- Department of Orthopedic Surgery, Orthopedic Sports Medicine, University of Kansas Medical Center, Kansas City, KS
| | | | - Trent Carter
- University of Kansas Health System, Lawrence, KS
| | - Bryan Vopat
- Department of Orthopedic Surgery, Orthopedic Sports Medicine, University of Kansas Medical Center, Kansas City, KS
| | - Jean-Philippe Darche
- Department of Orthopedic Surgery, Orthopedic Sports Medicine, University of Kansas Medical Center, Kansas City, KS
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Grubic N, Hill B, Phelan D, Baggish A, Dorian P, Johri AM. Bystander interventions and survival after exercise-related sudden cardiac arrest: a systematic review. Br J Sports Med 2021; 56:410-416. [PMID: 34853034 DOI: 10.1136/bjsports-2021-104623] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To evaluate the provision of bystander interventions and rates of survival after exercise-related sudden cardiac arrest (SCA). DESIGN Systematic review. DATA SOURCES MEDLINE, EMBASE, PubMed, CINAHL, SPORTDiscus, Cochrane Library and grey literature sources were searched from inception to November/December 2020. STUDY ELIGIBILITY CRITERIA Observational studies assessing a population of exercise-related SCA (out-of-hospital cardiac arrests that occurred during exercise or within 1 hour of cessation of activity), where bystander cardiopulmonary resuscitation (CPR) and/or automated external defibrillator (AED) use were reported, and survival outcomes were ascertained. METHODS Among all included studies, the median (IQR) proportions of bystander CPR and bystander AED use, as well as median (IQR) rate of survival to hospital discharge, were calculated. RESULTS A total of 29 studies were included in this review, with a median study duration of 78.7 months and a median sample size of 91. Most exercise-related SCA patients were male (median: 92%, IQR: 86%-96%), middle-aged (median: 51, IQR: 39-56 years), and presented with a shockable arrest rhythm (median: 78%, IQR: 62%-86%). Bystander CPR was initiated in a median of 71% (IQR: 59%-87%) of arrests, whereas bystander AED use occurred in a median of 31% (IQR: 19%-42%) of arrests. Among the 19 studies that reported survival to hospital discharge, the median rate of survival was 32% (IQR: 24%-49%). Studies which evaluated the relationship between bystander interventions and survival outcomes reported that both bystander CPR and AED use were associated with survival after exercise-related SCA. CONCLUSION Exercise-related SCA occurs predominantly in males and presents with a shockable ventricular arrhythmia in most cases, emphasising the importance of rapid access to defibrillation. Further efforts are needed to promote early recognition and a rapid bystander response to exercise-related SCA.
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Affiliation(s)
- Nicholas Grubic
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada .,Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Braeden Hill
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Dermot Phelan
- Sports Cardiology Center, Atrium Health Sanger Heart and Vascular Institute, Charlotte, North Carolina, USA
| | - Aaron Baggish
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Paul Dorian
- Department of Medicine, Division of Cardiology, University of Toronto, Toronto, Ontario, Canada
| | - Amer M Johri
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
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15
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Schattenkerk J, Kucera K, Peterson DF, Huggins RA, Drezner JA. Socioeconomic factors and outcomes from exercise-related sudden cardiac arrest in high school student-athletes in the USA. Br J Sports Med 2021; 56:138-143. [PMID: 34716143 PMCID: PMC8785056 DOI: 10.1136/bjsports-2021-104486] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2021] [Indexed: 11/15/2022]
Abstract
Objective Minority student-athletes have a lower survival rate from sudden cardiac arrest (SCA) than non-minority student-athletes. This study examined the relationship between high school indicators of socioeconomic status (SES) and survival in student-athletes with exercise-related SCA. Methods High school student-athletes in the USA with exercise-related SCA on school campuses were prospectively identified from 1 July 2014 to 30 June 2018 by the National Center for Catastrophic Sports Injury Research. High school indicators of SES included the following: median household and family income, proportion of students on free/reduced lunch and percent minority students. Resuscitation details included witnessed arrest, presence of an athletic trainer, bystander cardiopulmonary resuscitation and use of an on-site automated external defibrillator (AED). The primary outcome was survival to hospital discharge. Differences in survival were analysed using risk ratios (RR) and univariate general log-binomial regression models. Results Of 111 cases identified (mean age 15.8 years, 88% male, 49% white non-Hispanic), 75 (68%) survived. Minority student-athletes had a lower survival rate compared with white non-Hispanic student-athletes (51.1% vs 75.9%; RR 0.67, 95% CI 0.49 to 0.92). A non-significant monotonic increase in survival was observed with increasing median household or family income and with decreasing percent minority students or proportion on free/reduced lunch. The survival rate was 83% if an athletic trainer was on-site at the time of SCA and 85% if an on-site AED was used. Conclusions Minority student-athletes with exercise-related SCA on high school campuses have lower survival rates than white non-Hispanic athletes, but this difference is not fully explained by SES markers of the school.
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Affiliation(s)
- Jared Schattenkerk
- University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Kristen Kucera
- Department of Exercise & Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Danielle F Peterson
- Department of Orthopaedic Surgery, Oregon Health & Science University School of Medicine, Portland, Oregon, USA
| | - Robert A Huggins
- Department of Kinesiology, Korey Stringer Institute, University of Connecticut, Storrs, Connecticut, USA
| | - Jonathan A Drezner
- Department of Family Medicine, Center for Sports Cardiology, University of Washington, Seattle, Washington, USA
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16
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Arabadjian M, Serrato S, Sherrid MV. Availability and Utilization of Automated External Defibrillators in New York State Schools. Front Pediatr 2021; 9:711124. [PMID: 34660480 PMCID: PMC8514828 DOI: 10.3389/fped.2021.711124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 08/30/2021] [Indexed: 01/14/2023] Open
Abstract
Background: Use of automated external defibrillators (AEDs) in out-of-hospital cardiac arrests (OHCAs) improve survival. Professional health organizations recommend that AEDs be available in crowded places, including schools but currently only 18 US states require them. Sudden cardiac arrest (SCA) research in the school-age population has largely focused on school sub-groups, leaving out the majority of US students and adults working in schools. New York State (NYS) has one of the largest student populations in the US. Our objective was to gain epidemiologic data on SCA across a variety of school levels and examine the availability and utilization of AEDs in a state that requires them. Methods: This was an observational, cross-sectional study utilizing an electronic survey. We included NYS school nurses and collected electronic surveys in January-March, 2018. We analyzed demographic data of school characteristics, SCA occurrences and AED use and availability. Results: Of 876 respondents (36.1% response rate), 71 (8.2%) reported SCAs, with 41 occurring in adults. AEDs were deployed in 59 of 71 (84.3%) events, 40 individuals had long-term survival. Most SCAs occurred in middle-schools. School size or number of AEDs/school had no bearing on short-term or long-term survival. AEDs were widely available in private schools, though this was not required by state law. Conclusions: Our data suggest a need for more comprehensive examination of SCA in US schools. Research comparing the availability and utilization of school AEDs between states that do and do not require them is needed and may have important clinical and policy implications for SCA emergency preparedness in US schools.
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Affiliation(s)
- Milla Arabadjian
- Rory Meyers College of Nursing, New York University, New York, NY, United States.,Hypertrophic Cardiomyopathy Program, Division of Cardiology, New York University Langone Health, New York, NY, United States
| | - Stephanie Serrato
- Hypertrophic Cardiomyopathy Program, Division of Cardiology, New York University Langone Health, New York, NY, United States
| | - Mark V Sherrid
- Hypertrophic Cardiomyopathy Program, Division of Cardiology, New York University Langone Health, New York, NY, United States
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17
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Ojifinni K, Motara F, Laher AE. Knowledge, Attitudes and Perceptions Regarding Basic Life Support Among Teachers in Training. Cureus 2019; 11:e6302. [PMID: 31938594 PMCID: PMC6944153 DOI: 10.7759/cureus.6302] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Cardiac arrests may occur anytime, anywhere and to anyone including learners at schools. Teachers have a moral obligation to care for learners while on the school premises. Outcomes after cardiac arrest are better when the first-responder possesses adequate knowledge and skill in basic life support (BLS) and cardiopulmonary resuscitation (CPR). The aim of this study was to assess the knowledge, attitudes and perceptions of student-teachers pertaining to BLS. Methods This was a self-administered, questionnaire based, prospective and cross-sectional study of senior undergraduate student-teachers enrolled at a South African university. The study was conducted between 04 November 2017 and 18 February 2018. Results A total of 316 student-teachers, with a mean age of 21.8 ± 2.6 years completed the survey. Trauma-related emergencies, allergic reactions and breathing difficulties were witnessed during practice teaching sessions at various schools by 52.5% (n = 166), 36.4% (n = 115) and 32.9% (n = 104) of participants, respectively. The mean knowledge score pertaining to BLS was 4.0 ± 1.7 out of 12 points. Previous CPR training was associated with a good knowledge score (p = 0.005) and confidence in responding to an emergency (p = 0.005). Most of the participants (N = 288, 91.1%) had no formal training in CPR with more than three-quarters (76.4%) of them not knowing where to acquire training. Barriers to initiating CPR included fear of litigation (n = 264, 83.5%), injury to the victim (n = 238, 75.3%), presence of blood, vomitus or secretions (n = 206, 65.2%) and fear of contracting a disease (n = 186, 58.8%). Most (n = 255, 80.7%) respondents reported that they would perform CPR on a learner at school. Conclusion Student-teachers surveyed in this study displayed poor knowledge and perceptions but positive attitudes with regards to the practice of CPR and BLS. Consideration should be given to including formal CPR training as part of the curriculum for teachers in training.
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Affiliation(s)
- Kehinde Ojifinni
- Emergency Medicine, University of the Witwatersrand, Johannesburg, ZAF
| | - Feroza Motara
- Emergency Medicine, University of the Witwatersrand, Johannesburg, ZAF
| | - Abdullah E Laher
- Emergency Medicine, University of the Witwatersrand, Johannesburg, ZAF
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18
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Scarneo-Miller SE, DiStefano LJ, Singe SM, Register-Mihalik JK, Stearns RL, Casa DJ. Emergency Action Plans in Secondary Schools: Barriers, Facilitators, and Social Determinants Affecting Implementation. J Athl Train 2019; 55:80-87. [PMID: 31756132 DOI: 10.4085/1062-6050-484-18] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Secondary schools (SSs) inconsistently adopt emergency action plans (EAPs) for athletics. OBJECTIVE To describe the barriers, facilitators, and social determinants influencing EAP adoption in SSs in the United States. DESIGN Cross-sectional study. SETTING Secondary schools. PATIENTS OR OTHER PARTICIPANTS A national sample of athletic trainers (ATs; n = 9642) and athletic directors (ADs; n = 9687) were invited to participate in a Web-based questionnaire. A total of 1273 (13.2%) ATs and 702 (9.2%) ADs responded to the survey. MAIN OUTCOME MEASURE(S) The questionnaire addressed self-reported barriers to, facilitators of, and social determinants (eg, locale, funding classification [eg, public or private SS]) of EAP adoption. The responses of ATs and ADs were analyzed separately. Barriers, facilitators, and social determinants were evaluated using descriptive statistics. Contingency (2 × 2) tables were used to calculate the odds ratios (ORs) of adopting an EAP and the presence of each social determinant. RESULTS Perceived barriers to implementation were a lack of knowledge about how to implement an EAP and financial limitations. Facilitators were having access to health care personnel, state mandates, and support from a person in an authoritative position. Compared with ATs at rural schools, ATs at suburban schools displayed greater odds of having an EAP (χ2 = 5.63, P = .01, OR = 1.63 [95% confidence interval = 1.08, 2.44]). According to the ADs' responses, a larger SS enrollment (≥500) led to greater odds of adopting an EAP (OR = 2.02 [95% confidence interval = 1.41, 2.89]). CONCLUSIONS Perceived barriers to EAP adoption suggest that ATs and ADs need to be educated so they can provide additional information on the low cost of EAP adoption. Further, ADs described state mandates as facilitators to improve EAP adoption; therefore, efforts to educate state leaders about the need for mandated policies may be warranted. Certain social determinants (eg, school enrollment) may affect EAP adoption, but not every proposed determinant significantly affected adoption.
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Affiliation(s)
| | | | | | | | - Rebecca L Stearns
- Korey Stringer Institute.,Department of Kinesiology, University of Connecticut, Storrs
| | - Douglas J Casa
- Korey Stringer Institute.,Department of Kinesiology, University of Connecticut, Storrs
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19
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Ling G, Draghic N. Aerial drones for blood delivery. Transfusion 2019; 59:1608-1611. [PMID: 30980745 DOI: 10.1111/trf.15195] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 10/12/2018] [Accepted: 10/13/2018] [Indexed: 11/26/2022]
Abstract
Aerial drone technology is now in use to improve medical care, especially blood delivery. The use of aerial drones is broader than just this and includes aerial photography, express shipping and delivery, disaster management, search and rescue operations, crop monitoring, weather tracking, law enforcement, and structural assessment. This wide use promises to accelerate and, ideally, reduce the cost of technological advances of drones. By doing so, drone use offers the opportunity of improving health care, particularly in remote and/or underserved environments by decreasing lab testing turnaround times, enabling just-in-time lifesaving medical supply/device delivery, and reducing costs of routine prescription care in rural areas.
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Affiliation(s)
- Geoffrey Ling
- Division of Neurosciences Critical Care, Departments of Neurology, Neurosurgery and Anesthesiology-Critical Care Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland.,Department of Clinical Neurosciences, Inova Fairfax Hospital, Falls Church, Virginia
| | - Nicole Draghic
- Department of Clinical Neurosciences, Inova Fairfax Hospital, Falls Church, Virginia
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20
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Saberian S, Pendyala VS, Siebert VR, Himmel BA, R. Wigant R, Knepp MD, Orcutt JW, Mungee S, Chan DP, Baman TS. Disparities Regarding Inadequate Automated External Defibrillator Training and Potential Barriers to Successful Cardiac Resuscitation in Public School Systems. Am J Cardiol 2018; 122:1565-1569. [PMID: 30172365 DOI: 10.1016/j.amjcard.2018.07.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 07/13/2018] [Accepted: 07/17/2018] [Indexed: 11/25/2022]
Abstract
Installation of automated external defibrillators (AEDs) in public schools has been shown to improve outcomes for children with sudden cardiac arrest (SCA). However, the adequacy of faculty AED training and potential barriers to successful cardiac resuscitation remain unknown. A questionnaire was mailed to all public schools in the state of Illinois (n = 3796). The survey focused on the demographic variables of each school as well as the confidence of the responder regarding effectiveness of AED training. 2,192 surveys were included in this study (58% response rate). Independent variables for perceived inadequate AED training were schools that were predominantly black (odds ratio [OR] 3.93; 3.01 to 5.13) or Hispanic (OR 2.75; 2.11 to 3.58), elementary schools (OR 2.05; 1.69 to 2.50), schools with <250 students (OR 1.69; 1.19 to 2.40) and <25 faculty (OR 1.54; 1.10 to 2.15). Eighty-eight percent of responders cited at least one barrier to successful AED utilization. Location in a town setting (OR 9.34; 4.73 to 18.44) or rural setting (OR 3.18; 2.47 to 4.10) as well as upper socioeconomic status (OR 3.85; 2.04 to 7.29) were found to be predictors of schools with no barriers to AED utilization.
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21
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Adams WM, Scarneo SE, Casa DJ. Assessment of Evidence-Based Health and Safety Policies on Sudden Death and Concussion Management in Secondary School Athletics: A Benchmark Study. J Athl Train 2018; 53:756-767. [PMID: 30212234 DOI: 10.4085/1062-6050-220-17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT: Implementation of best-practice health and safety policies has been shown to be effective at reducing the risk of sudden death in sport; however, little is known about the extent to which these policies are required within secondary school athletics. OBJECTIVE: To examine best-practice health and safety policies pertaining to the leading causes of sudden death and to concussion management in sport mandated at the state level for secondary school athletics. DESIGN: Descriptive observational study. SETTING: State high school athletic associations (SHSAAs), state departments of education, and enacted legislation. PATIENTS OR OTHER PARTICIPANTS: United States (including the District of Columbia) SHSAAs. MAIN OUTCOME MEASURE(S): A review of SHSAA health and safety policies for the 2016-2017 academic year, state department of education policies, and enacted legislation was undertaken to assess the polices related to the leading causes of sudden death and concussion management in sport. Current best-practice recommendations used to assess health and safety policies were specific to emergency action plans, automated external defibrillators, heat acclimatization, environmental monitoring and modification, and concussion management. The total number of best-practice recommendations required for each SHSAA's member schools for the aforementioned areas was quantified and presented as total number and percentage of recommendations required. RESULTS: Four of 51 SHSAA member schools were required to follow best practices for emergency action plans, 7 of 51 for access to automated external defibrillators, 8 of 51 for heat acclimatization, and 3 of 51 for management of concussion. CONCLUSIONS: At the time of this study, SHSAA member schools were not required to follow all best-practice recommendations for preventing the leading causes of sudden death and for concussion management in sport. Continued advocacy for the development and implementation of best practices at the state level to be required of all secondary schools is needed to appropriately serve the health and well-being of our young student-athletes.
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Affiliation(s)
- William M Adams
- Department of Kinesiology, University of North Carolina at Greensboro
| | - Samantha E Scarneo
- Department of Kinesiology, Korey Stringer Institute, University of Connecticut, Storrs
| | - Douglas J Casa
- Department of Kinesiology, Korey Stringer Institute, University of Connecticut, Storrs
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22
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Drezner JA, Peterson DF, Siebert DM, Thomas LC, Lopez-Anderson M, Suchsland MZ, Harmon KG, Kucera KL. Survival After Exercise-Related Sudden Cardiac Arrest in Young Athletes: Can We Do Better? Sports Health 2018; 11:91-98. [PMID: 30204540 PMCID: PMC6299352 DOI: 10.1177/1941738118799084] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND: Sudden cardiac arrest (SCA) is the leading cause of death in young athletes during sports. HYPOTHESIS: Survival after SCA in young athletes is variable. STUDY DESIGN: Prospective, active surveillance study. LEVEL OF EVIDENCE: Level 3. METHODS: From July 1, 2014, to June 30, 2016, exercise-related SCA in competitive young athletes was identified through a systematic search of traditional and social media sources, direct reporting to the National Center for Catastrophic Sports Injury Research, searching of the National Collegiate Athletic Association Resolutions List, regular communication with national and state high school athletic associations, and review of cases in the Parent Heart Watch database. RESULTS: A total of 132 cases were identified during the 2-year study period (mean patient age, 16 years; age range, 11-27 years; 84% male; 51% white non-Hispanic/Latino, 30% black/African American, and 11% white Hispanic/Latino). High school athletes accounted for 78 (59%) cases, with 28 (21%) in middle school and 15 (11%) in college athletes. Overall survival was 48% (95% CI, 40%-57%; 64 survivors, 68 deaths). Survival was similar in male versus female athletes but higher in white non-Hispanic/Latino (40/67; 60%) versus black/African American (13/39; 33%) athletes (difference, 27%; 95% CI, 7%-45%; P = 0.008) and white non-Hispanic/Latino versus all minority (18/59; 31%) athletes (difference, 29%; 95% CI, 13%-46%; P = 0.001). Basketball accounted for 30% of cases, followed by football (25%), track/cross-country (12%), and soccer (11%). The majority (93%) of cases were witnessed. If a certified athletic trainer was on-site and involved in the resuscitation, 83% of athletes survived. If an on-site automated external defibrillator was used in the resuscitation, 89% of athletes survived. CONCLUSION: Exercise-related SCA in young, competitive athletes is typically witnessed, providing an opportunity for rapid resuscitation. Additional research is needed to identify factors that affect survival in different athlete populations. CLINICAL RELEVANCE: Public access defibrillator programs should be universal in schools and youth sporting venues and have the potential to increase survival after SCA in young athletes.
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Affiliation(s)
- Jonathan A. Drezner
- Jonathan A. Drezner, MD, Department of Family Medicine, Director, UW Medicine Center for Sports Cardiology, University of Washington, Box 354060, Seattle, WA 98195-4060 () (Twitter: @DreznerJon)
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