CPR Instruction in U.S. High Schools

Are High School Cardiopulmonary Resuscitation Education Mandates Working? Insights from a High School Survey on CPR Knowledge, Attitudes, and Readiness

BACKGROUND

Cardiopulmonary Resuscitation (CPR) and automated external defibrillator (AED) use significantly improve the chances of survival after out-of-hospital cardiac arrest. Subsequently, state laws mandate training in CPR and AED use for high school graduation. However, training and its impact vary and must be better understood.

OBJECTIVE

We assessed the current CPR training mandates and their impact.

METHODS

We performed a nationwide, cross-sectional, survey-based observational study of high schoolers in 9th to 12th grades in all 50 states from 2020 to 2022 (NCT04493970), assessing basic demographics, attitudes, knowledge and skills, and willingness to learn CPR and AED use.

RESULTS

We had an 8% response rate, resulting in 2,395 high school students surveyed. The mean age of respondents was 16.8±0.7 years, with 52.5% females. Of these, 86% underwent some form of training, and 25.1% had CPR training in the last year. Only 58.7% knew how to use an AED. Notably, 26.9% had previously witnessed CPR, and almost all (94%) realized the importance of learning CPR. Most respondents also believed recurrent and longitudinal would be beneficial.

CONCLUSIONS

Surprisingly, only a small cohort of students do not undergo CPR training even when it is mandatory. The quality of this training appears to be inadequate to impart appropriate confidence and knowledge levels. This suggests a need for a significant overhaul of CPR training mandates across the United States.

A novel scoring system and correlative analysis of the strength and effectiveness of nationwide high school cardiopulmonary resuscitation mandates: Insights from a high school CPR study

BACKGROUND

Numerous states have introduced cardiopulmonary resuscitation (CPR) training mandates for high school students and staff to prevent sudden cardiac death (SCD). However, the content and implementation of these mandates vary substantially. Furthermore, a comprehensive and objective assessment of these mandates and their impact is lacking.

OBJECTIVE

We aimed to conduct a thorough evaluation of CPR training mandates across the United States.

METHODS

We developed a novel scoring system based on proposed CPR standards, training and certification requirements, and legislative action to assess current mandates. This was used to rate the CPR mandates across all 50 states and the District of Columbia. Mandate scores were then compared with available real-world registry data as a surrogate for efficacy from 2018 to 2021.

RESULTS

State CPR mandate scores ranged from 0 to 47, with a higher score indicating more robust mandates. The median and mean scores were 24 (interquartile range, 19.5-27) and 21.52 ± 8.61, respectively, with 35 being the highest score. Intraobserver variability was 0.986 (95% CI, 0.944-1.028; P < .001). The year of implementation did not influence the strength of the score (R2 = -0.173; 95% CI, -0.447 to 0.131; P = .262). Correlation with SCD rate (R2 = -0.76; 95% CI, -0.492 to 0.367; P = .742), bystander-initiated CPR (R2 = -0.006; 95% CI, -0.437 to 0.427; P = .978), automated external defibrillator use (R2 = -0.125; 95% CI, -0.528 to 0.324; P = .590), and cardiovascular death rate (R2 = -0.13; 95% CI, -0.379 to 0.21; P = .355) failed to reach statistical significance.

CONCLUSION

Modest scoring consistency highlights the need for robust, standardized CPR requirements to potentially mitigate SCD. This study lays the groundwork for evidence-informed policy development in this area.

[Role of German cardiac arrest centers in mediating basic life support]

BACKGROUND AND OBJECTIVE

Despite a measurable increase in recent years, the bystander resuscitation rate in Germany lags behind the European comparison. Special centers for the care of patients after cardiac arrest, so-called cardiac arrest centers (CAC), have been established. The aim of this work is to evaluate the role of CACs, in addition to in-hospital patient care, in improving the bystander resuscitation rate in Germany and what obstacles exist in the implementation of resuscitation training.

MATERIALS AND METHODS

Online survey by the working group cardiopulmonary resuscitation (AG42) of the German Society of Cardiology (DGK) and the German Resuscitation Council (GRC) RESULTS: Of the 74 participating clinics (78.4% certified as CAC), 23 (31.1%) conduct lay resuscitation training. These mainly take place within the framework of action days for resuscitation (82.6%) or in schools (39.1%). Permanent cooperation with at least one school existed in 52.2%. Basic life support (BLS) resuscitation dummies are available in 63.5% of these clinics and an automated external defibrillator (AED) demonstration device in 43.2%. According to the interviewees, the biggest obstacles to the consistent implementation of resuscitation courses in schools include lack of qualified instructors, lack of refinancing and difficulties with regard to coordinating activities between schools and providers.

CONCLUSIONS

Direct training of lay rescuers by hospitals faces several obstacles. To increase the bystander resuscitation rate, focusing on targeted training of teachers as multipliers (train-the-trainer) can be a good approach for cardiac arrest centers.

Cardiopulmonary Resuscitation Education in United States Schools: Shortcomings and Future Directions

Cardiopulmonary resuscitation (CPR) is a lifesaving procedure that is performed during a cardiac arrest. CPR consists of chest compressions, rescue breaths, and the usage of an automated external defibrillator (AED) based on availability. Performance of CPR can greatly increase the chances of survival by enabling the manual perfusion of vital organs in lieu of the heart's normal function. Despite extensive studies demonstrating the efficacy and necessity of CPR in an emergency, most of the public across the United States is ill-equipped and/or educated on how to perform it. While there may be other contributing factors, the lack of CPR education across schools in the United States almost certainly furthers the CPR illiteracy of the general population. Although states require some degree of CPR training, the level of education that students receive varies widely across communities and school districts, largely dictated by the available funding for training courses. Despite the lack of CPR education in the United States, studies conducted abroad have shown the efficacy of a CPR course in preparing students to respond in emergencies-lending hope to mending the current situation in the United States. In this article, we analyze legislation dictating CPR instruction and hypothesize ways in which states' Department of Education might be able to promote education and hands-on experience for students across all ages of schooling. Ultimately, we hope to highlight the importance and feasibility of preparing the next generation of citizens across the United States to respond when their name is called upon in an emergency.

Sociodemographic factors associated with paediatric out-of-hospital cardiac arrest: A systematic review

BACKGROUND

Paediatric out-of-hospital cardiac arrest (POHCA) is associated with poor survival and severe neurological sequelae. We conducted a systematic review on the impact of sociodemographic factors across different stages of POHCA.

METHODS

We searched MEDLINE, EMBASE, and Web of Science from database inception to October 2022. We included studies examining the association between sociodemographic factors (i.e., race, ethnicity, migrant status and socioeconomic status [SES]) and POHCA risk, bystander cardiopulmonary resuscitation (CPR) provision, bystander automated external defibrillator (AED) application, survival (at or 30-days post-discharge), and neurological outcome. We synthesized the data qualitatively.

RESULTS

We screened 11,097 citations and included 18 articles (arising from 15 studies). There were 4 articles reporting on POHCA risk, 5 on bystander CPR provision, 3 on bystander AED application, 13 on survival, and 6 on neurological outcome. In all studies on POHCA risk, significant differences were found across racial groups, with minority populations being disproportionately impacted. There were no articles reporting on the association between SES and POHCA risk. Bystander CPR provision was consistently associated with race and ethnicity, with disparities impacting Black and Hispanic children. The association between bystander CPR provision and SES was variable. There was little evidence of socioeconomic or racial disparities in studies on bystander AED application, survival, and neurological outcome, particularly across adjusted analyses.

CONCLUSIONS

Race and ethnicity are likely associated with POHCA risk and bystander CPR provision. These findings highlight the importance of prioritizing at-risk groups in POHCA prevention and intervention efforts. Further research is needed to understand underlying mechanisms.

Temporarily Removed

BACKGROUND

Basic life support education for schoolchildren has become a key initiative to increase bystander cardiopulmonary resuscitation rates. Our objective was to review the existing literature on teaching schoolchildren basic life support to identify the best practices to provide basic life support training in schoolchildren.

METHODS

After topics and subgroups were defined, a comprehensive literature search was conducted. Systematic reviews and controlled and uncontrolled prospective and retrospective studies containing data on students <20 years of age were included.

RESULTS

Schoolchildren are highly motivated to learn basic life support. The CHECK-CALL-COMPRESS algorithm is recommended for all schoolchildren. Regular training in basic life support regardless of age consolidates long-term skills. Young children from 4 years of age are able to assess the first links in the chain of survival. By 10 to 12 years of age, effective chest compression depths and ventilation volumes can be achieved on training manikins. A combination of theoretical and practical training is recommended. Schoolteachers serve as effective basic life support instructors. Schoolchildren also serve as multipliers by passing on basic life support skills to others. The use of age-appropriate social media tools for teaching is a promising approach for schoolchildren of all ages.

CONCLUSIONS

Schoolchildren basic life support training has the potential to educate whole generations to respond to cardiac arrest and to increase survival after out-of-hospital cardiac arrest. Comprehensive legislation, curricula, and scientific assessment are crucial to further develop the education of schoolchildren in basic life support.

Racial, ethnic, and socioeconomic disparities in out-of-hospital cardiac arrest within the United States: Now is the time for change

This review highlights the current evidence on racial, ethnic, and socioeconomic disparities in cardiac arrest outcomes within the United States. Several studies demonstrate that patients from Black, Hispanic, or lower socioeconomic status backgrounds suffer the most from disparities at multiple levels of the resuscitation pathway, including in the provision of bystander cardiopulmonary resuscitation, defibrillator usage, and postresuscitation therapies. These gaps in care may altogether lead to lower survival rates and worse neurological outcomes for these patients. A multisystem, culturally sensitive approach to improving cardiac arrest outcomes is suggested in this article.

Public awareness of cardiopulmonary resuscitation and cardiac arrest in association with Christian Eriksen

OBJECTIVES

During the Union of European Football Association EURO 2020 Football Championship, Danish football player Christian Eriksen experienced a cardiac arrest on the field of play. With prompt intervention and cardiopulmonary resuscitation (CPR), Erikson had a positive outcome and survived the arrest. Our goal is to determine the extent to which this event informed the general population about cardiac arrests and CPR.

STUDY DESIGN

This was a cross-sectional internet analysis.

METHODS

First, Google Trends was used to identify the search interest of topics "Cardiopulmonary resuscitation," "Myocardial infarction," and disease "Cardiac arrest" worldwide from May 29, 2021, to June 19, 2021. Second, we downloaded Twitter data via Sprout Social using the keywords "CPR" and "cardiac arrest," which are presented as the absolute number of tweets. An ARIMA model was used to forecast expected search volumes.

RESULTS

The following week, there was an increase of 91.72% (95% confidence interval [CI] 89.01-94.93) for "Cardiac arrest" above expected values, an 80.67% (95% CI 75.84-85.5) increase for "Cardiopulmonary resuscitation," and a 65.50% (95% CI 62.98-68.02) increase for "Myocardial infarction." Within Twitter, there was a peak increase in daily tweets using "CPR" by 184,706 (95% CI 181,933-187,479) beyond expected values and a peak increase in the daily tweets using "cardiac arrest" by 73,126 (95% CI 72,499-73,752).

CONCLUSION

Although all cardiac arrests are undesirable, public knowledge of the positive effects of CPR could contribute to a means of promoting and increasing the desire for CPR awareness as well as its application.

Knowledge and attitudes toward basic life support: survey among school teachers

Aim: It is known that in cases of cardiac arrest, the chance of survival rates increases by 2-3 times with the bystander basic life support (BLS). Considering that children who spend a significant part of the day apart from their families at school have their teachers with them, it is understood how important the BLS knowledge and skills of teachers are. In our study, we analyzed the knowledge of primary, secondary and high school teachers about BLS and their thoughts about this training. Material and Method: The study was conducted by face-to-face interview with 200 primary/secondary school and high school teachers working in Istanbul in 2019. The teachers participating in the study were evaluated with questionnaires related to their demographic characteristics, their level of knowledge about BLS and their thoughts about BLS training. Correct answers and “yes” answers were calculated with 1 point, incorrect answers and “no” answers were calculated with 0 points. Results: In the BLS information levels survey of female participants, it was found that they scored statistically lower for questions “Do you know emergency medical service number?” and “Emergency medical service call-up in critical condition” (p˂0.05). Again, female participants had a lower score in the answers to all questions in the BLS application/education request questionnaire according to their gender (p˂0.05). Participants who had previously received BLS training were found to score higher on certain questions in BLS knowledge levels and BLS application/training request questionnaires. Conclusion: In the study, it was found that primary/secondary and high school teachers lack the available BLS information. It was determined that people who have been trained in this subject are more willing to BLS training and applications than people who have not been trained in BLS.

High school basic life support training: Is the trainer's experience of cardiopulmonary resuscitation in the actual setting important? A randomized control trial

BACKGROUND

Although basic life support (BLS) has been taught in school by a variety of professionals, it is still unclear that, whether the instructor's previous cardiopulmonary resuscitation (CPR) experience is an important factor. This study aimed to compare the effect of BLS training, based on trainer experience in actual situations, on knowledge and skills of secondary high school students.

MATERIALS AND METHODS

In this randomized controlled trial, 150 high school students were selected based on the inclusion criteria and then assigned into two groups, (76 in Group A), and (74 in Group B) randomly. Both groups were trained according to adult BLS: 2020 American Heart Association guidelines on mannequins in three 60 min in-person training sessions. The knowledge and skill scores were measured for both groups before, immediately, and 1 month after intervention by a questionnaire. Data were analyzed by the SPSS software version 22, using Chi-square, Mann-Whitney U, repeated-measure ANOVA tests, and statistically modeling at a significance level of 0.05.

RESULTS

There were no significant differences between groups regarding demographic characteristics. The knowledge and skill scores in both groups increased significantly compared to baseline immediately and 1 month after the intervention (P = 0.001). However, there was no significant difference in knowledge scores between groups (P = 0.076(. However, at the immediacy and 1 month after the intervention, the skill score in "Group A" was significantly higher than the "Group B" (P = 0.001).

CONCLUSIONS

The trainer's experience of CPR in the actual setting in the transfer of BLS knowledge is not important, but it improved Student's BSL skill acquisition score.

Understanding the Importance of the Lay Responder Experience in Out-of-Hospital Cardiac Arrest: A Scientific Statement From the American Heart Association

Bystander cardiopulmonary resuscitation (CPR) is critical to increasing survival from out-of-hospital cardiac arrest. However, the percentage of cases in which an individual receives bystander CPR is actually low, at only 35% to 40% globally. Preparing lay responders to recognize the signs of sudden cardiac arrest, call 9-1-1, and perform CPR in public and private locations is crucial to increasing survival from this public health problem. The objective of this scientific statement is to summarize the most recent published evidence about the lay responder experience of training, responding, and dealing with the residual impact of witnessing an out-of-hospital cardiac arrest. The scientific statement focuses on the experience-based literature of actual responders, which includes barriers to responding, experiences of doing CPR, use of an automated external defibrillator, the impact of dispatcher-assisted CPR, and the potential for postevent psychological sequelae. The large body of qualitative and observational studies identifies several gaps in crucial knowledge that, if targeted, could increase the likelihood that those who are trained in CPR will act. We suggest using the experience of actual responders to inform more contextualized training, including the implications of performing CPR on a family member, dispelling myths about harm, training and litigation, and recognition of the potential for psychologic sequelae after the event.

Availability and Utilization of Automated External Defibrillators in New York State Schools

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.

Evaluating barriers to community CPR education

OBJECTIVE

The primary objective of this study is to better understand the preferences of the general public regarding cardiopulmonary resuscitation (CPR) education as it relates to both format and the time and place of delivery.

METHODS

Survey data were collected from a convenience sample at large public gatherings in Baltimore, Maryland, between May 23, 2015, and February 11, 2017. The survey was a 23-item single-page instrument administered at fairs and festivals.

RESULTS

A total of 516 surveys were available for analysis. Twenty-four percent of the total population reported being very confident in performing CPR (scoring 8 to 10 on a Likert scale). Thirty-two percent of respondents who had previously taken a CPR class reported being very confident in performing CPR. A stepwise decline in reported confidence in performing CPR was observed as the time from last CPR class increased. Among all respondents the most favored instruction style was an instructor-led class. Least favorable was a local learning station at an event. The most favored location for instruction were libraries, while community festivals were least favored.

CONCLUSION

Respondent preferences regarding the location and style of the training differed little between socioeconomic groups. Instructor-led instruction at local libraries was the most preferred option. CPR education offered at local learning stations during events and at community festivals were least favored among respondents. This study's findings can be used to more effectively structure CPR outreach and educational programs in an attempt to increase rates of bystander CPR.

Actual resuscitation actions after the training of chest compression-only CPR and AED use among new university students

BACKGROUND

Although cardiopulmonary resuscitation (CPR) training is recommended in schools, there are few attempts to train all students at universities and no reports showing actual resuscitation actions at emergency settings after the training. We surveyed how many students encountered a collapsed person, whether they performed any resuscitation actions, and any reasons why they could not do any resuscitation actions.

METHODS

We have provided chest compression-only CPR and automated external defibrillator (AED) use training for 3000 new university students every April since 2015 and followed up on their subsequent emergency actions to collapsed persons in the real world. We carried out a questionnaire survey for 2nd through 4th-year students during the annual student health checkup period in 2018.

RESULTS

A total of 7595 students underwent the annual health checkup and 5549 of them (73.1%) responded to the survey. The rates of encountering collapsed persons and out-of-hospital cardiac arrest (OHCA) patients were 2.5 and 1.1 per 100 person-years, respectively. Of the 264 students who encountered a collapsed person, 82 (53.6%) who encountered non-OHCA collapsed persons and 54 (48.6%) who encountered OHCA persons performed at least one resuscitation action including either chest compression, AED use, or any other various resuscitation actions.

CONCLUSIONS

The incidence rate of encountering OHCA patients was 1.1 per 100 person-years and half of them who encountered a collapsed person performed at least one resuscitation action. Hands-on mass training would encourage university students to perform any resuscitation actions on the emergency scene.

Association of state-level CPR training initiatives with layperson CPR knowledge in the United States

STUDY AIM

Recent work has demonstrated low rates of layperson CPR training across the US. In an attempt to increase rates, some states passed legislation that requires CPR training before high school graduation. We hypothesized laypeople in states with required training would exhibit a greater likelihood of being currently trained in CPR when compared with laypeople in states without required CPR training.

METHODS

We used a previously conducted nationwide cross-sectional random-digit dial survey of the US adult population (09/2015-11/2015). Survey weighted descriptive statistics and logistic regression were used to assess the primary association of likelihood of CPR training and required CPR training by graduation.

RESULTS

Of the 9022 participants, 677 healthcare workers were excluded. Among those living in states with required training, 17% of laypersons were currently trained, while 14% of laypersons in states without required training were currently trained (p < 0.01). Amongst younger individuals (18-24), 29% were currently trained in states with required CPR training compared with 19% currently trained in states without required training (p < 0.01). Those in required training states were 34% more likely to be currently trained than individuals in states without required training (OR: 1.34, 95%CI: 1.20-1.50, p < 0.01). In a secondary analysis, younger laypersons in required training states were almost two times more likely to be currently trained (OR: 1.81, 95% CI: 1.18-2.78, p = 0.01).

CONCLUSIONS

Individuals were more likely to be currently trained in CPR in states with mandatory CPR training for high school graduation, suggesting a need for additional research on this public policy.

A 5-year change of knowledge and willingness by sampled respondents to perform bystander cardiopulmonary resuscitation in a metropolitan city

Background

Nationwide and regional interventions can help improve bystander cardiopulmonary resuscitation (CPR) awareness, knowledge, and the willingness. Periodic community investigation will help monitor the effect. This study aimed to compare the experience of CPR education, CPR knowledge, and CPR willingness, during a 5-year interval.

Methods

This is a pre and post study. Two surveys were done in February 2012 and December 2016. National and regional intervention including legislation promoting public involvement, standardizing CPR education programs, training CPR instructors, and installing supporting organizations were done at the period. In both surveys, respondents were selected via quota sampling in Daegu Metropolitan City and answered the survey through face-to-face interview. Respondents’ general demographic characteristics, CPR educational experience, CPR knowledge and CPR willingness were questioned.

Results

Total of 2141 respondents (1000 in 2012, 1141 in 2016) were selected. The percentage of respondents who received CPR education itself and recent education were higher after intervention compared to before intervention (36.2% vs. 55.1%, 16.9% vs. 30.1%, respectively). Correct knowledge of performing CPR seems to be improved overall (1.6% vs. 11.7%, odd ratio 14.28, 95% confidence interval 5.68–35.94). However, less respondents were willing to perform CPR on strangers (54.5% vs 35.0%).

Conclusion

Nationwide and regional interventions to promote bystander CPR and CPR education were associated with increased CPR education experience and improved correct CPR knowledge in performing bystander CPR. Willingness to perform bystander CPR on family did not increase significantly and CPR willingness to strangers was decreased. Additional legal and technological measures should be implemented to promote bystander CPR.

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

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.

Survival After Exercise-Related Sudden Cardiac Arrest in Young Athletes: Can We Do Better?

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.