Barriers to Heart Safe Schools: AED Needs Assessment in Southeastern Pennsylvania Public Schools
Presented By:
Brady Kwong, BA; Lindsey Flanagan, MPH; Abenezer Lemma, BS(c); Michiyah Collins, BA; Mariam Sy; Justine Shults, PhD; Victoria L. Vetter, MD, MPH
Children's Hospital of Philadelphia
kwongb@chop.eduOverview:
Background: Sudden cardiac arrest (SCA) is the leading cause of death on school campuses, comprising 75% of all young athlete-related deaths. One in 70 schools will have a SCA annually. The presence of a working automated external defibrillator (AED) and a cardiac emergency response plan (CERP) at a school can increase survival from 10% to >85%. Youth Heart Watch, an affiliate of Project ADAM®, works to prevent sudden cardiac death (SCD) among youth in schools and other community sites by helping facilities become Heart Safe. The primary Heart Safe School components involve a working AED, CPR/AED trained staff, a written CERP, and practiced SCD response drills.
Methods: Our study objective was to perform an AED school needs assessment in Southeastern Pennsylvania counties (Bucks, Chester, Delaware, and Montgomery), identifying schools needing AED units, staff CPR/AED training, and CERPs. To explore financial constraints, we analyzed the association between the Median Household Income and mean AEDs/school by school districts. Public schools in our study were surveyed by phone to determine quantity of AEDs and established CERP policies. We developed a REDCap database for data entry. Median Household Incomes were determined from the 2018 U.S. Census database. Descriptive statistics included frequency distribution, mean(SD), median, range IQR25-75 and tests of hypothesis statistical correlation of AEDs and household income of each county and district was determined using a Spearman’s test.
Results: We called 415 schools with 288 (~70%) responding. There were a total of 520 AEDs across all schools surveyed. All 288 responding schools had at least 1 AED; range: 1-9 units; median: 1; (IQR25,75=1,2); mean 1.8 ± 1.3. District offices and school administrators often indicated that the school nurse was the person responsible for AED information, maintenance, and school cardiac safety procedures. Few schools appeared to include CERPs in their medical safety procedures. The Median Household Income across the counties was $80,439 (IQR25,75=62,277,97.118); mean: $83,884(22,036). There was a positive correlation of Median Household Income by School District, r= .45 p<0.0005.
Conclusions: All responding schools had at least one AED, but one is needed for each 500 students and each building. One may not be sufficient for a specific school population or geography. While most schools have 1-2 AEDs,~ 9% have >3 AEDs. Our data suggest that mean AEDs are associated with the Median Household Income by District meaning that wealthier districts are likely have more AEDs. District budgets often depend on property taxes in addition to state funding. Most did not have a CERP and had not incorporated the components
of Heart Safe Schools. Often, the district office/administrative expectations regarding the schools’ AED programs and the actual onsite practices were not aligned. In reality, school nurses are not always readily available in schools. Presence of an AED alone does not translate to emergency staff preparedness to respond effectively to a cardiac arrest. Schools need a developed CERP with SCD drills and training to effectively respond to cardiac arrests to save the lives of students, staff, and citizens on their campus. The Project ADAM® Heart Safe School Program can provide the platform for these schools.
Methods: Our study objective was to perform an AED school needs assessment in Southeastern Pennsylvania counties (Bucks, Chester, Delaware, and Montgomery), identifying schools needing AED units, staff CPR/AED training, and CERPs. To explore financial constraints, we analyzed the association between the Median Household Income and mean AEDs/school by school districts. Public schools in our study were surveyed by phone to determine quantity of AEDs and established CERP policies. We developed a REDCap database for data entry. Median Household Incomes were determined from the 2018 U.S. Census database. Descriptive statistics included frequency distribution, mean(SD), median, range IQR25-75 and tests of hypothesis statistical correlation of AEDs and household income of each county and district was determined using a Spearman’s test.
Results: We called 415 schools with 288 (~70%) responding. There were a total of 520 AEDs across all schools surveyed. All 288 responding schools had at least 1 AED; range: 1-9 units; median: 1; (IQR25,75=1,2); mean 1.8 ± 1.3. District offices and school administrators often indicated that the school nurse was the person responsible for AED information, maintenance, and school cardiac safety procedures. Few schools appeared to include CERPs in their medical safety procedures. The Median Household Income across the counties was $80,439 (IQR25,75=62,277,97.118); mean: $83,884(22,036). There was a positive correlation of Median Household Income by School District, r= .45 p<0.0005.
Conclusions: All responding schools had at least one AED, but one is needed for each 500 students and each building. One may not be sufficient for a specific school population or geography. While most schools have 1-2 AEDs,~ 9% have >3 AEDs. Our data suggest that mean AEDs are associated with the Median Household Income by District meaning that wealthier districts are likely have more AEDs. District budgets often depend on property taxes in addition to state funding. Most did not have a CERP and had not incorporated the components
of Heart Safe Schools. Often, the district office/administrative expectations regarding the schools’ AED programs and the actual onsite practices were not aligned. In reality, school nurses are not always readily available in schools. Presence of an AED alone does not translate to emergency staff preparedness to respond effectively to a cardiac arrest. Schools need a developed CERP with SCD drills and training to effectively respond to cardiac arrests to save the lives of students, staff, and citizens on their campus. The Project ADAM® Heart Safe School Program can provide the platform for these schools.
