Student Athletes, Sudden Cardiac Death, and AED Legislation
Student Athletes, Sudden Cardiac Death, and AED Legislation
Purpose The purpose of this article is to present findings of a literature review examining the use of automatic external defibrillators (AEDs) for student athletes experiencing sudden cardiac arrest and variances in state legislation regarding the mandatory placement of AEDs in school gymnasiums and athletic fields.
Methods A broad search of computerized databases was conducted utilizing PubMed, Medline, CINHAHL, and the Cochrane Databases, which provided a broad but not exhaustive review of the current literature related to student athletes, sudden cardiac death, and the use of AEDs. The articles were evaluated and graded using Stetler's strength of evidence guidelines.
Findings A total of 17 articles are included in this literature review (Stetler's Grade I, n = 1; Grade II, n = 2; Grade III, n =2; Grade IV, n = 5; Grade V, n = 3; and Grade VI, n = 4). The literature produced few meta-analyses of controlled studies, experimental studies, and quasi-experimental studies on the topic of student athletes at risk for sudden cardiac death. The majority of the literature is based on expert opinion, case reports, and retrospective data sets. The literature does support the correlation of early cardiopulmonary resuscitation and defibrillation with increased survival rates among persons experiencing sudden cardiac arrest.
Conclusions Additional evidence-based research is needed to support the long-term outcomes of AED legislation and its utility in sparing the lives of student athletes. However, the evidence supporting early intervention, a coordinated emergency plan, and rapid emergency medical services response is conclusive enough to warrant state or federal legislation mandating that AEDs be present in all school gyms and athletic fields.
Sudden cardiac arrest (SCA) is a leading cause of death in children and young adults, accounting for 10,000 deaths in this age group annually in the United States (Sudden Cardiac Arrest Foundation, 2014). A primary cause of death in young athletes is SCA during exercise. Seventy-five percent of all fatalities that occur during sports in the United States are cardiovascular related. It is estimated that the incidence of SCA in young persons ranges from 0.5 to 20 per 100,000 person-years (Meyer et al., 2012). Student athletes who experience SCA are predominantly male, and most cases occur during physical activity or shortly after the activity. Few epidemiological studies on death in young athletes have been performed, and most are retrospective in nature and are subject to reporting bias. Prospective studies from Veneto, Italy, estimate that annual SCA incidence is 2.3 per 100,000 person-years for all causes and 2.1 per 100,000 person-years for cardiovascular causes (Patel & Elliott, 2012).
Many states lack legislation mandating the presence of automated external defibrillators (AEDs) within school gyms and their availability on athletic fields. Currently, there are large variances in AED legislation from state to state, with few states addressing the presence of AEDs at school sporting events. Additionally, there are no firm guidelines or regulations surrounding emergency preparedness in the event of a sudden cardiac event or legislation regarding pre-participation screening of athletes.
The purpose of this systematic review was to identify current research related to the risk of sudden cardiac death (SCD) among student athletes and the use of AEDs to reduce SCD among this population, with a particular focus on mandatory state and federal AED legislation.
Early action programs and the availability of AEDs have reduced the incidence of death in airports and casinos across the United States (Link & Estes, 2012). With this proven track record, the presence of AEDs on school athletic fields and in gyms would provide safer sports involvement for athletes at risk for SCA, as well as those who may currently be undiagnosed.
Abstract and Introduction
Abstract
Purpose The purpose of this article is to present findings of a literature review examining the use of automatic external defibrillators (AEDs) for student athletes experiencing sudden cardiac arrest and variances in state legislation regarding the mandatory placement of AEDs in school gymnasiums and athletic fields.
Methods A broad search of computerized databases was conducted utilizing PubMed, Medline, CINHAHL, and the Cochrane Databases, which provided a broad but not exhaustive review of the current literature related to student athletes, sudden cardiac death, and the use of AEDs. The articles were evaluated and graded using Stetler's strength of evidence guidelines.
Findings A total of 17 articles are included in this literature review (Stetler's Grade I, n = 1; Grade II, n = 2; Grade III, n =2; Grade IV, n = 5; Grade V, n = 3; and Grade VI, n = 4). The literature produced few meta-analyses of controlled studies, experimental studies, and quasi-experimental studies on the topic of student athletes at risk for sudden cardiac death. The majority of the literature is based on expert opinion, case reports, and retrospective data sets. The literature does support the correlation of early cardiopulmonary resuscitation and defibrillation with increased survival rates among persons experiencing sudden cardiac arrest.
Conclusions Additional evidence-based research is needed to support the long-term outcomes of AED legislation and its utility in sparing the lives of student athletes. However, the evidence supporting early intervention, a coordinated emergency plan, and rapid emergency medical services response is conclusive enough to warrant state or federal legislation mandating that AEDs be present in all school gyms and athletic fields.
Introduction
Sudden cardiac arrest (SCA) is a leading cause of death in children and young adults, accounting for 10,000 deaths in this age group annually in the United States (Sudden Cardiac Arrest Foundation, 2014). A primary cause of death in young athletes is SCA during exercise. Seventy-five percent of all fatalities that occur during sports in the United States are cardiovascular related. It is estimated that the incidence of SCA in young persons ranges from 0.5 to 20 per 100,000 person-years (Meyer et al., 2012). Student athletes who experience SCA are predominantly male, and most cases occur during physical activity or shortly after the activity. Few epidemiological studies on death in young athletes have been performed, and most are retrospective in nature and are subject to reporting bias. Prospective studies from Veneto, Italy, estimate that annual SCA incidence is 2.3 per 100,000 person-years for all causes and 2.1 per 100,000 person-years for cardiovascular causes (Patel & Elliott, 2012).
Many states lack legislation mandating the presence of automated external defibrillators (AEDs) within school gyms and their availability on athletic fields. Currently, there are large variances in AED legislation from state to state, with few states addressing the presence of AEDs at school sporting events. Additionally, there are no firm guidelines or regulations surrounding emergency preparedness in the event of a sudden cardiac event or legislation regarding pre-participation screening of athletes.
The purpose of this systematic review was to identify current research related to the risk of sudden cardiac death (SCD) among student athletes and the use of AEDs to reduce SCD among this population, with a particular focus on mandatory state and federal AED legislation.
Early action programs and the availability of AEDs have reduced the incidence of death in airports and casinos across the United States (Link & Estes, 2012). With this proven track record, the presence of AEDs on school athletic fields and in gyms would provide safer sports involvement for athletes at risk for SCA, as well as those who may currently be undiagnosed.
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